Patient education: Stroke rehabilitation exercises (The Basics)

What is a stroke? — Stroke is when a part of the brain is damaged because of a problem with blood flow (figure 1). The effects of a stroke depend on a lot of things, including:

●Which part and how much of the brain is affected

●How quickly the stroke is treated

Some people who have a stroke have no lasting effects. But many people have serious problems after a stroke. For example, they might be unable to speak or feed themselves, or they might be unable to move 1 side of their body.

What are stroke rehabilitation exercises? — The goal of stroke rehabilitation exercises is to help you get back some of the abilities you lost due to the stroke. Rehabilitation is sometimes called "rehab." Different types of exercises, activities, and treatments can help different kinds of problems.

The exercises described below can help with many of the physical problems caused by a stroke. Recovery after a stroke also involves other things. For example, you might need to relearn how to care for yourself and how to do your normal daily activities.

What kinds of exercises might I need to do? — Your doctor and health care team will help you make a plan that meets your needs. You might have better results if you do your exercises regularly as instructed.

You might need to do:

●Range-of-motion exercises – These help you move your joints as much as possible. Range-of-motion exercises can be:

•Active – You move the body part by itself.

•Assisted – You need help to move your body part. You might need help from a person, another part of your body, or a device to help you move. Using a shoulder pulley is an example of an active assisted range-of-motion exercise.

•Passive – Some other person or a machine moves your body part.

●Strengthening exercises – These keep your muscles firm and strong. You might start by just using your own body weight as resistance. As you get stronger, you can make the exercise harder with bands, weights, or machines. You might also use pressure from another person. A biceps curl with a dumbbell is an example of a strengthening exercise.

●Stretching exercises – These keep your muscles flexible and help your joints move more easily. This can result in greater range of motion. When you stretch your hamstring muscles, you are stretching the muscles in the back of your thigh. This makes it easier to straighten your knee all of the way and to walk.

●Coordination exercises – These work on using different body parts together to do an activity. An example of a coordination exercise is to turn the palm of 1 hand up while you turn the palm of the other hand down.

●Swallowing exercises – These stretch and strengthen the muscles used to swallow. An example of a swallowing exercise is to press your tongue against the roof of your mouth as hard as you can and swallow.

●Cognitive, or "thinking," exercises – These are exercises that use your brain. Examples include:

•Solving problems

•Improving attention span

•Improving memory, word finding, or math skills

•Understanding and reasoning

●Eye exercises – These work on the muscles that control how your eyes move. You might also do activities to help you notice objects outside of your field of vision.

●Speech exercises – These strengthen the muscles of your tongue and around your mouth. This kind of exercise can help you form and say words properly. Moving your tongue from side to side is an example.

●Language exercises – These help you understand others and express yourself. Word games and singing are examples.

●Balance exercises – These strengthen the weaker side of your body. They work on helping you walk, sit, or stand without falling. Standing on an uneven surface is an example.

●Weightbearing exercises – These put weight on your legs or arms. For example, doing a mini-squat is a weightbearing exercise for your legs. A pushup is a weightbearing exercise for your arms.

●Gross motor exercises – These work on big movements like walking or throwing a ball.

●Fine motor exercises – These work on coordination in your hand. An example of a fine motor exercise would be touching each finger of your hand to your thumb.

●Forced-use exercises – You only use your weaker side to do these exercises. For example, you might use your affected hand to hold your toothbrush and brush your teeth. You might also be asked to repeat a certain activity or task many times. This can help your brain get used to doing the activity.

●Sensory re-education exercises –These work to retrain your brain to process the sense of touch. This might involve light touch, texture, pressure, or different temperature.

●Mirror therapy – This involves using a mirror to create a reflection of the stronger side of your body. This makes it look like the weaker side is moving in the same way. Over time, this might help improve how you move, use, and sense with your weaker side.

How can these exercises help me? — Your recovery and progress depend on a lot of different things. These include the size of the stroke and what part of your brain was damaged by the stroke. The most important thing you can do to help recover is to continue rehab. Do all of the exercises, activities, and therapies your health care team recommends.

Also, try to be patient. It takes time to heal and learn new ways to cope, but work and patience can pay off.

More on this topic

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