Why exercise? How do I even get started? The importance of exercise in stroke rehab to support recovery, and guidelines to follow
In Singapore, the number of stroke episodes increased from 5,890 episodes in 2010 to 8,849 episodes in 2019. To mitigate the impact of stroke, preventive measures that reduce cerebrovascular risk, as well as post-stroke interventions that improve prognosis and reduce recurrence risk, are essential.
Health Promotion Board, Singapore. Stroke Registry Annual Report 2019. Singapore: National Registry of Diseases Office, 2021
If you have suffered a stroke, you may wonder how to improve your functional mobility and get back to participating in the activities that once enjoyed. You may wonder what you can do to improve your upper and lower body strength and avoid complications like joint contractures and falls.
Whichever stage of your stroke rehab you are at, doctors and experts agree on one thing: Your rehabilitation will be severely hampered if you don't get some physical exercise. Therefore, you need to consult your therapist for proper exercise guidance. You should learn about the risks of lifestyle choices, the benefits of exercise, and the different exercise types fit for stroke survivors.
The Danger that Sedentary Lifestyles Pose
You've probably heard the phrases "sedentary" and "inactive" lifestyles used interchangeably. They all imply the same thing: a way of life that involves sitting or lying down for long periods and doing little or no physical activity. Unfortunately, people in the industrialized world are becoming increasingly sedentary. Research shows that sitting for more than eight hours without moving around can make you more likely to have a stroke. A recent study also reveals that stroke survivors often become physically deconditioned and adopt sedentary lifestyles. For this reason, it's important to encourage them to engage in physically demanding activities under close supervision.
Importance of Exercising after a Stroke
The aftereffects of a stroke can vary from patient to patient. This affects which exercise will be most fruitful for each patient. Exercise is vital because:
1. It helps you to recover from the physical effects of the stroke
A stroke often causes physical problems like hemiplegia or hemiparesis, which means one side of the body is weak or can't move. These problems make it more likely that a stroke survivor will fall and make it harder for them to do daily tasks. So, a personalized after-stroke exercise plan should be made by therapists to help improve the safety of individuals and their independence.
2. It reduces the risk of another stroke
Common risk factors for stroke include hypertension, blood cholesterol, obesity, and excess body fat. Thankfully, exercise can help manage all of these conditions. Exercise is essential for health and rehabilitation after stroke, but patients should not overdo it. Worsening conditions like post-stroke fatigue may occur if the body is pushed too far. Patients recovering from strokes should work with therapists to develop individualized, well-rounded treatment plans.
After Stroke Exercise Guidelines
Your ability levels and prior medical issues will determine which exercises are most beneficial to you after a stroke. Here are the most recent recommendations by the American Heart Association:
Strength training. Muscle atrophy, common during hospitalization and the days following discharge, can be prevented and even reversed with strength training. Lightweights that can be lifted by the stroke survivors at least 10-15 times are ideal for strength training. It is recommended to undertake strength training on the musculature of the major muscle groups 2-3 days a week, with a total of 8-10 exercises.
Aerobic exercise. Aerobic exercise should be a top priority to help reduce the risk of a second stroke. Experts suggest that people who have had a stroke should do aerobic exercise for 20–60 minutes a day, 3–7 days a week. After that, the therapist should change the dose depending on how it fits the patient.
Gait training. Your gait is how you walk, and gait training is the process of getting better at walking. Walking exercises are essential for individuals to regain their "pre-stroke" levels of mobility. In addition, training one's gait can increase one's stamina and hence one's ability to do the Activities of Daily Living independently and for extended periods. You will need the assistance of a physiotherapist to train your gait.
Balance and core exercises. People at a high risk of falling should engage in balance and core exercises.
Stretching and range-of-motion exercises. Stroke survivors are strongly encouraged to engage in stretching and range-of-motion exercises to help them regain mobility and avoid contractures, a progressive condition characterized by excessively rigid, tight muscles.
To avoid misunderstandings, you should develop exercise goals and post-stroke physiotherapy planning in collaboration with your therapist. Consistency and repetitions are crucial during stroke recovery, regardless of your doctor's or therapist's advice.
Why Repetitions are Important in Neurorehab
Neurorehab is a term used by certain therapists to describe neuromuscular rehabilitation techniques, which aim to improve muscle and nerve communication.
A stroke severely damages brain-muscle connections, but neuromuscular training can help recover movement by stimulating neuroplasticity. Neuroplasticity is the brain's natural ability to rewire itself to learn new things and gain new skills. It is how people who have had a stroke can get their mobility and functional areas back, like being able to walk, dress, and do the things they need to do every day.
Your therapist may recommend massed practice when discussing the most beneficial activities to perform after a stroke. Generally, a massed practice is an excessive number of repetitions used to promote neuroplasticity.
When learning something new, the brain prefers to be as efficient as possible; thus, it needs lots of practice. The brain recognizes the importance of activity when performed regularly and adapts to make it less stressful for an individual.
The Bottom Line
Patients recovering from a stroke are at a higher risk for developing sedentary habits; therefore, they must be encouraged to engage in physical activity under close medical supervision. Besides lowering the possibility of future cardiovascular issues, regular exercise boosts functional capacity or the ability to carry out daily tasks.
Start Exercising Today!
At RehabWorks, we're proud of our patient-centered care and know everyone's journey is different. With our holistic approach, you'll be able to improve your mobility and health for the foreseeable future. You can enjoy better overall health and a higher quality of life.
Don't hesitate to contact us for more information, help, or to find out about the recent advancements in stroke rehabilitation. We'll get back to you within 24 hours!
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