Role of exercises in Stroke rehabilitation

By avn
9:15 am Posted March 18, 2017
In Stroke

Recovery from stroke may be a very slow and long process, and feel like a daunting task, as the brain needs to relearn skills lost due to the damage caused by the stroke.

The good news, however, is the brain is resilient and capable of adapting to the changes caused by the stroke. So, recovery is indeed possible after a stroke.

Exercises play a vital role in the road to recovery after the stroke. They can help in promoting flexibility, decreasing pain and stiffness, improving balance and coordination, maintaining range of motion in the affected arm or leg, and helping in returning to normal movement. Note that it is advisable to have someone stand nearby when doing the exercises. Given below is a list of various types of stroke rehab exercises.

    • Passive Range of Motion:

These types of exercises involve an external force moving a body part, such as strong arm moving the weak or paralyzed arm, a caregiver moving the affected limb, etc. This is important to maintain flexibility of the joints and to prevent contracture of the joints. Even patients who are totally paralytic need to perform passive range of motion as contracture can lead to skin breakdown, tissue breakdown, pain, decreased blood flow, and also prevent the movement of the limb even after muscle function has returned.

    • Active Assistive Range of Motion (AAROM):

These types of exercises involve the affected limb movement with assistance, but the affected limb is weak and not completely paralytic. In such cases, the affected limb requires help and the therapist or caregiver assists in lifting the limb further when the patient could lift the limb partially.

    • Active Range of Motion (AROM):

These types of exercises are performed when patients can move a body part without any assistance. Many stroke patients may not be able to add resistance due to the weakness from the stroke, and cannot perform resistance exercises, but may be able to perform active range of motion exercises. AROM enables the patient to gain joint flexibility, strength, and muscle endurance.

    • Strengthening/Resistance Training:

Stroke rehab exercises also contain strengthening exercises that involves moving a body part against resistance, which will slowly help in the muscles getting stronger.

    • Stretching Exercises:

Stroke results in tightening of the muscles and increased muscle tone. Stretching will help prevent joint contracture and muscle shortening if done regularly. When manual stretching is not enough, stretching with the use of a splint may be required to relieve tight joints and muscles.

    • Weight-bearing exercises:

Weight bearing helps reduce excessive muscle toning caused by stroke and also helps in strengthening the weak muscles.

    • Scapula mobilization:

Most stroke patients experience shoulder pain because the muscles attached to the shoulder blade (scapula) become weak with increased muscle tone due to which lifting the arm overhead becomes a problem. Exercises to the scapula helps in mobilization. This results in improvement of range of motion of the shoulder and also pain prevention.

    • Balance exercises:

Most of the patients experience balancing problems after a stroke. The first thing to learn is for the patient to maintain balance when sitting. Later the patient must work on improving balance while standing. This will also enable the patient to walk without loss of balance. Balance exercises are very important in stroke rehab as it helps in preventing falls.

    • Gross and fine motor skills:

Gross motor skills are improved with coordination exercises when walking or moving the limbs. The patient is able to perform these in a coordinated manner. Fine motor skills are also improved with coordination exercises and helpthe patient in feeding himself, buttoning clothes, writing, etc.

    • Constraint-induced Movement Therapy (CIMT):

In this technique, the movement of the stronger side is limited and the patient is made to move the weaker side to perform certain activities.

    • Eye exercises:

Some stroke survivors may have visual problems like double vision, visual field loss, etc. Eye exercises help in overcoming these issues.

    • Improving Sensation:

A patient may be having numbness, tingling, or decreased sensation after a stroke. Sensory re-education is a method to retrain the sensory system so that there is improvement in sensation and hand function.

    • Swallowing exercises:

After a stroke, it may be difficult for the patient to swallow and can be life threatening as food and water may enter the lungs. A licensed speech therapist may help in improving swallowing and also recommend a diet to prevent aspiration.

    • Cognitive exercises:

Exercises to improve the patient’s memory, problem solving, reasoning, following directions, etc. may be recommended for patients affected by stroke.

    • Speech exercises:

Exercises will be suggested to improve articulation caused due to weak mouth and tongue musculature or improve patient’s ability to recall and understand words.

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