Neurobiomechanics - Biomechanics and Neurology - Page I 1 I 2 I 3 I 4 I 5 I 6 

Explaining the Mystery of the South East Stroke Belt

 

1)  Foreword

2)  Introduction

3)  Physical Geography and Stroke Incidences

4)  The Reasons forthe Lower Incidence of Stroke in Florida

5)  The Reasons for the Higher Incidence of Stroke in North Florida than in South Florida

6)  The Reasons for the Lower Incidence of Stroke in the New York Metropolitan Area

7)  The Reasons forthe Racial Disparity in Stroke Incidence

8)  Susceptibility to Stroke when Migrated to Geographical Regions with Lower Incidence of Stroke

9)  Summary
 

1) Foreword

Everywhere in the world people are afraid from stroke and the majority of them are afraid even just thinking about stroke. Living in certain geographical areas where it is known that on average strokes occur more often than in other areas is an extra burden. 
  • Understanding why in some geographical areas incidences of stroke are more common than in others will open the way to understanding the real cause of stroke and will enable us to design an effective and efficient treatment for stroke survivors. 
  • Knowing the factors which make us more prone to stroke will offer an explanation of how to make us more resistant, or at least less vulnerable, to stroke.  

I am sure that everyone will be able to do something about the prevention of stroke without changing the place of residency.  

I hope this article will not only bring a positive attitude to everyone but it will also give us knowledge towards preventing stroke, it doesn’t matter if he/she is a stroke survivor or he/she lives in a particular geographical area. 

2) Introduction

It has been known for about fifty years that the incidences of stroke are more common in the South Eastern States of the USA, an area known as the “Stroke Belt”. In the “Stroke Belt” area the incidences of ischemic and hemorrhagic strokes (and an increased risk of death from stroke) are substantially higher than in the rest of the USA. (Even children in Stroke Belt states have an increased risk of death from stroke compared with children in other states to an extent similar to adults).

 

The “Stroke Belt” is usually defined as an 11 state region which includes; Virginia, North Carolina, South Carolina, Georgia, Alabama, Mississippi, Louisiana, Arkansas, Tennessee, Kentucky and Indiana. Incidences of stroke in these states is 50% higher than in the West and in the Northeast of the US, 30% higher than in the Midwest of the US and nearly twice higher than in the New York metropolitan area. By taking a closer look at the available data we can see that not only is the “Mystery of the Southeast Stroke Belt” a reality but the “Mystery of the Midwest Stroke” is also a reality, because for unknown reasons, the Midwest of the country has a higher incidence of strokes than the West and Northeast of the country.

 

By comparing the incidences of stroke between the West and the Northeast of the country with the New York metropolitan area, we can see that the incidences of stroke is much higher in the West and Northeast than it is in the New York metropolitan area and because of this fact, we can call it the “Mystery of the Northeast Stroke” and the “Mystery of the West Stroke”.

 

Actually, any incident of stroke, it doesn’t matter if it is in the Southeast or in the Northeast of the country or anywhere in the world, is a mystery because till this day, no one knows why some people are affected by stroke and others are not.

3) Physical Geography and Stroke Incidences

By comparing the incidences of stroke between different regions we can see that the geographical factors play an important role in the incidences of stroke. This leads to the conclusion that by understanding why incidences of stroke are more common in some regions than in others, this will enable us to make the first step in attempting to understand the real cause of stroke anywhere in the world.

 

If we take a look at the map of the area where the Stroke Belt States are located, we can see that a significant part of their territory consists of flat surfaces of the ground (plain area). This points out that the people who live in hilly areas and in mountainous areas are less prone to strokes compared to the population that lives in a flat (plain) area.

 

One more contributing fact that leads to this conclusion is that this stroke belt has a “buckle” (a zone within a zone) where stroke death rates are “substantially higher” than in the stroke belt itself, and twice as high as the rest of the country.

 

Reporting in the May issue (1997) of the American Heart Association journal “Stroke”, scientists identify the “buckle” as the coastal plain sectors of North Carolina, South Carolina and Georgia. In this 153-county area, the new study shows that stroke deaths are 2.1 times higher than the rate of the nation’s average among people whose ages are 35 to 54, and 1.7 times greater for people between the ages of 55 and 74.

 

Taking a look at the geographical map of this region it is visible that the coastal plain sectors of North Carolina, South Carolina and Georgia is completely flat and as it is more distanced from the coast, the area is less flat (piedmont). This shows that the population living in coastal plain areas in those three states are more prone to stroke than people who live in the piedmont and mountainous regions in the same state.

 

We can see that somehow physical geographical factors are responsible for the increased and decreased incidences of stroke in a particularly geographical area (coastal flat areas, piedmont and mountainous areas) inside the Stroke Belt area.

 

The question why and how geographical-environmental factor is to some extent responsible for the incidence of stroke will be easily answered by a short introduction about locomotion and muscle activity.

 

1.      Any human locomotion is at the same time a motor skill activity.

 

2.      A diversity of motions means a diversity of neuromuscular system activity.

 

3.      The diversity of physical activities is at the same time a diversity of neuromuscular control centre activities.

 

The maintenance or improvement of the physical skills ability means at the same time the maintenance or improvement of the neuromuscular control centre.

 

We are performing locomotion like walking, running and as well as the voluntary and involuntary movement of the limbs by the voluntary and involuntary activities of the muscles.

 

The activity of the muscles is in a causal relation with the neuromuscular control centre activity and neuromuscular peripheral system activity.

 

Every conscious physical activity consists of the mental activity, neuronal activity and the musculoskeletal system activity.

 

The question why and how geographical-environmental factors are to some extent responsible for the incidences of stroke will be answered by comparing the everyday locomotion done in flat areas to the everyday locomotion done in a hilly (piedmont) and a mountainous area.

 

People who live in areas with hills and mountains are more frequently forced to incorporate a diversity of motion in their everyday locomotion because they are more often confronted with activities like walking up a hill, walking down a hill and walking diagonally up and down a hill etc.

 

On the other side, the people who live in a flat-plain area do not often have the opportunity to walk down or up a hill, most of their lives they walk only on flat surfaces.

 

Walking on a flat surface for most of the time has the consequence that the habitual gait is used to perform everyday locomotion (habitual walking and running pattern) to a greater extent than by people who live in a hilly and mountainous area.

 

The people who live in hills and mountainous areas, are in general more often obligated to incorporate diverse physical skills in their everyday locomotion. In general, they will more often exercise their motor skills compared to the people living in flat areas.

 

By exercising our own motor skill we are at the same time exercising our own neuromuscular control centre. (It can be said that by exercising-using our own motor skill ability we are exercising-using our own neuromuscular control centre).

 

The physical geography of mountainous area obligates us to use a diversity of physical skills (slowing and speeding skills, jumping skill etc.) in order to perform everyday locomotion.

 

A diversity of physical activities is at the same time a diversity of neuromuscular control centre activity.

 

Concerning the neuromuscular control system, the physical geography of hilly and mountainous region forces an increased activity of the neuromuscular control centre and on the other side; it forces an increased diversity of the neuromuscular control centre activity while performing everyday locomotion.

 

Habitual locomotion for a prolonged period of time has the consequence that the musculoskeletal system and neuromuscular peripheral system is physically active, but the neuromuscular control centre is under-active.

 

A prolonged period of inactivity or insufficient activity of the neuromuscular control centre leads to its deterioration.

 

1.      By a prolonged period of doing physical activities mainly in a habitual way, the motor skill deteriorates.

 

2.      A deterioration of motor skill ability means at the same time a deterioration of the neuromuscular system.

 

On a side note: the geographical environment of hilly and mountainous areas obligates us to do locomotion in such a way that our mind is in the present. For example, when we are walking down the hill we have to take care not to fall down. And all the time by doing this activity our mind is in the present. Also, we can’t walk down the hill with habitual walking patterns. On the other side, unexpected obstacles on our way by walking or running are factors that obligate us to increase awareness and diversify our motions.

 

Apart from that everyday locomotion in a hilly and a mountainous area forces an increased diversity of motion and activity of the neuromuscular control centre; it has a calming effect on the mind. It is an excellent guardian against stress because as we are mentally involved in physical activities (the entire brain is involved in physical activity) there is no space left for the stress.

 

Analysing and comparing the biomechanics when walking on an even and uneven grounds shows that the daily locomotion performed in a hilly and mountainous area to a greater extent is sufficient to maintain the optimal state of the neuromuscular control centre and that the daily locomotion performed only in a flat (plain) area isn’t sufficient to maintain the neuromuscular control centre to an optimal state.

 

Differences between the locomotion performed in a mountainous and a hilly area, and the locomotion performed in a flat area explains why the people who live in mountainous regions are less prone to stroke than people who live in a flat area.

 

4) The Reasons for the Lower Incidence of Stroke in Florida

If we take a look at the physical geography of Florida we can see that the whole area is flat, as same as the coastal plain sectors of Georgia, South Carolina and North Carolina and this area is known as a “Buckle” of the “Stroke Belt”.

 

Despite similar physical geography to the state located in the buckle zone, the southern part of Florida has one of the lower incidences of stroke in the US.

 

Like the people living in the coastal plain sectors of Georgia, South Carolina and North Carolina, the people who live in the southern part of Florida do not often have the opportunity to walk on an uneven ground like walking up and down a hill, etc.

 

If we take a closer look, we can see the factors which are responsible for the lower incidences of stroke in the southern part of Florida.

 

Because of the warm climate for the most part of the year and sandy beaches, the population in the southern part of Florida have more opportunities to walk with bare feet.

 

Walking with bare feet has the consequence of an increased sensory contact between the feet and the ground, and that has the consequence of providing stimulations for the peripheral nervous system (PNS).

 

1.      Increased sensory contact between the body surface and environment increases the peripheral nervous system activity (PNS). 

 

2.      The central nervous system gets input through the periphery nervous system. Increased activity of the peripheral nervous system has the consequence of an increased activity of the central nervous system (CNS).

 

Also, because of the warm climate for most part of the year, people in the southern part of Florida spend more time in the sea water and in swimming pools.

 

From a biomechanical point of view, swimming alone is a particularly important motor skill. The musculoskeletal system works slightly differently when the locomotion, like walking, running etc. is performed in the water.

 

By swimming, the musculoskeletal system is to a greater extent differently engaged to perform swimming locomotion. On the other side, by swimming the neuromuscular control centre is differently engaged than what is the case by walking locomotion.

 

Walking, running in the water, particularly swimming greatly enhances motor skill ability and motor skill diversity. Enhancing the motor skill’s ability and diversity has the consequence of enhancing the neuromuscular control centre. 

 

The state of the neuromuscular control centre (and the state of the central and periphery nervous system) to a greater extent determines the state of the mental immune system.

 

When we enhance the neuromuscular control centre, at the same time we are enhance the mental immune system and cognitive ability. (It appears that maintaining the neuromuscular control centre, neuromuscular peripheral system, central nervous system and peripheral nervous system to an optimal state will ward against neuron-cognitive diseases, like Alzheimer etc.).

 

On the other side, the sensory contact between the body surface and the water provides stimulation for the central and periphery nervous system. Actually, the increased sensory contact caused by the water has the consequence that the periphery and the central nervous system are more active.

 

In everyday life, we are not aware that by taking a shower and washing the face with water that has a temperature different from the temperature of the body we unknowingly activate the nervous system. By doing this, we are stimulating the periphery and central nervous system. By stimulating the periphery nervous system, the central nervous system is more than usually active.

 

Providing optimal sensory stimulation to the periphery nervous system is what maintains the periphery and the central nervous system to an optimal condition.

 

Staying inside for a prolonged period of time will negatively affect not only the neuromuscular control centre and the neuromuscular peripheral system, but it will also negatively affect the central and the peripheral nervous system, because the inside of the house has an air temperature that it is relatively constant for most of the time.

 

Apart from the benefits for the musculoskeletal system and motor skill, regularly taking even short walks outside in the fresh air will positively affect the central and the peripheral nervous system.

 

Walking with bare feet on sandy beaches and in the water is an effective way for maintaining and improving motor skill and a diversity of motor skills, which has positive consequences for the neuromuscular control centre, neuromuscular peripheral system and the central and peripheral nervous system. People who live in the southern part of Florida, compared to most parts of the USA, have more opportunities to do that.

 

Walking with bare feet demands an increased level of mental awareness about the surface and small objects that are on the ground like a sharp stone etc. is the factor that demands constant mental awareness for the time of doing this activity and it is impossible to walk by maintaining a habitual walking pattern. On the other side, walking with bare feet obligates us to be more aware of the surrounding environment.

 

Walking while wearing footwear doesn’t obligate us to take care where we are stepping and how we are stepping and because of that fact, we can do locomotion by using our habitual walking pattern.

 

One more fact is that by walking with bare feet has the consequence of increased sensory stimulation to the peripheral nervous system because of the increased sensory contact between the bottom of the feet and the ground (increased sensory contact with the environment).

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(Explaining the Mystery of the South East Stroke Belt)

1)  Foreword – Page 1a

2)  Introduction – Page 1b

3)  Physical Geography and Stroke Incidences – Page 1c

4)  The Reasons for the Lower Incidence of Stroke in Florida – Page 1d

5)  The Reasons for the Higher Incidence of Stroke in North Florida than in South Florida – Page 2a

6)  The Reasons for the Lower Incidence of Stroke in the New York Metropolitan Area – Page 2b

7)  The Reasons for the Racial Disparity in Stroke Incidence – Page 3a

8)  Susceptibility to Stroke when Migrated to Geographical Regions with Lower Incidence of Stroke – Page 3b

9)  Summary – Page 3c

 


E-book:  Autism Linked to Stationary Bikes, Treadmills, Trampolines and Bouncy Castles (Contents of this Book) – Page 6

 

 


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