Regaining Movement After A Stroke: What You Need To Know

Regaining movement after a stroke is possible, but the recovery process is different for everyone. Rehabilitation is key to regaining movement, and it's important to start as soon as possible. A team of rehabilitation nurses, physical therapists, and occupational therapists will create a specific plan to help the patient regain their abilities. This may include relearning basic tasks and exercises to rebuild strength and balance. The brain's ability to rewire itself through neuroplasticity plays a crucial role in recovery, and consistent practice is essential. While recovery can be frustrating and slow, giving yourself time and working closely with a rehab team can improve your chances of regaining movement.

Passive exercises can help stimulate the brain and activate neuroplasticity

Passive exercises can be performed independently by using the non-affected arm to move the affected arm. Alternatively, a therapist or trained caregiver can move the affected arm for the patient.

Passive exercises are an excellent way to stimulate the brain and activate neuroplasticity. Neuroplasticity refers to the brain's ability to restructure or rewire itself when it recognises the need for adaptation. In other words, it can continue developing and changing throughout life.

Neuroplasticity works regardless of the severity of arm mobility impairment. What matters is that the brain is stimulated by moving the arm.

Passive exercises can help stroke survivors regain arm movement over time and with dedication. Even if results are not immediate, passive exercises still have tremendous benefits. It is important to move flaccid limbs through their range of motion to help prevent muscle shortening and joint stiffness, reducing the risk of developing contractures.

Neuroplasticity occurs based on experiences and practices. To regain arm movement after a stroke, it is necessary to encourage the brain to adapt through repetitive practice. When a skill is practised, specific neural pathways in the brain are activated. These neural pathways may initially be weak but can be strengthened through repetition.

Therefore, passive exercises are a valuable tool to stimulate the brain and activate neuroplasticity, helping stroke survivors on their road to recovery.

Rehabilitation psychologists can help stroke patients with cognitive and emotional impacts

A stroke is a life-altering event that can have severe physical, cognitive, and emotional impacts. Rehabilitation psychologists play a crucial role in helping stroke patients cope with these challenges and improving their overall cognitive and emotional functioning.

Stroke patients often experience a range of emotional difficulties, including depression, anxiety, and insomnia. These issues can negatively impact their rehabilitation and recovery journey. Rehabilitation psychologists are trained to assess and address these emotional challenges. They provide psychological interventions and therapies to help patients cope with the emotional fallout of a stroke and make sense of their new reality.

One of the key roles of rehabilitation psychologists is to help stroke patients and their caregivers understand and adjust to cognitive impairments. They can provide strategies and techniques to improve cognitive function and build resilience in the face of permanent lifestyle changes. This may include teaching new coping strategies and helping patients draw on their residual strengths to manage their new circumstances effectively.

Rehabilitation psychologists also support patients in dealing with the psychological aspects of physical disabilities resulting from a stroke. They can help patients come to terms with their physical limitations and find ways to adapt to their new condition. This may involve working with patients to set realistic goals, improve their motivation, and develop problem-solving skills to overcome challenges.

Additionally, rehabilitation psychologists can provide valuable support to caregivers of stroke patients. Caregivers often experience stress, anxiety, and depression due to the challenges of caring for a loved one with a stroke. Psychologists can offer guidance, education, and emotional support to caregivers, helping them navigate the complexities of their new roles and responsibilities.

By addressing the cognitive and emotional impacts of a stroke, rehabilitation psychologists play a vital role in the recovery process. They work collaboratively with other healthcare professionals, such as neurologists and physical therapists, to ensure holistic patient care. Through their interventions, rehabilitation psychologists can help stroke patients regain a sense of control, improve their quality of life, and facilitate their reintegration into the community.

Physical therapy exercises can improve gait after a stroke

Stroke is a leading cause of long-term disability, and gait recovery is often a primary goal for patients. Gait training is the process of improving walking function and mechanics through practice and specific exercises. Gait training for stroke patients takes a slightly different approach.

The ability to walk may be impaired after a stroke due to the brain having difficulty sending the correct signals to the body, resulting in weakness, imbalance, or coordination issues that affect gait. Depending on the type of stroke and what part of the brain is affected, patients may struggle with different aspects of walking. Some examples include decreased dorsiflexion, knee flexion, and hip flexion, which make it harder to swing the leg through each step. Gait training exercises primarily target the legs but can also include the feet, trunk, and arms.

• Seated leg lifts: Lift the affected leg into the chest and then place it back down, alternating between legs for 20-30 reps.
• Flamingo stand: Practice standing on one leg for 30 seconds, then switch to the other foot.
• Knee extensions: Extend the leg out in front, parallel to the floor, and then slowly bring it back down, alternating between legs for 10 reps.
• Leg lifts: Lift the leg out to the side and hold for a few seconds, then bring it back down, doing 15 reps on each side.

Balance and core exercises are also important for gait training, as walking requires coordination from the full body. Some examples include:

• Abdominal draw-in: Lay on the back with bent legs and try to flatten the lower back by engaging the abdominals, then slowly lower and lift one leg at a time for 20 reps.
• Knee-to-chest hug: Pull one knee up to the chest while the other leg stays straight, holding for 3-5 seconds and alternating for 10 reps.

Foot exercises can also help improve gait and stability, such as:

• Ankle dorsiflexion: Move the foot up towards the knee and then extend it back down, doing 20 reps.
• Assisted toe raises: Use the unaffected foot to assist the affected foot in raising and lowering, doing 15 reps.
• Heel raises: Point the toes and lift the heels, doing 15 reps.

Other rehabilitation methods that can supplement gait training exercises include strength training, balance and core training, functional electrical stimulation, and high-tech home exercise equipment. Improving gait after a stroke requires a comprehensive and individualized approach, combining various exercises and rehabilitation methods.

Electrical stimulation can be used to retrain the brain to activate muscles needed for walking

Electrical stimulation is a promising technique that can be used to retrain the brain to activate muscles needed for walking. This method, known as Functional Electrical Stimulation (FES), involves delivering short bursts of electrical pulses to the muscles, causing them to contract and produce functional movements.

FES has been shown to induce short- and long-term neurophysiological changes in the central nervous system, including the spinal cord and cortical neural circuits. This stimulation can be applied in a functional manner to activate paralysed muscles and generate limb movements, particularly in individuals who have sustained central nervous system injuries such as a stroke.

The application of FES over time can help individuals with neurological impairments regain some voluntary function. During FES therapy (FEST), individuals are asked to attempt each movement, and FES is applied by the therapist to assist in completing the movement. This associative intervention likely involves Hebbian learning principles, where the simultaneous activation of pre- and post-synaptic terminals strengthens the connection.

Brain-computer interface (BCI) technologies offer a way to synchronize cortical commands and movements generated by FES, which is advantageous for inducing neuroplasticity. BCI systems can translate brain signals into novel outputs and effectively synchronize cortical commands with FES-generated movements.

Clinical studies have shown that BCI-controlled FES is more effective in producing functional and cortical changes compared to FES alone. This combination of cortical activation and peripheral stimulation can enhance associative Hebbian learning and facilitate the creation of new pathways for transmitting neuronal commands from the cortex to the desired muscles.

Overall, electrical stimulation is a promising approach to retrain the brain and improve motor function, with potential applications in stroke rehabilitation to enhance walking ability.

Speech therapy can help patients with language impairments after a stroke

A stroke is a life-threatening medical condition that requires immediate treatment. The road to recovery after a stroke can be long and uncertain, and different people recover in a range of ways. Starting to move more after a stroke can be a massive boost to your recovery, your confidence, and your well-being. Physical and occupational therapy can help determine which areas of the brain have been affected by working with a patient to complete various tasks, like walking or brushing their hair.

Speech-language therapy is crucial for patients who experience language impairments after a stroke. Speech-language pathologists, also known as speech therapists, are experts in communication, cognition, and eating/swallowing rehabilitation. They can provide personalized exercises to help individuals recover their speech production skills. Here are some ways in which speech therapy can help patients with language impairments:

• Breathing exercises: People with aphasia, a common language impairment after a stroke, often have trouble regulating their breathing while speaking. Breathing exercises help them learn to plan breathing pauses, making it easier to speak at length and be understood.
• Tongue strengthening exercises: Tongue stretches and exercises strengthen the tongue muscle and improve neural pathways, making it easier for patients to form words and produce the right sounds.
• Practicing speech sounds: Aphasia patients often struggle with making the right sounds and words. Focused practice on specific sounds and words can help them improve their speech clarity and strength.
• Sentence practice: While singular word formation may not be an issue, many stroke patients struggle with forming complete and correct sentences. Combining sentence practice with other exercises, such as naming pictures, can help link speech to communication.
• Visualising speech: Even if a patient cannot physically produce speech, visualising themselves practicing verbal exercises can promote brain adaptation and rewiring, which is crucial for recovery.
• Singing therapy: Singing therapy can be effective, especially for those with aphasia. Singing activates the right hemisphere of the brain, allowing individuals to produce words in different pitches and rhythms, even when they cannot speak normally.

The key to successful recovery after a stroke is repetition and consistency in practicing speech therapy exercises. This sparks neuroplasticity, the brain's ability to rewire itself, which is essential for regaining lost skills and improving language abilities.

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