Human Performance and Rehabilitation Centers, Inc.

Think F.A.S.T! Warning Signs of a Stroke

Plain and simple, a stroke is an emergency. It’s important to recognize warning signs and know when to call for help. Surviving a stroke and minimizing its debilitating effects depends on how fast a patient receives treatment.

In recent decades, our society has become more aware of the warning signs of a heart attack, and this knowledge has saved lives. But we also need to know how to spot signs of a stroke, which we should think of as a “brain attack.”

Stroke is the No. 4 leading cause of death in the United States and a leading cause of severe long-term disability. The Centers for Disease Control and Prevention has labeled the majority of the southeastern U.S. states the Stroke Belt because of our higher rates of stroke incidence and mortality. Contributing factors include the region’s higher rates of uncontrolled blood pressure, smoking, diabetes, obesity, high fat diets and poor activity levels. Strokes affect African Americans at a higher rate than Caucasian.

If you or a loved one is having a stroke, acting F.A.S.T. is key. According to the American Stroke Association, patients who take a thrombolytic or clot-busting drug within the first three hours of their first symptom can reduce long-term disability from ischemic stroke, which accounts for about 87% of stroke cases.

To recognize the signs, think F.A.S.T.

F.A.S.T. stands for:

  • Face drooping. Sudden numbness or weakness of the face, especially on one side of the body, is a key sign that something is wrong.
  • Arm weakness. Sudden numbness or weakness of the arm or leg, especially on one side of the body, is also a sign.
  • Speech difficulty. Sudden confusion with speaking or understanding.
  • Time to call 9-1-1. Acting quickly has the potential to save lives and ensure a better recovery.

Symptoms can also include sudden trouble seeing or blurred vision in one or both eyes; trouble walking, dizziness or a loss of balance or coordination, or a sudden severe headache with no known cause. Any one of these can signal that is stroke is happening.

It’s important to try to document a patient’s last known well time so that first responders can pinpoint exactly when the stroke occurred. This critical piece of information will influence how the patient is treated and can greatly improve long-term outcomes.



Good News: Bladder Leakage Improved by Strengthening Pelvic Floor

For many women, basic acts like sneezing, coughing and even laughing can trigger bladder leakage. It’s an embarrassing nuisance, but the good news is that physical therapy is an effective tool for eliminating and improving this condition.

About half of all women say they have experienced urine leakage at some point in their lives, and for some, it’s a daily event. The culprit is often weak muscles in the pelvic floor, or pelvic floor dysfunction (PFD). Certain acts like coughing, laughing bending or high impact exercise push on the bladder, but the pelvic muscles are not strong enough to push back and prevent leakage. This is called stress incontinence. Women of all ages experience this type of incontinence. We’re not talking about mental stress, but physical stress to the pelvic floor. That’s why women who have experienced pregnancy and delivery, or who may be carrying extra weight are at greater risk for experiencing this kind of bladder leakage. Athletes that engage in heavy impact exercise, running and jumping are also at risk. Older women may experience bladder leakage due to reduction in hormone levels and age-related muscular changes, but aging itself is not a cause of stress incontinence.

So, how can physical therapy help? The short version is we strengthen the pelvic floor muscles, a group of muscles that attach from the pubic bone in the front of the body to the tailbone behind. These muscles, resembling a hammock, are intricate and incredibly important, and it’s easy to take them for granted. Most of us have thought about toning our deltoids, glutes and quads, but have we considered strengthening our pelvic floor? We should.

A physical therapist who specializes in PFD will develop a targeted plan that will strengthen the pelvic floor and reduce and even eliminate bladder leakage. Such a plan goes beyond telling a woman to “just do Kegels,” the pelvic exercises developed by Dr. Arnold Kegel in 1948. Kegels are helpful, but they are not one size, fits all, since every woman is unique. Moreover, not all women understand how to perform this exercise correctly. About 51% cannot do a Kegel correctly with verbal instructions alone.

Kegels are just part of our approach. Physical therapists deliver a comprehensive program for strengthening the pelvic floor, followed up with customized at home exercises tailored to each patient’s therapy goals.

The National Association for Continence (NAFC) website reports it takes an average of seven years – seven! – before a woman will discuss bladder problems with her physician. Don’t wait. Physical therapy is a non-invasive, highly effective tool in resolving this issue.


Visit our Women’s Health page to learn more about other services offered for conditions specific to women.