Post Stroke Exercise

Exercising and moving around safely may not be something you think about, unless you’ve had a stroke. Many stroke survivors have trouble moving as they did before suffering from a stroke. These problems occur from balance issues and arm or leg paralysis. As a result, about 40% of stroke survivors have serious falls within a year of their strokes. However, with proper training and exercise, stroke survivors can regain muscle control and balance.

The most common physical effect of stroke is muscle weakness and having less control of an affected arm or leg. Survivors often work with therapists to restore strength and control through exercise programs as seen on my previous blog Stroke Prevention: Exercise and Physical Activity. They also learn skills to deal with the loss of certain body movements. When paralysis occurs, the muscle, or group of muscles are unable to move on their own. After stroke, signals from the brain to the muscles often do not work right. This is due to the damage to the brain from the stroke . This damage can cause an arm or leg to become paralyzed or to develop spasticity. Spasticity is a condition where muscles are stiff and resist being stretched. It can be found throughout the body but is most common in the arms, fingers or legs. Depending on where it occurs, it can result in an arm being pressed against the chest, a stiff knee, or a pointed foot that interferes with walking. It can also be accompanied by painful muscle spasms.

Therapy can include range-of-motion exercises, gentle stretching, and splinting or casting. Specific therapy techniques include:

• Physical exercise and stretching- Stretching helps maintain full range of motion and prevent permanent muscle shortening.
• Braces- Braces can hold a muscle in a normal position to keep it from contracting.
• Intrathecal baclofen therapy (ITB)- ITB delivers medication where it's most effective and minimizes side effects that often accompany oral medications. A small pump is surgically implanted to supply baclofen to the spinal cord.
• Oral Medications- Several oral medications can help relax the nerves so that they don't send a continuous message to the muscles to contract. Side effects may occur with oral medications, such as weakness, drowsiness or nausea.
• Injections- Some medications can be injected to block nerves and help relieve spasticity in a particular muscle group. This treatment weakens or paralyzes the overactive muscle. Side effects are minimized, but there may be soreness where injected.

Walking, bending and stretching are forms of exercise that can help strengthen your body and keep it flexible. Mild exercise, which should be undertaken every day, can take the form of a relaxing walk. Stretching exercises, such as extending the arms or bending the torso, should be done regularly. Moving weakened or paralyzed body parts can be done while seated or lying down.

Fatigue while exercising is to be expected. Stroke victims will experience good and bad days. Therefore, exercise programs should be modified accordingly to accommodate for fatigue or other conditions. Avoid overexertion and pain when helping a stroke victim. The road to recovery is not an easy one for stroke victims. It takes patience and understanding to help reach their physical fitness goals.

References

HOPE- Stroke Recovery Guide. (2015, January 1). Retrieved April 11, 2015, from http://www.stroke.org/sites/default/files/resources/HOPE_Guide_2007_chap4.pdf

Spasticity. (2015, March 5). Retrieved April 10, 2015, from http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/PhysicalChallenges/Spasticity_UCM_309770_Article.jsp