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The Value of Therapeutic Exercise for Stroke Patients

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Recovering from a stroke can be a challenging journey, but with the right approach, significant progress is possible. Understanding the value of exercise for stroke patients can help.

Strokes, affecting nearly 800,000 people in the U.S. annually, can lead to physical and cognitive impairments. However, with early intervention and targeted exercises, many stroke survivors can regain strength, mobility, and independence.

This article explores the critical role of exercise in stroke recovery, from improving heart function and balance to enhancing cognitive abilities and fine motor skills.

By understanding the importance of neuroplasticity and functional movement, stroke survivors can navigate recovery with greater confidence and success.

The Role of Exercise in Stroke Recovery

Female nurse doing physiotherapy with senior man

Regular targeted exercise can improve strength, mobility, quality of life, and independence for stroke survivors. Depending on the nature of the brain injury, stroke rehabilitation exercises can include small, low-grade movements as well as larger, more complex ones.

Regular exercise can lead to greater independence while reducing complications and common risks for stroke survivors like falls and heart disease.

Guidance from both physical and occupational therapists helps build an appropriate recovery exercise program as a stroke survivor seeks to regain function for daily living.

Depending on the affected areas, recovery programming will ideally include task-specific training and aerobic exercise.

Aerobic exercise can be beneficial for stroke patients to improve heart function and reduce the risk of future strokes. Cardiovascular fitness can also lessen depressive symptoms, improve blood flow, and improve overall quality of life throughout recovery.³
Task-specific exercises for stroke patients with paralysis can help to restore muscle strength and coordination in muscles weakened by the stroke. For example, exercises like Tai Chi or treadmill walking are particularly effective for regaining walking and posture function for day-to-day tasks.²

Regardless of the nature of the stroke, it’s essential to begin a program early, ideally starting with stroke exercises in the hospital and continuing at home or in rehab as your recovery progresses.²

Stroke recovery exercises are usually specific, multifaceted, and guided by a physical therapist. Let’s look at some of the most common elements of a recovery program.

Neuroplasticity: The Key to Recovery

Stroke patient exercising during rehabilitation in hospital

Understanding neuroplasticity’s role can help underline the importance of exercise in post-stroke recovery.

Neural pathways in the brain can naturally reorganize and restructure in response to learning and practice. Neuroplasticity is the brain’s ability to grow and develop through experience.

After a stroke, stimulation of the peripheral nervous system—the connection of the outer body to the brain—can retrain the brain and body to regain lost areas of function.

Methods like electrical stimulation can also help to correct muscle weakness on the stroke-affected side to re-learn functions that may have been lost as a result of your brain injury.³

Functional Movement for Daily Activities

The term “functional movement” refers to movements you might encounter daily, which can be trained just like other exercises.

Deliberately performing basic functional movements like using your hands, walking, standing from a seat, and using stairs is vital for post-stroke recovery.

Repetition is important in improving daily functioning, and doing these exercises over and over can help your brain make the most out of the neuroplasticity principle.

For example, one of the most commonly performed progress tests for stroke survivors involves measures of improvement in walking ability and speed over time. This indicates that walking can improve function and predict recovery outcomes in some stroke patients.²

During initial recovery, constraint-induced movement therapy is a particularly beneficial functional method. This technique involves restricting your fully functioning limb from movement, forcing you to use your affected limb to perform activities, and discouraging patients from favoring their unaffected limb.¹

Balance Exercise for Stroke Recovery

Stroke patient recover physical activity in rehab center

Improving balance is central to most stroke rehab programs, as a lack of balance control can put you at risk for falls and avoidable injuries from equilibrium impairment and weakness.

Carefully reaching outside your base of support, standing with your feet close together, or turning your head side-to-side while walking are common balance exercises for stroke patients.

More advanced balance exercises might include standing on one leg, skipping, or walking on uneven surfaces.²

Balance challenge exercises often require more supervision than other exercises, and having another person around to assist during the most challenging exercises – either in PT or at home – is the safest way to practice balance.

Hand Exercises to Improve Dexterity After a Stroke

Young hands holding old elderly senior hands. Support for the seniors concept

Weakened grip and loss of fine motor skills and dexterity are common stroke side effects.

As with other program elements, your hand exercise routine will be carefully tailored to your needs, whether you require more strength, coordination, or both.

While practicing various hand movements is ideal, it is best to get guidance for your hand exercise program from a professional such as an occupational therapist.

Some OC stroke exercises might include ball squeezes, resisted finger straightening, or picking up marbles from a table.⁴

Performing hand exercises can be frustrating and difficult initially during stroke recovery, but persistence and repetition are both important to rebuilding these neural pathways.

Cognitive Exercises for Stroke Recovery

Mature patient using physiotherapy equipment for brain exercise in clinic

Most tasks during a typical day involve physical and cognitive components; we do not perform many purely physical acts without thinking, and vice versa.

Some of the more frustrating physical deficits of stroke involve memory and thinking. Trouble remembering names, faces, and events is a common issue among stroke survivors, and simple tasks can become a challenge.

As a result, retraining your brain can take more patience and time than retraining your muscles.

Studies show that a combination of physical and cognitive exercise, like playing memory games while stepping over obstacles, offers the best results for cognitive function in post-stroke patients.¹

Although these exercises may be frustrating, this combination can be beneficial in recovering both brain health and physical abilities over time.

Speech Exercises

Restoring speech and language abilities after a stroke can be a slow and tedious process. Depending on your impairments, a speech pathologist can help you identify targeted exercises specific to your challenging areas.

Depending on where the stroke occurred in the brain, some patients may have more trouble with “finding the right words”, while others may have trouble with articulation. You may even have difficulty with comprehension of what other people are saying.

Similarly, weakness in the facial muscles around your mouth and throat can lead to difficulty chewing and swallowing. For this reason, a speech therapist may help you adjust your diet for safety and avoid choking or aspiration while eating.

Summary

Stroke recovery is different for every survivor, and rehabilitation can be challenging and complicated, with many ups and downs. Regardless, it’s hard to overestimate the importance of exercise for stroke patients.

Nonetheless, patience and determination, combined with well-prescribed exercise and attention to re-educating your brain, can aid recovery.

A comprehensive plan and a well-informed, compassionate therapy and care team is crucial as you navigate the rocky terrain back to a healthy brain.

Key Takeaways

Strokes are common neurological conditions, affecting approximately 800,000 people in the U.S. each year.
Damage from a stroke can cause both physical and mental impairments, but recovery is possible with proper rehabilitation.
Exercise is critical for stroke recovery, improving strength, mobility, and independence.
Stroke rehabilitation exercises include small, low-grade movements and more complex tasks depending on the injury.
Aerobic exercise benefits heart function, reduces future stroke risk, and improves overall quality of life.
Task-specific exercises help stroke patients regain muscle strength and coordination, improving daily function.
Early initiation of a recovery program, ideally starting in the hospital, is essential for better outcomes.
Neuroplasticity allows the brain to reorganize and regain lost functions through targeted exercise and stimulation.
Functional movement exercises focus on daily activities like walking, standing, and using stairs to improve recovery.
Balance exercises help reduce fall risk and improve stability, requiring supervision for more challenging tasks.
Hand exercises target grip strength and fine motor skills, which are essential for regaining dexterity after a stroke.
Cognitive exercises combine physical and mental challenges, aiding in brain function and memory recovery.
Speech exercises address language, articulation, and comprehension issues with the help of a speech pathologist.
Recovery from a stroke is a challenging process, requiring patience, determination, and a well-rounded rehabilitation plan.

FAQs

What are the benefits of therapeutic exercise for stroke patients?

Therapeutic exercise is crucial for stroke patients as it aids in regaining lost mobility, improving muscle strength, and enhancing coordination. These exercises help restore independence by targeting specific impairments caused by the stroke. Moreover, therapeutic exercise significantly boost cardiovascular health, reduces the risk of future strokes, and improves overall quality of life. It also promotes neuroplasticity, the brain’s ability to adapt and rewire itself, which is essential for recovery.

How soon should stroke patients begin therapeutic exercises?

Stroke patients need to begin therapeutic exercises as soon as they are medically stable, often starting in the hospital under the guidance of physical and occupational therapists. Early intervention is critical because it helps prevent complications like muscle atrophy and joint stiffness, which can occur due to immobility. Starting exercises early also capitalizes on the brain’s heightened neuroplasticity following a stroke, which can lead to better long-term recovery outcomes.

What types of exercises are recommended for stroke recovery?

Stroke recovery programs typically include a combination of aerobic exercises, strength training, balance exercises, and task-specific movements. Aerobic activities, such as walking or cycling, improve cardiovascular health and endurance. Strength training focuses on rebuilding muscle power, particularly in weakened limbs. Balance exercises help prevent falls and improve stability. Task-specific movements, such as reaching or grasping, are designed to restore functional abilities needed for daily activities. The exact regimen is personalized based on the patient’s specific needs and goals, often under the guidance of physical and occupational therapists.

Can therapeutic exercise help with speech recovery after a stroke?

Yes, therapeutic exercise can significantly aid in speech recovery. Stroke can impact speech, language, and swallowing abilities, depending on the area of the brain affected. Speech therapists work with patients to perform specific exercises that target these areas, such as articulation drills, word retrieval practice, and breath control exercises. In some cases, therapeutic activities may also involve strengthening the muscles around the mouth and throat, improving speech clarity and the ability to swallow safely. Consistent practice is essential for regaining communication skills and enhancing overall recovery.

What role does neuroplasticity play in stroke recovery?

Neuroplasticity refers to the brain’s ability to reorganize itself by forming new neural connections, particularly after an injury like a stroke. This adaptability is crucial for stroke recovery, as therapeutic exercises stimulate neuroplasticity, helping the brain rewire to regain lost functions. For instance, if one brain area is damaged, another area may take over its tasks through repeated practice and targeted exercises. By engaging in consistent therapeutic exercises, stroke patients can encourage the brain to create new pathways, improving movement, cognition, and overall function. Neuroplasticity is a fundamental concept in designing effective stroke rehabilitation programs.

References

Yulin, D., Linman, W., & Yinhu, H. (2022). Exercise for Stroke Rehabilitation: A Bibliometric Analysis of Global Research From 2001 to 2021. Frontiers in Aging Neuroscience, 14. https://www.frontiersin.org/articles/10.3389/fnagi.2022.876954/full
Eng J. J. (2010). Fitness and Mobility Exercise (FAME) Program for stroke. Topics in geriatric rehabilitation, 26(4), 310–323. https://doi.org/10.1097/TGR.0b013e3181fee736.
Dimyan, M. A., & Cohen, L. G. (2011). Neuroplasticity in the context of motor rehabilitation after stroke. Nature reviews. Neurology, 7(2), 76–85. https://doi.org/10.1038/nrneurol.2010.200
Hand Exercises for Stroke Patients. (2022, May 16). Baystate Health. https://www.baystatehealth.org/news/2021/05/hand-exercises-for-stroke-recovery