Looking for new ways to help your stroke survivor patient move forward? Every 40 seconds, someone in the United States has a stroke. In other words, there are more than 795,000 stroke survivors living with the consequences of stroke in the U.S. each year.
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The thing is…
It doesn't end when they leave the hospital.
Chronic stroke recovery is an ongoing process that can take months and years after a stroke. And with a few important exercise strategies, this is where real change can take place.
Key takeaways:
- Recovery doesn't end when stroke survivors leave the hospital.
- Exercise is one of the most important tools in chronic stroke recovery.
- The best exercise programs include movement-based activities that are progressive.
- Consistency and effort are more important than starting at a high level of intensity.
- A full recovery from stroke is possible, but it takes time.
The Link Between Exercise and Chronic Stroke Recovery
Stroke reduces mobility in more than half of stroke survivors age 65 and older, affecting the ability to do basic functions like walking, sitting, climbing stairs, and more. But many people are surprised to learn the following…
Exercise is one of the most important things chronic stroke survivors can do to improve movement.
The chronic phase of stroke recovery generally starts around 6 months after the initial injury and can last for years. It's during this phase that stroke survivors are at risk of developing learned non-use, or giving up trying to move the affected parts of their body because it's hard.
But when you exercise those affected body parts, amazing things happen. Exercise and chronic stroke research shows that carefully directed exercises can create meaningful improvements in strength, balance, walking speed, and more.
This is because of the power of neuroplasticity. Your brain is able to create new pathways and connections at any time throughout your life. The right exercises can lead the brain to repair the areas affected by stroke.
Cool, right?
Studies show that over 80% of stroke survivors experience varying degrees of motor function loss, with 50% still have motor dysfunction 3 months after stroke. But a tailored exercise plan can lead to dramatic improvements.
Exercise for Stroke Recovery: The Movement Matters
If you have stroke, there is damage to certain parts of your brain. But did you know your brain has the ability to change itself by forming new connections around damaged areas?
This process is called neuroplasticity, and the best way to make it happen is through movement. This is especially true for stroke recovery.
The power of movement-based exercises includes:
- increased blood flow to affected areas of the brain
- stimulation of new neural pathways
- reduction of inflammation
- increased confidence and reduced fear
Stroke recovery studies have shown that stroke survivors who participate in regular exercise routines have better walking speed, balance, muscle strength, and even emotional health.
But the type of movement is just as important as the regularity of the movements.
Exercise Approaches That Help With Chronic Stroke Recovery
Not all exercises and movements are created equal when it comes to helping chronic stroke survivors recover mobility.
I'll break down the types of exercise that studies have shown are the most helpful for long-term recovery.
Aerobic Exercise is Important to Chronic Stroke Recovery
If there is one area of exercise that should be the foundation of any chronic stroke recovery program, it's cardiovascular training.
When you have stroke, your ability to perform cardiovascular exercise is usually drastically reduced. Some research has even found that stroke patients have approximately 50% lower cardiopulmonary fitness than those without stroke.
The best aerobic exercises for stroke recovery include:
- walking programs (start slow and gradually increase over time)
- stationary cycling (helps to build leg strength and endurance)
- water aerobics (low-impact with buoyancy to support weight)
Moderate-intensity activity for 20-30 minutes 3-5 times per week is an ideal place to start. But don't worry if you aren't at that level yet. Start where you are and work to gradually increase over time.
Strength Training to Rebuild After Stroke
Muscle weakness and loss of strength is a common consequence of stroke on both the affected side of the body and the unaffected side. Studies show that stroke survivors can lose strength on both sides of the body.
Strength training for stroke recovery should include:
- progressive resistance with weights, bands, or bodyweight
- functional movements that mimic daily activities
- core exercises to improve stability and balance
The goal is not to "bulk up" but to rebuild strength necessary for daily living.
Balance and Coordination Exercises
Falls are one of the leading fears for chronic stroke survivors, and for good reason. Balance issues are extremely common following stroke.
Balance exercises should include:
- standing exercises on different surfaces (pillows, foam pads)
- weight shifting activities
- dual-task training (performing two activities simultaneously)
Challenge your balance in a safe way and work to build confidence.
Task-Specific Training to Practice Essential Movements
Task-specific training is exactly what it sounds like. You practice specific tasks and movements that you want to get better at.
If walking is difficult, practice walking. If reaching and grasping is challenging, then reach and grasp as part of your therapy.
Task-specific training can include:
- Gait training for walking improvement
- Reaching and grasping exercises for arm and hand function
- Stair climbing for functional mobility
Task-specific training works because it helps the brain and body work together to perform functional tasks.
Form a Game Plan to Build Mobility
Ready to put it all together? Let's talk about how to form an exercise and movement plan for chronic stroke recovery.
Assess Where the Patient Is at Present
The first step of any exercise program is an assessment to see where the stroke survivor is at with their current level of mobility, strength, balance, and cardiorespiratory fitness.
A professional physical therapist can provide this evaluation.
Create a Weekly Exercise Plan
Ideally, a chronic stroke exercise program should include all of the elements above in a weekly plan.
For example:
- Monday: Aerobic exercise and balance training
- Tuesday: Strength training and task-specific practice
- Wednesday: Aerobic exercise and flexibility
- Thursday: Strength training and coordination work
- Friday: Aerobic exercise and balance training
- Saturday: Task-specific practice and fun activities
- Sunday: Rest or gentle movement
The key here is to be consistent and not overdo it.
Track Progress and Celebrate Improvements
One of the most underrated parts of an exercise program is progress tracking.
Keep a simple log of what exercises were done, how the stroke survivor felt, and any progress noted.
This information is gold when it comes to making adjustments and fine-tuning the exercise approach.
Common Obstacles in Stroke Recovery Exercise Programs
In the real world, chronic stroke recovery isn't always easy or smooth. There are common obstacles that make exercise difficult for stroke survivors.
Fatigue and Energy Level Management
Fatigue is one of the biggest challenges to exercise and movement for stroke survivors. The key is working with your energy levels rather than trying to push through.
Some tips for fatigue management include:
- exercising when energy levels are highest
- breaking up workouts into smaller sessions
- listening to the body and resting when needed
Fear and Confidence
It's completely normal to be afraid of falling or injuring yourself again. Building confidence takes time, but exercise can help.
Some tips for increasing confidence:
- start with supported exercises
- use proper safety equipment
- work with qualified professionals
- celebrate the small victories
Important: Always consult a doctor before starting any exercise program. If you experience chest pain, shortness of breath, dizziness, or weakness, stop exercise immediately.
The Future of Stroke Recovery Through Exercise
Chronic stroke recovery is not a race. It's a long journey that requires patience, consistency, and effort.
The key takeaways from this guide are:
- Chronic stroke recovery starts with an assessment.
- All types of exercise should be included in an exercise plan.
- Stroke survivors should track progress and celebrate victories.
- Working with qualified professionals is important for safety and support.
- Listening to your body is important to avoid overexertion and injury.
- Consistency and patience are key in recovery.
Complete recovery from stroke may look different for each person, but exercise provides the best chance at regaining independence and quality of life.
Don't wait to be motivated. The best time to start is now.
You'll be glad you took every opportunity to exercise moving forward.
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