A stroke is an insidious disease that affects the structures of the human brain, causing serious disturbances in it. Pathology leads to the failure of various body functions and never passes without a trace. In addition to drug therapy, constant, strictly dosed and individually selected physical activities contribute to the restoration of health during the rehabilitation period. In the materials of our article, the reader will find answers to many questions. For example, what is the essence of exercise therapy after a stroke? The set of exercises prescribed by the doctor is performed only while in the hospital, or continues at home treatment? What types of loads are applicable for a similar diagnosis? And much more.
What is a stroke?
A stroke is an acute circulatory disturbance of brain structures, the symptoms of which appear suddenly and occur in separate foci or in the general structure as a whole.
This pathology often leads to death. According to statistics, after coronary heart disease, cerebrovascular diseases are in second place among the causes leading to mortality from pathologies of the circulatory system. A cerebral infarction and various cerebral hemorrhages are also a form of stroke.
If the manifestations of the disease can be detected in a timely manner and proceed to immediate treatment, the patient has a chance at life. However, pathology in most cases leads to impaired motor or sensory functions of the body, causes a deterioration in brain activity — impaired speech, memory, spatial orientation, and thinking.
Depending on what type of stroke is diagnosed in the patient, the patient’s chances for recovery and the continuation of a full life vary. So, ischemic strokes, which make up 75-80% in the structure of the disease, are easier to treat. Hemorrhagic stroke has more severe consequences and is much more difficult to treat.
Why is rehabilitation necessary?
The treatment of patients who have undergone such a disease is a complex process, consisting of many stages and requiring patience and a systematic approach. Therapy begins with resuscitation, where the patient is given direct treatment to survive. Further, specialists of a neurological hospital are engaged in the restoration of affected brain cells of the patient.
You need to understand that the effect of drug treatment is not unlimited. However, there are additional techniques to speed up recovery from a stroke. LFK is one of them.
Pathological changes in brain structures are irreversible - dead cells cannot be restored and this neurological deficit is irreplaceable. Fortunately, brain activity and impaired motor activity are inextricably linked. Consequently, the restoration of the patient’s mental skills can occur after the return of motor function in paralyzed limbs or throughout the body.
The movement prevents stagnation of blood in paralyzed tissues and restores muscle memory, and also mobilizes the activity of other neurons that are not affected by pathological processes. Dosed physical activity will contribute to the restoration of brain function. Therefore, it is very important after discharge of the patient from the hospital to begin the immediate implementation of a set of exercises aimed at improving the condition of the body as a whole.
The effect of physical activity
As noted earlier, the treatment and rehabilitation strategy should be implemented gradually, in stages and methodically. This means that before the achievement of the goal, a lot of time will pass, desire and discipline will be required both on the part of the patient himself, and on the part of relatives or people caring for him. At the initial stage in the hospital, physical exercises and care are carried out by doctors. Recovery procedures, such as massage and light motor activity, begin almost from the first day after the onset of the disease. Exercise therapy and exercises after a stroke :
- protect the skin from pressure sores, especially in the legs - in the heel areas, where there is the greatest contact with the bed, and the body is subjected to increased pressure;
- reduce muscle tone and general stress that occurs with paralysis due to stroke; at the same time, increased excitability gradually passes;
- improve tissue microcirculation, gradually restoring normal blood circulation;
- help to resume subtle movements in the hands and upper limbs in general;
- against the background of a stroke, contracture may occur - the restriction of movements in the joint with the congealing of muscles that are in constant strain. Exercise provides the prevention of this phenomenon.
Where to begin?
The question of how long it will take to partially restore the lost functions of the body in the post-stroke period cannot be answered unambiguously.
It all depends on the type of pathology, the size of the lesion and localization in the brain structures, as well as the time that has passed since the onset of the disease to the provision of medical care. Accordingly, the larger these indicators, the worse the forecasts. In any case, one must not lose heart and give up, it is necessary to fight for life and for health. Before proceeding with the recovery procedures, it is necessary to consult a doctor - the set of exercises in each case will be different. For example, exercise therapy after ischemic stroke differs from the loads in the hemorrhagic type of pathology.
At first, in case of paralysis of the patient (full or one of the sides) for a week or two, it is recommended to influence the muscles by changing the position. To avoid stagnation of blood and the formation of pressure sores, it is recommended to turn the patient over every 2-3 hours.
After a specified period of time, passive types of loads (massage) begin, which are feasible with the help of third parties. The purpose of these manipulations is to relax the muscles and prepare them for subsequent (active) loads.
Massage and passive loads
There are certain rules when performing massage manipulations. First, through circular motions, you should warm up the skin and ensure the flow of blood to the tissues. Efforts should not be excessive, rather an easy and enjoyable procedure is needed. Massage (passive exercise therapy) of the hands after a stroke is performed from top to bottom - from the hand to the shoulder. Accordingly, the legs are kneaded from the foot to the hips.
When massaging the surface of the body, specifically the back, apply more abrupt movements with the implementation of tweaks and taps. Massaging the chest, use soft pressure, movements are performed in a circle from the center out.
After massage procedures, passive loads begin. These include alternating flexion and extension of the limbs - arms and legs. The mechanism for performing the exercises is as follows. The patient is laid on his back, and the limb is raised and bent in the joint so that when it extends it slides along the surface of the bed. Through these exercises, exercise therapy after a stroke for the legs, as well as the arms, gradually restore the motor memory of the body. An important indicator of success in this case is the consistency of procedures - exercises are carried out for 40 minutes twice a day, starting from the second week - three times a day.
Mental exercise
As noted above, limb movement is controlled through muscle memory. To restore it, daily mental exercises are required. The following scheme is recommended. When performing a physical exercise, you must repeatedly repeat the command out loud. For example, when bending the arm, say: “I bend my arm, I move my fingers, etc.” If the patient at this stage is difficult to pronounce the words, close people should do it for him. This technique is also good because it trains the patient’s speech apparatus. Mental exercise therapy after a stroke (at home should be performed methodically and constantly) leads to good recovery rates.
Throughout the entire course of treatment, it is necessary to praise the patient for any actions on his part, in every way to encourage and reassure him, to tune in to a positive outcome of the situation. Often patients with a similar diagnosis are reluctant to exercise, experience depressive states, and do not believe in their own strengths. This is the wrong position. A psychological attitude is the key to success in any business. It is important to explain to the person that the outcome of the treatment depends only on him, and no one but himself will help him.
Speech Recovery
The result of a stroke can be not only a violation of motor function, but also a speech disorder of the patient. Such disruptions in the body last a long time, from several months to several years, and require constant recovery measures. Persistence, an unchanging desire to recover and the methodical nature of the exercises are necessary from the patient. You can’t stop classes in any case, and then sooner or later the result and positive dynamics will appear.
Exercises for the articular apparatus are aimed at restoring the lost function of nerve cells located in the zone of the center of speech. Firstly, in order for the patient’s speech to normal, he must constantly hear it from others. The task of relatives and friends is to constantly talk with a person who has had a stroke so that in the future he can play sounds on his own.
If speech is completely lost, you should start with the pronunciation of individual sounds, then syllables, then words, the volume of which should increase over time. At the final stage, it is useful to read poetry and pronounce tongue twisters. Good results in treatment are given by music. It is useful for the patient to listen to singing, as well as to try to sing songs himself - first simple, then more serious.
Articulation exercises. Memory recovery
Due to a stroke, there is a violation of the mobility of the facial muscles with their subsequent solidification. This phenomenon leads to a person losing his ability to talk. A set of exercises is provided for training the speech apparatus. The patient is recommended:
- push the tongue forward as far as possible;
- curl lips into a tube, bite your teeth;
- lick lips with tongue from left to right and from right to left;
- bite alternately upper and lower lips.
With a stroke, memory is impaired, and one of the most important tasks in rehabilitation is the restoration of this particular type of nervous activity. Along with drug therapy, specialists carry out functional recovery correction with the patient. The technique involves training the brain by memorizing numbers, words, poems.
In addition, board games have a positive effect on memory recovery. In general, the game technique used in rehabilitation gives good results - the patient concentrates on the performed action on the one hand, and is distracted from the situation and surrounding reality on the other.
Active loads
When the first results appear and the patient gains confidence in his own strengths and a favorable outcome of the disease, one can gradually switch to active physical activity. During this period, as a rule, the patient is discharged, and a change in the situation of the hospital to home walls helps to improve the mood and raise the “fighting spirit” of a person.
Exercise exercises after a stroke (carried out at home) are quite diverse. At first, it can be classes in bed, then in the sitting and standing position. After success at these stages, you can move on to walking. It should be noted that in each case, the intensity of the loads may vary, and should be calculated by the doctor in accordance with the patient’s history.
The loads should be daily and take several hours during the day at separate intervals.
Physical therapy in a sitting position consists of a set of the following exercises:
- eye muscle training can be performed by rotating the eyeballs in different directions - diagonally, from right to left, from top to bottom, open and close the eyelids, such exercises help normalize pressure;
- relieve tension after the above exercises will help squinting, with a repetition of 10-15 times;
- stretch the neck muscles allow rotation of the head in different directions and at a different pace;
- after a stroke, it is necessary to develop finger motility, to train grasping reflexes. For these purposes, expanders are used;
- You can train the muscles of the legs and feet by stretching and contracting them.
Consistently in a sitting state, you can proceed to more amplitude exercises - lifting the limbs, on your own or with the help of a belt.
Exercise therapy standing
It should be noted that standing position offers more opportunities for physical exertion and training of legs and arms.
Restorative gymnastics is based on the basic exercises:
- Raising the arms: the initial position of the body is straight, the arms are at the seams, the legs are shoulder-width apart. It is necessary to raise your arms while inhaling, lower them down while exhaling. The course should be repeated 4-6 times.
- Squats without taking off your heels with stretching your arms forward. The purpose of the exercise is to maintain balance and exercise the muscles of the legs. The exercise is repeated 4-8 times.
- Tilts left and right with the extension of the opposite arm.
- Turns of the body, which are slow twisting of the torso. The exercise is repeated at least 5 times.
- In order to stretch the joints, perform rotations with the hand and foot, bring their hands into the castle behind.
- Such an exercise helps to train both arms and legs - with an outstretched arm, swing the legs with a small amplitude to the side. It is recommended that you hold the support with your free hand and do not hold your breath. Manipulation is repeated 7-8 times with each leg.
Simulators
After a person who has had a stroke, gets a little stronger and gets used to the active load, you can proceed to classes on special simulators. The use of these devices will not only strengthen the muscle corset and restore motor function, but also improve the overall emotional state of the patient.
During the rehabilitation period, classes should be carried out only under the supervision of a doctor and with the use of cardiomonitors - devices with which you can track the performance of the heart.
Depending on the functional purpose of the simulator, all devices will conditionally be combined into several groups.
- A verticalizer is a device that gives a vertical position to the body of a person who cannot do this on his own. Such a simulator supports a person and gradually prepares him for upright posture.
- Lokomat is a skeleton simulator - a device for those who learn to walk again.
- Mini-simulators are devices for training limbs and restoring the motor skills of fingers.
- Asset-pass simulators help restore the function of the joints of the upper and lower extremities.
- Exercise bikes increase endurance and improve the general condition of the patient.
Important Rules
Rehabilitation is an incredibly important stage in the treatment process, so you can not lose precious time. There are some rules, the implementation of which will help to achieve success and achieve good results in restoring the body of a sick person.
First of all, you must strictly adhere to the advice of your doctor. This means that you can not engage in amateur activity. Remember, only a specialist with education and work experience can correctly select and calculate the amount and intensity of physical activity in each case, that is, draw up a physical therapy program after a stroke. The set of exercises is strictly individual.
Engaged in active physical education, you can not overwork. The load should begin with light exercises, gradually moving to more complex ones. It is important to understand that the goal of physical activity is not muscle building, but the stimulation of new brain cells to work.
Before performing any workloads (active or passive), it is extremely important to warm the skin so that all tissues receive blood flow. This is especially true for bedridden patients.
People who are close to a sick person need to monitor his mood, gently demand that he follow the doctor’s instructions, to note any of his successes.
Do not forget about the methodological and systematic nature of rehabilitation measures. Exercises should be daily. Time is the best medicine.