Exercise after a stroke is crucial to your recovery, but knowing exactly what exercises to do can seem overwhelming. Every stroke is different and each survivor will experience different side effects. This means that the best exercises to do after a stroke vary from person to person. Your treatment team should develop post-stroke exercise guidelines tailored to your needs.
The type of stroke, the area of the brain affected, and the severity of symptoms influence the type of exercise that will be most beneficial for each survivor. For example, some stroke survivors may be able to do active exercise immediately after the stroke, while others will need to focus on passive exercise first. Additionally, some stroke survivors may do aerobic exercise in addition to walking, while for others, gait training may be the primary goal.
It is important for anyone who has experienced a stroke to work closely with their treatment team to obtain the best recommendations. This will help you create a plan tailored to your recovery journey so you can achieve your own unique goals. To help you have this conversation, it may be helpful to know the benefits and types of exercises available after a stroke.
Why exercise after a stroke is important
Exercise after a stroke is crucial for two main reasons: rehabilitating the physical effects of a stroke and preventing another stroke. For these reasons, it is important to perform exercises that improve mobility, strength and overall cardiovascular health.
Often, a stroke leads to a physical disability, such as hemiplegia or hemiparesis. This refers to paralysis or weakness on one side of the body, which can affect many aspects of a survivor’s life. These impairments increase the risk of falling after a stroke and reduce performance in activities of daily living (ADL). Therefore, a tailored post-stroke exercise regimen should be developed to improve safety and independence.
Stroke prevention is another reason why exercise after a stroke is so important. According to American Stroke Association1 in 4 people who survive will experience a second stroke. A stroke is usually not an isolated event, and risk factors often precede a stroke. Risk factors for stroke include high blood pressure, high cholesterol, diabetes and obesity. Fortunately, all of these conditions can be improved with exercise and other stroke prevention practices.
Although exercise is essential for good health and recovery after a stroke, stroke survivors should remember safe techniques to avoid excessive physical exertion. Putting too much pressure on the body can potentially result in stroke regression or exacerbate conditions such as post-stroke fatigue. Stroke patients will achieve the best results with a balanced treatment regimen designed with the help of a therapist.
To get an idea of what exercises your treatment team may recommend, let’s take a look at the latest guidelines. We will review recommendations for exercise repetition and frequency to maximize recovery.
Exercise guidelines after stroke
Because a stroke causes brain damage, survivors may experience secondary physical, cognitive, and even emotional effects. Therefore, the best exercise for you after a stroke depends on your individual symptoms and fitness level, as well as any pre-existing conditions. Many stroke survivors will receive guidelines and recommendations that prioritize stroke rehabilitation and stroke prevention to help address these concerns.
Here are the current guidelines for exercise after stroke, as recommended American Heart Association: :
- Early mobilization is a valuable tool for people in the acute stage of stroke rehabilitation if the patient’s health condition is stable. Early stage exercises should be performed as tolerated by the patient and may include sitting or standing, self-care activities and walking at a low level. Early mobilization can help limit deconditioning, improve vital signs, and reduce the risk of other medical complications such as pneumonia.
- Aerobic exercise should be prioritized for a variety of reasons, including preventing another stroke. Aerobic exercise, such as walking or cycling with your arms/legs, can improve walking efficiency, increase endurance, and even improve cognitive function. Experts recommend aerobic exercise after stroke for 20-60 minutes a day, 3-5 days a week. Dosage should be adjusted depending on the individual’s fitness level.
- Strength exercises It is recommended to reverse the muscle wasting that usually occurs during and several days after hospitalization. Muscle strengthening can help increase independence, reduce side effects such as foot drop, and improve endurance. Strength training should be performed 2-3 days a week and consist of 8-10 exercises involving the main muscle groups. These exercises should be performed in at least one set of 10-15 repetitions, and the resistance should be increased over time, depending on individual progress.
- Stretching and range of motion exercises are essential components of post-stroke exercise programs. These exercises can improve flexibility, reduce the risk of injury, and help prevent contractures after a stroke. Range of motion exercises should be performed 2-3 days a week, and each exercise should last at least 10-30 seconds.
- Balance exercises AND basic exercises after a stroke, are recommended to increase safety during everyday activities and reduce the risk of falling. These exercises should be included in your post-stroke exercise program at least 2-3 days a week.
- Walking exercises refers to exercises focused on walking and should be a top priority to help patients return to their pre-stroke level of activity as quickly as possible. Gait training can help increase independence in daily activities and improve tolerance of long-term physical activity. Your physiotherapist will help you start walking training, even if you need help at first.
It is important to work with your treatment team to establish exercise goals after a stroke. Your team will likely include a physiotherapist, an occupational therapist and a speech therapist. While your PT and OT can provide exercises for your arms, legs, and balance, your speech therapist can provide exercises to improve your speech and swallowing after a stroke
Some patients may need to prioritize gait training to develop the motivation to pursue consistent aerobic exercise after stroke. Other patients with mild secondary effects may be able to adapt to both gait training and other forms of aerobic exercise. No matter what your doctor or therapist recommends, one thing remains the same throughout the stroke recovery process: consistency and consistency count.
Repetition is the key to exercise after a stroke
Some therapists call rehabilitation exercises the so-called neuromuscular training, which focuses on training your nerves and muscles to communicate. When a stroke disrupts the connections between the brain and muscles (resulting in impaired movement patterns), neuromuscular training can help restore movement by activating neuroplasticity.
Neuroplasticity is the brain’s natural ability to reorganize and learn new skills. In this way, stroke patients can regain lost abilities in everyday life, such as walking, dressing and moving around. By practicing therapeutic exercises after a stroke, survivors can reconnect these connections to healthy areas of the brain to help regain lost function.
When discussing the best post-stroke exercises with your therapist, you may hear that they refer to something called mass practice. This refers to the high number of repetitions used to stimulate neuroplasticity during stroke therapy exercises.
The brain requires intense repetition to learn new skills because it likes to be efficient. When something is done frequently, the brain learns that the task is important and responds by making it easier to complete. Many therapists emphasize high repetitions to encourage neuroplasticity during rehabilitation. The more you consistently practice an exercise or task, the easier it will become.
Preparing for exercise after a stroke
It is important for stroke patients to work closely with their treatment team to develop an exercise plan that takes into account their specific needs and goals. Post-stroke exercise guidelines typically include a unique combination of aerobic exercise, strength training, range of motion, and balance. Exercise after a stroke (along with other healthy habits) can maximize your recovery and prevent another stroke.
For an extra boost of motivation, try incorporating game-based rehabilitation equipment into your rehabilitation program, such as FitMi home therapy from Flint Rehab. This device is designed to assist with neuromuscular training at home and can motivate stroke survivors to perform therapeutic exercises frequently.