Stroke Recovery: Physical Therapy's Benefits And Advantages

Stroke is a leading cause of long-term disability and can result in a loss of mobility and movement. Physical therapy can help stroke patients regain movement and walking ability, decrease disability, and improve function.

Physical therapy for stroke patients can help stimulate affected muscles and nerves to maintain circulation and prevent stiffness, and guide patients through the stages of stroke recovery as they relearn basic muscle movements.

Therapy can include exercises, stretching, and range-of-motion activities, as well as training on mobility aids such as walkers or canes.

The type of physical therapy and rehabilitation program will depend on the patient's immediate physical needs and complication risks. Inpatient programs are intensive and incorporate multiple areas of expertise into patient monitoring and treatment, while outpatient programs provide treatment without requiring that patient’s stay overnight.

Physical therapy can help stroke patients retrain their healthy brain cells to control the affected body parts and improve their overall quality of life.

Improving Movement and Walking Ability

Physical therapy is a vital part of the rehabilitation process for stroke patients, with the ultimate goal of helping them regain as much function and independence as possible. Physical therapy can help stroke patients improve their walking ability, balance, coordination, and overall mobility.

One of the first goals of physical therapy for stroke patients is to help them regain movement and strength in their arms and legs. This often begins with passive exercises, where the patient is assisted by a therapist or caregiver in moving their limbs. This can help stimulate neuroplasticity and encourage the brain to rewire and heal itself. As the patient's strength and mobility improve, they can progress to active exercises, where they perform the movements independently.

Balance training is an important component of physical therapy for stroke patients, as it helps them improve their balance and coordination, reducing the risk of falls. This type of training involves practicing activities that challenge balance, such as standing on an uneven surface or walking in a straight line.

Gait training is also a crucial aspect of physical therapy for stroke patients, as it helps them improve their walking ability. This may include practicing walking heel-to-toe, walking in a square pattern, or using a walker or cane for support. Gait training can help stroke patients improve their walking speed, endurance, and overall mobility.

In addition to balance and gait training, physical therapists may also incorporate strengthening exercises to help stroke patients improve their muscle strength. These exercises focus on building strength in the legs, arms, and core, which can help improve the patient's ability to walk and perform daily activities.

Another technique used in physical therapy for stroke patients is constraint-induced movement therapy. This involves constraining the unaffected arm to force the use of the affected arm, helping the patient regain function in their affected arm.

Overall, physical therapy plays a crucial role in helping stroke patients improve their movement and walking ability. By incorporating a variety of exercises and techniques, physical therapists can help stroke patients regain their independence and improve their quality of life.

Reducing Disability

Stroke is a leading cause of long-term disability, and physical therapy is an important part of the recovery process. Physical therapy can help stroke patients to restore movement and walking ability, decrease disability, and improve function.

Early Mobilisation

Immobility is associated with a number of post-stroke complications, such as deep vein thrombosis. Early mobilisation can help to prevent these complications and aid recovery. It is recommended that mobilisation begins within 24-48 hours of stroke onset, unless the patient is receiving palliative care.

Gait & Mobility

The ability to walk independently is a high priority for many stroke patients. Gait and mobility training can help to improve walking distance and reduce anxiety. Gait and mobility exercises include:

• Circuit class therapy
• Treadmill training
• Virtual reality training
• Electromechanical-assisted gait training
• Cueing of cadence
• Functional electrical stimulation
• Overground walking
• Community walking

Upper Limb

Up to 85% of individuals post-stroke experience altered arm function, and loss of arm function adversely affects quality of life. Upper limb exercises include:

• Bilateral arm training
• Constraint-induced movement therapy
• Electrical stimulation
• Robot-assisted arm training
• Virtual reality
• Mirror therapy
• Mental practice
• Progressive resistance training

Spasticity Management

Spasticity is common after a stroke, especially in a non-functional arm. It can cause discomfort or pain and is associated with activity limitation. Stretching is not recommended for reducing spasticity, but other treatments include:

• Adjunct therapies such as electrical stimulation, casting, taping, and stretching
• Botulinum toxin injections

Contracture Management

Contractures are not uncommon in limbs affected by spasticity, and can impede activities such as washing or dressing. Serial casting may be trialled to reduce severe, persistent contractures. Active motor training should also be provided to elicit muscle activity.

Improving Function

Physical therapy can help patients regain movement patterns such as:

• Getting out of a chair
• Walking
• Climbing stairs

To achieve this, physical therapists use a variety of techniques, including:

• Task-oriented and functional training
• Strength training
• Walking and balance training
• Constraint-induced movement therapy
• Electrical stimulation
• Virtual reality or video game tools
• Biofeedback
• Aquatic therapy

The duration of physical therapy depends on the severity of the stroke and the patient's level of disability. It may be required for months or even years.

Relearning Basic Skills

Stroke patients often experience paralysis on one side of the body, resulting in a loss of function in one arm and one leg. Physical therapy helps stroke patients relearn basic skills and retrain their healthy brain cells to control the affected body parts.

Physical therapy for stroke patients typically begins in the hospital shortly after the stroke, focusing on simple tasks like trying to pick up an object. Over time, the program progresses to help patients relearn more complex motor tasks like walking.

• Task-oriented training: This involves practicing real-life motions, such as getting up from a chair, walking, climbing stairs, and other daily activities.
• Strength training: This can include traditional strength training with weights or functional strength training, such as practicing real-time tasks like rising from a chair to strengthen leg muscles.
• Walking and balance training: Physical therapists use various methods to improve balance and walking, such as bearing weight on the affected leg, walking on a treadmill, stepping onto stairs, and walking over different surfaces.
• Constraint-induced movement therapy: This involves constraining the patient's strong arm with a mitten or a sling to force them to use the affected arm to perform daily tasks, building strength and control.
• Functional electrical stimulation: Small electrical pulses are used to activate nerves and stimulate weakened muscles, improving movement and control.
• Motor imagery and mental practice: This technique uses tools to strengthen arms, hands, feet, and legs by "rehearsing" movements without actually performing them, stimulating the brain to control the desired movement.
• Positioning: Proper positioning helps reduce muscle pain, spasms, slowness, or stiffness resulting from the stroke. Physical therapists teach patients how to safely transfer from sitting to standing and how to support themselves when sitting or lying down using aids like foam wedges and slings.

Preventing Complications

Physical therapy is a key component of the rehabilitation process for many people who have had a stroke. It can help improve recovery and minimise disability. During physical therapy, a therapist uses a variety of techniques to help stroke survivors regain their ability to move, such as strengthening exercises, treadmill training, or having them perform everyday activities.

• Preventing immobility-related complications: Immobility is associated with a number of post-stroke complications such as deep vein thrombosis. Physical therapy can help stroke survivors regain movement and prevent these complications.
• Reducing the risk of falls: Balance difficulties are common after a stroke, often due to reduced limb and trunk motor control. Physical therapy can help improve balance and reduce the risk of falls.
• Improving cardiorespiratory fitness: Rehabilitation should include individually tailored exercise interventions to improve cardiorespiratory fitness.
• Managing spasticity: Spasticity is common after a stroke and can cause discomfort or pain. Physical therapy techniques such as stretching, electrical stimulation, and the use of muscle relaxants can help manage spasticity.
• Preventing contractures: A muscle contracture is a permanent shortening of a muscle or joint. Physical therapy techniques such as active motor training and serial casting can help prevent or treat contractures.
• Managing fatigue: Fatigue is a common complaint after a stroke and can impact daily living activities. Physical therapy can help identify triggers and re-energizers, and provide strategies to manage fatigue.

Frequently asked questions