02/12/2023
Stroke is the major cause of preventable disabilities in developed countries despite numerous research and resources that have been allocated to its management.
Many developing countries like Nigeria are still grappling with fragile health systems and basic health care coverage for its masses.
Stroke rehabilitation is mostly tertiary care in these countries and is very expensive in terms of economic, social costs to stroke survivors and their families.
Post-stroke rehabilitation outcomes tend to be generally poor too due to limited to absent health care financing to make available and utilize cutting edge rehabilitation technologies and implement best current evidence in the management of stroke in most countries of the developing world.
With increasing stroke incidence in populations less than 50 years of age, stroke is becoming an existential threat to the economic, social, and labour capital of the developing world especially in Africa and Nigeria in particular.
The miracle news is that stroke is 80% of the time preventable and this prevention is based primarily on consistent subtle lifestyle changes to the modifiable risk factors of stroke.
The major lifestyle changes to prevent stroke include:
>EXERCISE (Physically Active Lifestyle): Target is 150 mins on moderate-intensity (not so hard to catch your breath while performing) exercise per week. While it may be good to sustain each bout of exercise for 10 mins, every minute counts!, and you can exercise for less than 10 mins and get the necessary benefits.
Exercise/physical activity is beneficial for optimum cardiovascular conditioning, mood enhancement, proper sleep, stress relief, good musculoskeletal health, mental health, and alertness, etc.
**Tips to physically active/exercise lifestyle**:
*Take 15 min evening/morning walks with your partner, pets, children...
*Have a Friday evening dance tradition (in your living room/outdoors, alone or with a company)
*Park your cars in spaces further from your office and walk briskly from the car to your office every workday
*Interrupt every 2 hours of sitting with 5 min walk (go to a colleagues desk, walk to the restroom stretch yourself and come back, etc)
*Wash your cars or mow your lawns by yourself at least once or twice a month
*Have s*x with your partner frequently
*Go swimming (if you can swim), cycling (if you can), visit the gym, etc once or twice per week, etc
>GOOD SLEEP HYGIENE: Lack of sleep is a killer and a big stroke/cardiovascular disease risk. 7-8 hours of nighttime sleep is optimum for proper body functioning. Lack of sleep increases your stress level and reduces your body's ability to recover from stress and many microtraumas it encounters during your daily activities. It favours abnormal weight gain, increased anxiety, cerebral ischemia, etc.
Maintain a regular sleeping and waking schedule even on weekends and public holidays. Sleep they say is the best form of rest. Get enough of it!
**Tips for good sleep hygiene**:
*Have a sleep schedule
*Stop using your phone, PCs, watching TV, 30mins-1hour before your sleep time
*Use bed for only sleep and s*x (helps condition the mind to fall asleep)
*Lie on your bed only when you are feeling sleepy and ready to sleep (If you didn't fall asleep 10 mins after lying down get out of bed and sit in the living room until you feel sleepy.
*Do physical activities in the evenings
*Eat early dinner (at least 2 hours before bedtime)and stop drinking water and fluids 1 hour before bedtime.
>Healthy Diet/Maintain a Healthy Weight:
Weight changes (in absence of underlying illness) are a direct result of the direction of calorie balance and healthy eating is its most significant modulator.
**Tips to a healthy eating lifestyle**:
*Eat less of junk meals and roadside grills and more of planned meals
*Drink water every two hours
*Eat foods with a high glycemic index less at a time. This includes fruits/veggies high on natural sugars e.g pineapple, onion, etc
*Eat with sustenance in mind not pleasure
*Eat sparingly processed foods, white bread, grilled/fried meat, etc
>Smoking Cessation:
Stop ci******es smoking both as an active or passive smoker.
**Tips for smoking cessation**:
*If an active smoker, strive to smoke one less stick per day or your usual daily number of sticks smoked. Every 6 weeks drop 1 less stick further until there is none left in your hand.
*Seek counseling and support groups
*Go on alternatives like ni****ne patches.
>Reduce Alcohol Intake:
Alcohol exerts influences on the kidney, afterload on the heart, and blood pressure. While alcoholic drinks at a certain proportion may not pose a negative impact on the body, excessive intake of alcohol will negatively impact your heart, blood vessels, kidneys, and liver.
**Tips to reducing alcohol intake**:
*Do not use alcohol as a coping mechanism for emotional stress, etc.
*Drink alcohol with glasses to easily regulate your intake
*Avoid 'awoof' drinking
In stroke and other chronic diseases, prevention is the miracle, not the cure.
_Callistus Okigbo(PT)
Your favorite health partner.
