Walking aids for hemiplegia. – Wheeleo®

Hemiplegia: causes, symptoms, treatment and recovery of mobility

Hemiplegia is complete or partial paralysis of one side of the body, usually affecting the arm, leg and sometimes the face. It most often occurs after a stroke, but can have other origins. Understanding this condition is the first step to better support recovery and return to a daily life as independent as possible, thanks in particular to adapted aids such as the Wheeleo®.

What is hemiplegia?

Simple definition: The term “hemiplegia” comes from the Greek hemi (half) and plêgê (blow, hit). It refers to the total or near-total paralysis of one half of the body, on the left or right, resulting from a brain or spinal cord lesion.

In practical terms, a person with hemiplegia loses motor control on one side of the body. The lesion responsible is located on the opposite side of the brain: damage to the left hemisphere causes right hemiplegia, and vice versa. This cross-organization is explained by the pathways of nerve fibers that decussate (cross) in the brain stem.

Hemiplegia and hemiparesis: what’s the difference?

It’s important to distinguish between two closely related terms. Hemiplegia refers to total paralysis, while hemiparesis corresponds to partial paralysis: motor skills are diminished, but not completely abolished. In clinical practice, the two forms often coexist, and may evolve towards each other as recovery progresses.

Flaccid hemiplegia and spastic hemiplegia

In the first few hours or days following injury, we generally observe a flaccid hemiplegia: the muscles on the affected side are soft and toneless. Gradually, in many cases, spasticity sets in: muscles become rigid and difficult to control, complicating walking and everyday movements.

Left hemiplegia

• Lesion in the right hemisphere
• Left arm paralyzed
• Left leg paralyzed
• Sometimes left face affected
• Frequent disorders of spatial perception

Right hemiplegia

• Lesion in the left hemisphere
• Right arm paralyzed
• Right leg paralyzed
• Sometimes affected right face
• Frequent language disorders (aphasia)

What causes hemiplegia?

Hemiplegia has a variety of causes. The most common is stroke, but other pathologies can also cause paralysis.

Stroke, the main cause

A stroke occurs when the blood supply to part of the brain is suddenly interrupted, either by occlusion (ischemic stroke) or hemorrhage (hemorrhagic stroke). Oxygen-deprived nerve cells die within minutes, leaving sequelae that can result in hemiplegia. In Belgium, around 20,000 people suffer a stroke every year.

Other common causes

• Head trauma: fall, road accident, violent impact to the head.
• Brain tumor: a mass compresses or destroys motor areas.
• Multiple sclerosis (MS): demyelinating lesions can affect the motor pathways.
• Encephalitis or meningitis: serious brain infections that can damage the motor cortex.
• Cerebral palsy (in children): damage to the brain before, during or shortly after birth.
• Brain abscess or vascular malformation (cavernoma, arteriovenous malformation).

What are the symptoms of hemiplegia?

Symptoms of hemiplegia mainly affect one side of the body, and may combine motor, sensory and cognitive disorders.

Motor symptoms

• Paralysis or weakness of the arm or leg on the affected side.
• Facial collapse (central facial paralysis) on the same side.
• Difficulty or inability to walk unaided.
• Spasticity or flaccidity of upper and lower limbs.
• Coordination and balance disorders.

Associated symptoms (non-motor)

• Sensory disorders (numbness, neuropathic pain).
• Aphasia or dysarthria (language problems, especially in right hemiplegia).
• Spatial hemineglect (unconsciously ignoring the paralyzed side).
• Intense fatigue and mood disorders.
• Difficulty swallowing (dysphagia).

How is hemiplegia diagnosed?

Diagnosis of hemiplegia is primarily clinical: the doctor assesses muscle strength, reflexes, sensitivity and coordination on each side of the body. A neurological examination helps locate the lesion and estimate its extent.

The complementary examinations used are as follows:

• Cerebral MRI: the gold standard for visualizing brain lesions (ischemia, hemorrhage, tumor).
• Cerebral computed tomography (CT): performed urgently to distinguish ischemic stroke from hemorrhagic stroke.
• Electromyogram (EMG): evaluates the electrical activity of muscles and nerves.
• Biological and cardiac workup: check for vascular risk factors (diabetes, hypertension, atrial fibrillation).

Hemiplegia, hemiparesis, stroke, paraplegia: what are the differences?

How is hemiplegia treated and rehabilitated?

There is no single treatment: the management of hemiplegia is multidisciplinary and tailored to each individual patient. It combines an acute medical phase with an intensive, long-term rehabilitation program.

Acute medical treatment (stroke)

• Thrombolysis (ischemic stroke): intravenous injection of a clot-dissolving drug within the first few hours.
• Mechanical thrombectomy: surgical removal of the clot by catheterization.
• Neurosurgery: evacuation of a hematoma in cases of hemorrhagic stroke or head trauma.
• Medications: antispastic, painkillers, anticoagulants, depending on etiology.

Multidisciplinary rehabilitation

Rehabilitation is the central pillar of recovery from hemiplegia. It calls on a number of professionals in the healthcare sector:

• Physiotherapy: work on mobility, muscle strengthening, balance and walking.
• Occupational therapy: relearning everyday gestures (dressing, cooking, writing).
• Speech therapy: treatment of language and swallowing disorders.
• Neuropsychology: treatment of cognitive and emotional disorders.
• Fittings: ankle orthoses, splints, walking aids to compensate for upper and lower limb deficits.

Hemiplegia and recovery: regaining your autonomy

Recovery from hemiplegia is variable, depending on the extent of the brain injury, the patient’s age, the early stage of treatment and the person’s motivation. Neuroplasticity (the brain’s ability to reorganize its connections) plays a fundamental role.

Good to know: Recovery is fastest during the first three to six months, but can continue for several years thanks to a regular rehabilitation program and the use of adapted technical aids.

Can hemiplegia be cured?

Total recovery is possible in some cases, particularly when the brain lesion is limited and treatment is carried out at a very early stage. However, for the majority of patients, the aim is to maximize functional recovery and compensate for persistent after-effects, rather than “cure” in the strict sense. Some people recover near-normal walking, while others retain permanent deficits requiring long-term support.

Can a hemiplegic walk?

Yes, in many cases, a hemiplegic patient can learn to walk again, thanks to physiotherapy and mobility aids. The ability to walk depends in particular on the recovery of the affected leg and balance. Adapted technical aids (cane, one-handed walker) help to ensure safe walking, even when the arm or upper limbs are not functional.

Everyday life with hemiplegia: how Wheeleo® makes a difference

One of the major challenges of daily life with hemiplegia is managing movement with only one side of the body functional. Conventional walkers require the use of both hands, making them unusable for a person with one arm paralyzed.

The Wheeleo® was designed to meet precisely this need: it’s a one-handed walker that frees up the able-bodied side while providing continuous support for walking. Unlike a simple cane, it offers a larger support surface and greater stability, reducing the risk of falling.

• One-handed operation (valid arm).
• Active support for the body during all phases of walking.
• Promotes a more natural, less tiring gait.
• Suitable for both indoors and outdoors.
• Helps you regain greater independence in daily activities.

For many patients, this mobility aid represents a turning point: it enables them to go out on their own, to move around the house without constant assistance, and to regain confidence in their ability to get around – a key step in the recovery process.

Frequently asked questions about hemiplegia

Q: What causes hemiplegia?

Hemiplegia is caused by damage to the motor pathways of the central nervous system. The most common cause is stroke, either ischemic (occlusion of an artery) or hemorrhagic (rupture of a vessel). Other causes include head trauma, brain tumors, brain infections (encephalitis) and, in children, cerebral palsy.

Q: Can hemiplegia be cured?

Full recovery is possible, especially if the injury is minimal and treatment is rapid. In the majority of cases, recovery is partial: intensive re-education (physiotherapy, occupational therapy) and technical aids make it possible to reduce after-effects and significantly improve autonomy and quality of life. The brain’s neuroplasticity offers real possibilities for recovery, especially in the first few months.

Q: What’s the difference between hemiplegia and stroke?

Stroke is an acute medical event (a cerebrovascular accident), while hemiplegia is one of its possible consequences. In other words, the stroke is the cause, and the hemiplegia is the after-effect. Not all strokes result in hemiplegia.

Stroke & Go is officially created on December 25, 2019.

https://www.stroke-go.be