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Gondola FAQ on stroke information

What is a stroke?

Stroke is a medical condition that occurs when blood flow to a part of the brain is disrupted, either due to a blockage in a blood vessel or bleeding in the brain.

Gondola FAQ on stroke information
Gondola FAQ on stroke information

What is a stroke? 

stroke occurs when the supply of blood to a part of the brain is disrupted or reduced, depriving the brain tissue of oxygen and nutrients. Within a few minutes, brain cells begin to die.

When to seek medical advice

Immediate action can reduce brain damage and keep potential complications to a minimum.

You must seek immediate medical advice at the first signs or symptoms of stroke, even if the symptoms seem to rise and fall in intensity or disappear altogether. Check for the following signs of stroke, even called FAST warning signs:

  • Facial Dropping – Ask the person to smile. Is one side of their face drooping?
  • Arm Weakness – Ask the person to raise both arms. Does one arm fall? Are they unable to raise one arm?
  • Speech difficulties – Ask the person to repeat a simple sentence. Is their speech garbled or strange?
  • Time – If any of the symptoms above occurs, time is of the essence.

If you notice any of these signs, call 112 (the European emergency number) or the local emergency number immediately, without waiting to see if the symptoms stop. The longer a stroke goes untreated, the greater the potential for brain damage and disability.

Stroke: risk factors.

Many factors may elevate stroke risk, and some may also increase the risk of a heart attack.

Potentially treatable stroke risk factors:

Identifying and managing the risk factors for stroke is essential in preventing this devastating condition. While some stroke risk factors, such as age, ethnicity, and gender, cannot be changed, there are several potentially treatable risk factors that individuals can address to reduce their risk of stroke. These include lifestyle factors such as being overweight or obese, lack of exercise, smoking, alcohol use, and drug use, as well as medical risk factors such as high blood pressure, high cholesterol levels, diabetes, sleep apnea, cardiovascular disease, and family history. In addition, hormone therapy may also be a risk factor for stroke in some individuals.

  • lifestyle (being overweight or obese, lack of exercise, smoking, alcohol use, drug use)
  • medical risk (blood pressure, cholesterol level, diabetes, sleep apnea, cardiovascular disease, family history)
  • Other risk factors:
    • age
    • ethnicity
    • gender
    • hormone therapy

Stroke symptoms

It is important to watch out for the following signs and symptoms and to pay attention to when they begin. Their duration can have an impact on the choice of treatment.

Trouble speaking and understanding

The person may experience confusion; words may be slurred, and they may have difficulty understanding speech.

Paralysis or numbness in the face, arm, or leg

The person may experience sudden numbness, weakness, or paralysis in the face, arm, or leg. It often occurs only on one side of the body. If the person attempts to raise both arms above their head simultaneously and one arm begins to fall, the person may have experienced a stroke. In addition, one side of the mouth may droop when attempting to smile.

Problems with vision in one or both eyes

Sight may be suddenly blurred or blackened in one or both eyes, or the person may experience double vision.


A sudden severe headache, perhaps accompanied by vomiting, dizziness, or altered consciousness, may indicate that the person is having a stroke.

Trouble walking

The person may trip or experience sudden dizziness, loss of balance, or coordination.

What causes a stroke

A stroke can be caused by a blocked artery (ischemic stroke) or a leaking or burst blood vessel (hemorrhagic stroke).

Some individuals may experience only a temporary interruption of blood flow to the brain (transient ischemic attack, or TIA), which does not cause permanent damage.

Ischemic stroke

About 80% of strokes are ischemic. These occur when the arteries supplying blood to the brain narrow or become blocked, severely reducing blood flow (ischemia).

The most common types of ischemic stroke are:

  • Thrombotic strokes occur when a blood clot (thrombus) forms in one of the arteries that supply blood to the brain.
  • Embolic strokes occur when a blood clot or other debris, formed far from the brain (usually in the heart), is then carried by the bloodstream to the brain, where it gets stuck in the brain’s narrower arteries. This type of blood clot is called an embolus.
Hemorrhagic stroke

A hemorrhagic stroke occurs when a blood vessel in the brain leaks blood or ruptures. Many different conditions that affect the blood vessels can cause a brain hemorrhage:

  • high blood pressure
  • excessive treatment with anticoagulants
  • aneurysm

One less common cause of a hemorrhage is the rupturing of an abnormal tangle of thin-walled blood vessels (arteriovenous malformation).

Types of hemorrhagic stroke include:

  • Intracerebral hemorrhage: a blood vessel in the brain bursts and bleeds into the surrounding brain tissue, damaging the brain cells. The same cells are also blood-deprived, so it’s double damage. High blood pressure, trauma, blood vessel malformation, blood thinners, and other conditions may cause an intracerebral hemorrhage.
  • Subarachnoid hemorrhage (SAH): an artery on or near the surface of the brain bursts, bleeding into the intracranial space. A common symptom of such a bleed is a sudden, severe headache.

A subarachnoid hemorrhage is usually caused by a small saccular or berry aneurysm rupture. Following the bleeding, the blood vessels in the brain may dilate and contract irregularly (vasospasm), causing damage to the brain cells by further reducing blood flow.

Stroke: complications.

Occasionally a stroke can cause temporary or permanent disability, depending on how long the brain remains blood-deprived and which brain area has been affected.

The treatment effectiveness for these post-stroke complications varies from person to person.

Disability after a stroke.

The type and degree of disability after a stroke depend on the brain area that has been damaged.

Generally, strokes can cause five main types of disability:

  • paralysis or problems controlling movement
  • sensory disturbances, including pain
  • problems using or understanding language
  • problems with thinking and memory
  • emotional disturbances
Paralysis or problems controlling movement (motor control)

Paralysis is one of the most common disabilities caused by stroke. It usually occurs on the body side opposite to the side of the brain damaged and may involve the face, an arm, a leg, or the entire side of the body.

This paralysis on one side of the body is called hemiplegia (weakness on one side of the body is called hemiparesis). Stroke patients with hemiparesis or hemiplegia may have difficulties performing everyday tasks, such as walking or grasping objects.

Some stroke patients have trouble swallowing (dysphagia) due to damage to the brain part that controls the muscles used for this purpose.

Damage to the lower section of the brain, the cerebellum, can impact the body’s ability to coordinate movement, a disability called ataxia, which leads to problems with body posture, walking, and balance.

Difficulty in talking or swallowing

a stroke can affect control of the muscles in the mouth and throat, making it difficult to speak clearly (dysarthria), swallow (dysphagia), or eat.

Memory loss or difficulty in thinking.
Emotional problems

The person may have difficulty controlling their emotions or develop depression.


The person may experience pain, numbness, .or other strange sensations in the parts of the body affected by the stroke.

Changes in behavior or the ability of self-caring

Stroke prevention.

Knowing the stroke risk factors, following your physician’s advice, and adopting a healthy lifestyle are the prevention foundation, even for those who have already suffered a stroke or a transient ischemic attack (TIA).

Many strokes prevention advice is the same as those for heart disease.

Control high blood pressure (hypertension).

Exercise, stress management, maintaining a healthy body weight, and limiting sodium and alcohol intake can help to keep high blood pressure under control. In addition to recommending lifestyle changes, your physician may prescribe drugs to treat high blood pressure.

Reduce the amount of cholesterol and saturated fats in your diet

If you cannot control your cholesterol through diet, your physician may prescribe a drug to lower cholesterol.

Quit smoking
Control diabetes

Diet, exercise, body weight management, and medications can help manage diabetes.

Maintain healthy body weight.

Losing just 10 kilos can lower blood pressure and improve cholesterol levels.

A diet rich in fruits and vegetables.

A diet containing five or more portions of fruit or vegetables per day can reduce stroke risk. Following the Mediterranean diet can be helpful with olive oil, fruit, nuts, vegetables, and whole grains.

Regular physical exercise.

Aerobic, or “cardio,” exercise reduces stroke risk because it lowers blood pressure, increases levels of high-density lipoprotein (“good”) cholesterol, and improves the overall blood vessel and heart health.

Drink alcohol in moderation.

Drinking excessive amounts of alcohol increases the risk of high blood pressure and ischemic and hemorrhagic stroke. However, drinking small or moderate amounts of alcohol can help to prevent ischemic stroke and decrease blood coagulation. Keep in mind that alcohol can interact with some medications. It is a good idea to talk about it with your physician.

Treat obstructive sleep apnea (OSA).

OSA treatment involves the administration of oxygen during the night or a small oral device that helps the person breathe.

Avoid using illicit drugs.

Some drugs, such as cocaine and methamphetamines, are risk factors for TIA or stroke. Cocaine reduces blood flow and can narrow the arteries.

Stroke prevention medications.

If you have had an ischemic stroke or a TIA, your physician may prescribe drugs for secondary stroke prevention.

  • Antiplatelet drugs: Platelets are the blood cells that form clots. The most commonly used antiplatelet drug is aspirin; your physician can help you determine the correct dosage. If aspirin does not prevent a TIA or you cannot take aspirin, your physician may prescribe another medication, such as clopidogrel (Plavix), as an alternative.
  • Anticoagulants: These drugs, which include heparin and warfarin (Coumadin, Jantoven), reduce blood coagulation (clotting). Warfarin is a potent blood thinner and must be taken carefully following the instructions on the leaflet.

Post-stroke treatment.

Every year in the world, around 18,000,000 people experience a stroke. Roughly two-thirds of these require stroke rehabilitation to become as independent as possible and achieve an improved quality of life.

Although rehabilitation cannot “cure” the stroke consequences because it cannot repair damage to the brain, it can help individuals to improve their life after a stroke.

What is post-stroke rehabilitation?

Rehabilitation helps to recover abilities lost due to damage to a part of the brain, such as coordination and leg movement.

Rehabilitation also teaches new ways of performing tasks to bypass or compensate for residual disabilities, for example, learning to take a bath or dress oneself with only one hand or to communicate effectively when language skills have been affected.

Experts agree that any stroke rehab plan’s essential component is a constant, well-focused, and direct practice, which is the same used when learning a new skill.

Nurses and rehabilitation therapists help patients to perform increasingly complex actions, like bathing themselves, dressing, and using the bathroom; they encourage patients to use the limbs affected by the stroke while performing those tasks.

Stroke recovery plans aimed at maintaining and refining skills can require the assistance of specialists for months or years after the stroke itself.

When does post-stroke rehabilitation begin? 

Rehabilitation treatment begins in the hospital in intensive care once the patient’s overall condition has stabilized, often within 24-48 hours after the stroke event. However, this varies significantly from patient to patient.

The first step involves encouraging independent movement because many individuals are paralyzed or severely weakened. For examples, patients should change position frequently when lying in bed and commit to passive (the therapist actively helps the patient to move a limb repeatedly) or active exercises (performed by the patient without physical assistance) to strengthen the limbs affected by the stroke.

The most extensive stroke rehabilitation study, recently conducted in the United States, compared two typical techniques for helping stroke patients to improve their walking: training on a treadmill or working on strength and balance exercises at home with a physical therapist. Both equally enhanced the patient’s walking ability to one year after stroke.

The study showed that 52% of participants had significant improvements in walking abilities, everyday activities, and quality of life, regardless of the impairments’ severity or whether they began training 2 or 6 months after the stroke.

Where can a patient go for post-stroke rehabilitation?

Upon discharge from the hospital, most patients return home, but some move into medical facilities such as those listed below.

Inpatient hospital units.

Inpatient facilities can be freestanding or part of larger hospital complexes. Patients usually remain in these facilities for 2-3 weeks, engaging in a coordinated and intensive rehabilitation program.

Outpatient facilities.

Outpatient facilities are often part of a larger hospital structure and provide access to physicians and therapists specializing in stroke rehabilitation.

While patients spend nights at home, they generally spend several hours per day at these facilities, often three days a week, engaging in coordinated therapy sessions.

Nursing facilities.

The rehabilitation services available at nursing facilities are more varied than those in inpatient and outpatient facilities.

Specialized nursing facilities usually emphasize rehabilitation, while traditional nursing homes focus more on residential care.

Home-based rehabilitation programs.

Home-based rehabilitation offers a high degree of flexibility. For example, stroke patients can participate in an intensive level of therapy several hours per week or follow a less demanding regimen.

The main disadvantage of these programs is their lack of specialized equipment. Nevertheless, undergoing home-based treatment has the advantage of allowing patients to practice their skills and develop compensatory strategies in the context of their own living environments.

AMPS therapy

Gondola AMPS therapy is a promising treatment option for stroke patients as it has been shown to effectively treat motor symptoms associated with neurological disorders such as stroke. The therapy is non-invasive and involves pressure stimulation of specific target areas on both feet, which enhances the connectivity between the brain and the body. It is a convenient therapy that can be performed comfortably and independently at home using the Gondola Home device. The therapy is easy to use and quick, lasting only two minutes per session. Patients need only insert their feet into the device, press a button, and wait for the therapy to be completed. With its non-invasive and painless nature, Gondola AMPS therapy can provide a convenient and accessible solution for stroke patients looking to improve their motor function and overall well-being.

Post-stroke rehabilitation specialists.

Stroke recovery could involve many specialists, such as physicians, rehabilitation nurses, physical therapists, occupational therapists, educators, speech and language therapists, and psychotherapists.


Physicians’ primary responsibility is managing and coordinating patients’ long-term care and recommending the best rehabilitation plans to address their individual needs.

Neurologists usually lead acute-care teams specialized in stroke, which guide patient care during hospitalization. Other specialists, especially PM&Rs (physical medicine and rehabilitation physicians or physiatrists), lead the rehabilitation phase of treatment.

Rehabilitation nurses

Nurses specialized in rehabilitation teach patients how to perform basic everyday activities, routine health treatments, take care of their skin, get out of bed, get into a wheelchair, and about the specific needs of people with diabetes.

Rehabilitation nurses also work to reduce the risk factors that could lead to a second stroke.

Physical therapists

Physical therapists (also known as physiotherapists) are specialized in sensory and motor disabilities treatment. They evaluate the strength, resistance, range of movement, gait abnormalities, and sensory impairments of stroke patients to plan personalized rehabilitation programs that aim to help patients recover control of their motor functions.

Physical therapists help patients to regain the use of limbs, teach them compensatory strategies to reduce the impact of any remaining impairments, and successively determine exercise regimens to maintain the skills they have just learned.

Persons with disabilities usually avoid using affected limbs. It’s a behavior called learned non-use. However, repetitive use of the affected limbs promotes neuroplasticity and helps to reduce disability. Therefore, physical therapists employ strategies to encourage using affected limbs, including selective sensory stimulation, like tapping or stroking, active and passive range-of-motion exercises and temporarily restraining healthy limbs when practicing motor exercises.

People too weak to bear weight can still practice repetitive movements during hydrotherapy (where water provides sensory stimulation and supports the patient’s weight) or partially supported by a harness.

Physical therapists often use selective sensory stimulation to encourage the patients to use impaired limbs and help them regain awareness of stimuli on the neglected side of the body.

Occupational and recreational therapists

Occupational therapists are also concerned with improving motor and sensory abilities and ensuring patient safety post-stroke.

They often teach patients how to split a complex activity down into smaller steps, practice each part separately, and eventually perform the action in its entirety. This strategy can improve coordination and help people with apraxia relearn how to perform planned activities.

Occupational therapists also teach people how to develop compensatory strategies and change those things that limit their activities of daily living.