Physiotherapy exercises for stroke: exercises and expert recommendations

Rehabilitation after a stroke involves the implementation of restorative measures in a complex - medication therapy, physiotherapy exercises, physiotherapy procedures, massages and unconventional methods of influencing the nervous cells.

Physiotherapy (exercise therapy) after a stroke occupies a predetermining place in this entire list, since by physical impact on atrophied muscles can make immobilized limbs, speech apparatus, visual organs.

The condition for the effectiveness of the recovery process is the rational distribution of the load on the muscles and the regular implementation of the exercises recommended by the attending physician.

The role of exercise therapy in patient recovery

Physical therapy is an integral part of a stroke recovery program. Its benefits are as follows:

• the possibility of restoring the mobility of the joints of the limbs and returning tense muscles to normal;
• prevention of the appearance of complications such as bedsores on the back, buttocks and feet in bedridden patients;
• return of sensitivity and mobility of paralyzed limbs;
• removal of muscle hypertonia and prevention of the formation of contractures;
• elimination of speech disorders by acting on facial and language muscles;
• restoration of hand motor skills, writing and drawing skills;
• improved vision;
• restoration of the whole body.

For the effectiveness of exercise therapy after a stroke, physical exercise must be combined with other methods. recovery - massages, medication, physiotherapy, social and psychological activities adaptation.

Lfk and passive loads

The post-stroke recovery period begins 3-4 days after the attack with the performance of passive gymnastics. Medical staff or trained relatives do the exercises instead of the patient, making their own efforts to regain sensitivity and strength in the limbs.

Passive exercise therapy begins with a massage, which includes the following manipulations:

• stroking movements in a circle;
• impact on muscle tissue, from the upper back to the legs;
• tapping on the back;
• impact on the muscles of the chest - from the chest to the armpits;
• massaging the arms from the shoulder joint to the fingers, and the legs from the buttocks to the foot.

Initially, the healthy side of the body is massaged, then the affected side of the body.

Passive gymnastics can be performed both in a hospital and at home. To do this, up to 3 times a day for half an hour, a health worker or caregiver for a sick person helps to perform the following exercises:

• hand development - flexion of the fingers followed by extension, rotation of the hand, flexion-extension of the elbow joint, lifting and lowering the shoulder;
• development of a paralyzed leg - flexion followed by extension of the fingers, circular rotation of the feet, bending of the leg at the knee and hip joint;
• restoration of motor skills and grasping reflex - a rounded object is placed in the affected arm of the patient;
• development of limbs in a suspended state - with a leg or hand suspended on a towel, rotational and pendulum movements are performed.

Active physiotherapy exercises

To active exercise therapy after a stroke, when the patient begins to perform gymnastics on his own, they switch after the doctor's recommendation. First, the bias is done on exercises in a supine position, then the development of the limbs while sitting is connected to them. With confident performance of the described exercises, the patient is allowed to engage in physiotherapy exercises while standing.

Lying exercises

1. Straightening the affected limb - with effort, the limb in the joints straightens as far as it is possible (hand - in the elbow joint and wrist, leg - in the knee) and fixed for half an hour with tires.
2. Turns of the head - slowly turn the head first to the left, then to the right, while fixing the gaze in front of you.
3. Flexion and extension of the limbs - in an even position on the back, first, the arm is bent at the elbow, fix it for a few seconds, then unbent it to its original position. A similar exercise is performed with the legs when bending them at the knee joint.
4. Bending the fingers into a fist - the exercise is performed up to 10 times per approach, alternately with both hands, at first - the patient, then - healthy.
5. Pulling up the trunk - while lying on your back, you need to grab the headboard with both hands and pull yourself up to it, as if on a horizontal bar. At the same time, the legs should be straightened as much as possible, and the socks should be extended.
6. Sliding legs - lying on your back with straightened legs, you need to bend them at the knees and pull them towards you, while the feet should not come off the bed.

Sitting exercises

1. Rotation of the head to the sides and tilting.
2. Swing legs - in a sitting position on a solid surface with outstretched legs, it is necessary to slowly raise one limb, then the other.
3. Reduction of the shoulder blades - while sitting with straightened legs, you need to bring your hands behind your back while inhaling, lock them in the lock for a few seconds and then slowly return to their original position as you exhale.
4. Exercise with a gymnastic stick - sitting on a chair, grasp the sports equipment with both hands and rest against the floor. Breathing evenly, it is necessary to swing the body in different directions, while leaning on a stick.
5. Throwing a tennis ball from one hand to the other.

Standing exercises

1. Raising the legs - with your hand resting on the back of the chair, you need to alternately raise your legs and put them on the chair, and then return to their original position.
2. Leading the leg to the side - in the same position, first, one leg is retracted to the side and fixed for 3-5 seconds, then the other.
3. Raising your arms - placing your legs at shoulder level, you need to slowly raise your arms while inhaling, lock them into a lock above your head, and then lower them down as you exhale.
4. Turns of the body - standing with the arms spread apart, turns of the body are performed first in one direction, then in the other.
5. The inclinations are in the position of the hands on the belt, and the legs are shoulder-width apart, you need to inhale, tilt forward, linger for 3-5 seconds and then straighten out with an exhalation.
6. Squats - standing with a straight back, you need to inhale, stretch your arms in front of you and sit down as you exhale. After that, in a sitting position, inhale and exhale after getting up.
7. Walking in place - the exercise is performed for 20 seconds, after which a break is required to restore breathing.

Lfk for eyes after a stroke

In case of visual disturbances caused by a cerebral stroke, the patient is prescribed medication and exercise therapy. The program is designed individually for each patient, but there are a number of basic eye exercises that are suitable for each of them:

1. "Pressing with the palm". The eyes are covered with palms, after which they take several deep breaths through the nose and exhalations through the mouth. Next, the palms are lightly pressed first on the upper, and then on the lower part of the orbit. At the initial stage, the exercise is performed 3-5 times, gradually increasing the number to 15 repetitions.
2. "Squinting". Both eyes close their eyes tightly, hold the position for up to 5 seconds, after which they sharply relax the eye muscles.
3. "Massaging the eyeballs." The closed eyes are massaged with fingers in a circle through the eyelids, while the pressure should be light.
4. "Exercise with a pencil." The pencil is placed in front of the eyes, after which they begin to move it in a circle, in different directions, bringing it closer and removing it. During this exercise, the head should remain motionless.

Mandatory exercises for restoring vision after a stroke are eye movements - left and right, diagonal bevel, up and down, in a circle, bringing the pupils to the bridge of the nose.

Exercise therapy for legs after a stroke

1. Finger movements - flexion, extension, fingering.
2. Abduction of the leg - in the prone position, the leg slides along the surface to the side, while the arms should be located along the body. When performing the exercise while standing, a chair is used instead of a support, and the leg with a straightened back is retracted up and to the side.
3. Pulling up socks - socks should be pulled towards you as much as possible, resting your heels on a hard surface.
4. Knee curls - performed in all body positions.
5. Raising the heels - sitting on a chair, the patient raises the heels, thus accentuating the force of gravity on the toes. After being in this position for 10-15 seconds, you need to return your legs to their original position and rest your heels on the floor.
6. Jumping - within a minute, you need to jump up.

Exercise therapy for hands after a stroke

1. Rotation of the hand in the wrist - circular movements, swing to the sides.
2. Clenching the fingers into a fist, followed by unclenching - when performing the exercise, a rubber ball can be used, which is put into the palm and squeezed as much as possible.
3. Elbow development - rotational movements, flexion-extension.
4. Load on the shoulders - raising the arms at the shoulders and lowering, rotational circular movements in both directions in a position when the arms are raised up and the palms are lowered to the shoulders.
5. "Scissors" - hands are put straight in front of you, after which they cross each other and return to their original position. The exercise is repeated up to 10 times.
6. Development of finger motor skills - it is necessary to sort out objects of different sizes and configurations, previously folded into one container. Items in the form of buttons, peas, nuts, beans and pencils must be taken one at a time.

Articulation and speech

To restore speech and articulation, a patient with a stroke must, from the first days after the attack, perform exercises that may seem too simple for a healthy person:

1. "Smile". Smile broadly, exposing as many teeth as possible, stay in this position for 5-10 seconds, and then close your lips.
2. "Swing". Stick your tongue out of your mouth, lift it up and try to reach the tip of your nose with it. After that, lower your tongue down, trying to reach them to the chin.
3. "Shoulder". Stick out your tongue as far as possible, while lowering its tip down. In this position, linger for 7-10 seconds.
4. "Tube". The lips are folded into a tube and pulled forward as much as possible.
5. "Groove". The tongue is pushed out and rolled up in the form of a gutter for 5-10 seconds.
6. "Biting". Lips alternately bite with teeth - first the upper one, lifting the lower jaw up, then - vice versa.

The exercise therapy program, which restores speech and articulation after a stroke, also includes the pronunciation of letters of the alphabet, words (from simple to complex) and tongue twisters.

Breathing exercises

After the patient has come to his senses and his main life systems begin to work stably, he needs to perform breathing exercises. Regular training of the respiratory system will strengthen it, normalize lung function and eliminate congestion, as well as reduce the hypertonicity of the facial muscles.

Before starting a workout, you need to sit down, lean on a hard surface, rest your feet on the floor or stretch them out on the bed, and put your hands on your knees. Exercises are performed from 4 to 8 repetitions, depending on the patient's well-being.

Exercise number 1.

Hands are spread apart. At the entrance through the nose, bend forward, bringing the hands together in the form of hugging oneself by the shoulders. After a delay in this position for a few seconds, the hands are parted to their original position, while the exhalation is carried out through the mouth.

Exercise number 2.

The palms are located on the thighs in the first third of them. On inhalation through the nose, the arms are straightened at the elbows, the chest is pulled up. After a few seconds, exhalation is carried out through the mouth, the arms relax and the body bends forward.

Exercise number 3.

The palms are on the belt. On inhalation through the nose, the palms slide along the waist and close in front of the body with the back as tightly as possible to each other, after which they go down in this position. The chin at this moment should be pressed against the chest. On exhalation through the mouth, the hands are maximally retracted behind the back, and the head rises up.

When performing breathing exercises, your eyes should be open. In case of dizziness, shortness of breath or nausea, classes should be stopped, and further actions should be agreed with a doctor.

Exercise machines and their role after a stroke

For the efficiency and speed of recovery of movement functions after a stroke, the following simulators are used:

• A walker is the simplest exercise machine used to restore gait function.
• Exercise bike - necessary to restore the functions of movement of the lower extremities, strengthen the cardiovascular system and improve the body as a whole.
• Exercise machine "Bud" - is used to develop the hand, restore the grasping reflex, the function of "squeezing - unclenching".
• Exercise machine "Shagonog" - helps to strengthen the muscle tissue of the legs in bedridden patients.
• Verticalizer - helps to restore the functioning of the vestibular apparatus, giving an upright position to the body.
• Robotic simulators are machines programmed for the execution of brain commands by parts of the body.
• Step platform - helps to restore the function of walking up the stairs and strengthen the calf muscles.

Before using any simulator, you should consult your doctor. Only a specialist can recommend an effective model and the degree of load on the body, taking into account the nature of motor dysfunctions.

Contraindications to exercise therapy

Despite the effectiveness of the use of exercise therapy in the recovery period after a stroke, there are a number of pathological conditions in which classes are contraindicated:

• severe pain syndrome;
• a second attack in an elderly person;
• increased body temperature;
• pneumonia, pulmonary edema;
• heart disease;
• tachycardia;
• arterial hypertension in the acute stage;
• epileptic seizures;
• diabetes;
• psychical deviations;
• malignant tumors;
• tuberculosis;
• coma.

If there is a history of the described diseases, the attending physician draws up an individual program, selecting gentle exercises to restore motor functions. In case of manifestation of acute conditions (for example, high temperature or hypertensive crisis), it is necessary to wait for the normalization of health and only after that proceed to physiotherapy exercises.

Source: http://progolovy.ru/zabolevaniya/lfk-posle-insulta-kompleks-uprazhnenij

Exercise therapy for stroke

Stroke - This is a brain damage in acute cerebrovascular accident. This disease is one of the most disabling and socially maladjusted. That is, in many cases, the patient becomes helpless, requiring constant care and attention.

These disorders, as a rule, are the cause of spastic paralysis, as well as paresis of the extremities on the opposite side of the body in relation to the focus of brain damage.

At the same time, muscle tone in the flexors of the arm and extensors of the leg increases, and accordingly, the tone in the extensor muscles of the arm and flexors of the leg decreases.

Due to this factor, contracture with flexion in the elbow joint and pronation is noted in the hand. wrist joint, as for the lower limb - there is a pronounced extension in the knee joint.

After the patient's condition becomes stable, it is necessary to begin motor rehabilitation, gradually increasing the intensity of therapeutic exercises included in the course of exercise therapy for stroke. It is very important to start doing physical therapy and therapeutic exercises for stroke during the time, because thanks to therapeutic exercises, a number of positive changes occur in the body, namely:

1. There is a significant improvement in the work of the cardiovascular system, as well as the functions of other systems and organs.
2. Correct breathing is being established.
3. Locally increased muscle tone is reduced and the development of contractures is prevented.
4. Healthy muscles are strengthened.
5. The overall emotional state improves significantly.
6. The patient adapts to his social functioning, and if possible, he can return to daily duties (this therapy is called occupational therapy).

Therapeutic gymnastics in stroke contributes to the fact that, during therapeutic exercises, compensatory mechanisms are involved in the process to restore lost functions. Moreover, multiple repetitions of exercises cause the emergence of new reflex connections.

Elementary course of physiotherapy exercises for stroke includes passive movements of the affected limbs, as well as massage. Passive exercise therapy for stroke carried out with the help of an instructor-methodologist. The main purpose of these exercises is to relax the muscles of the affected body part.

Massage should be done taking into account the affected muscle. The extensors should be massaged on the arm, and the flexors of the lower leg and foot on the leg. Then you need to smoothly move from passive to active movements.

Moreover, at first, active therapeutic exercises for stroke are performed with a healthy part of the body without extraneous help, and then, with the help of an instructor-methodologist, the muscles of the paralyzed part are gradually involved in the process body. Exercises should be performed at a slow pace, gently, smoothly, in no case should they cause acute pain.

As a rule, exercises begin in the proximal regions and gradually move on to the distal regions. Exercises must be repeated many times, while it is necessary to ensure that breathing is rhythmic and correct, it is necessary to pause for breathing.

Exercise therapy for stroke has its own rules, which are as follows:

1. Do exercises for the healthy side of the body first.
2. Special therapeutic exercises must be alternated with fortifying exercises.
3. Classes should be regular.
4. Exercise for stroke should be increased gradually.
5. During classes, you should maintain a positive emotional background.

We present to your attention one of the possible complexes of physiotherapy exercises for stroke. This complex is recommended to be performed in the early period of treatment of stroke or traumatic brain injury (subject to bed rest):

Exercise number 1

The exercise is performed with your healthy hand. When performing the exercise, it is necessary to use the wrist and elbow joints. Run 4-5 times.

Exercise number 2

Flexion and extension of the sore arm at the elbow. If necessary, you can help with your healthy hand. Repeat 4-8 times.

Exercise number 3

Breathing exercise. Repeat 4-8 times.

Exercise number 4

Raising and lowering the shoulders. Perform the exercise rhythmically, with a gradually increasing amplitude, combining with rubbing and stroking. Run 4-8 times.

Exercise number 5

Perform passive movements in the joints of the hand and foot (3-5 minutes).

Exercise number 6

Perform active exercises - flexion and extension of the arms at the elbow joints (with the arms bent). The amplitude should be as high as possible. Run 6-10 times.

Exercise number 7

Perform movements with your healthy leg. If necessary, then - to help and strengthen the internal rotation. Do it 4-6 times.

Exercise number 8

Perform movements with a sore leg. Movements should be of medium depth. Run 4-6 times.

Exercise number 9

Perform breathing exercises 4-8 times.

Exercise number 10

Perform active exercises for the hand and fingers, while the position of the forearm should be vertical (3-4 minutes).

Exercise number 11

Passive movements for all joints of the affected limb. Perform at a slow pace, soft and smooth. If necessary, help and facilitate the exercise. Run 3-4 times.

Exercise number 12

Perform abduction and adduction of the bent hip (with bent legs). You can also extend and flatten the bent hips. Do it 5-6 times.

Exercise number 13

Perform active circular movements of the shoulders (with the help and regulation of breathing phases). Repeat 4-5 times.

Exercise number 14

Bend the back without lifting the pelvis (with limited tension). Repeat 3-4 times.

Exercise number 15

Breathing exercises. Run 3-4 times.

Exercise number 16

Perform passive movements - at a slow pace, softly and smoothly. If necessary, you can help and facilitate the exercise. Perform 2-3 minutes.

Thus, the total time required to perform this set of exercise therapy exercises for stroke is 25-40 minutes.

During exercise gymnastics with a stroke, it is necessary to take pauses for rest, at least 1-2 minutes. When the exercises are completed, you need to ensure the correct position of the paretic limbs.

A set of physical exercises Lfk for stroke becomes more complicated in the late period of hemiparesis treatment. Physiotherapy exercises and remedial gymnastics are given in sitting and standing positions.

Also, the complex of exercises includes walking in various versions and training in self-service. Exercises with objects, elements of games are widely used.

When performing exercises of the LFK complex in stroke, special attention should be paid to the development of the functions of the hand and fingers, as well as to relaxing the muscles and reducing stiffness.

Source: http://lfk-gimnastika.com/lfk-pri-zabolevaniyakh/75-lfk-pri-insulte

Physiotherapy exercises (exercise therapy) after a stroke

Exercise therapy after a stroke is an important part of patient rehabilitation. The consequences of a stroke remain with a person for life, since the affected cells can no longer be restored. But their functions can be performed by other brain cells. In order for this to become possible, it is important to perform the necessary actions.

The recovery process consists of several stages. In the first hours of an attack, a person enters the intensive care unit, where doctors fight for his life and stabilize his condition.

At the next stage, the patient is transferred to the neurological department, where he receives the necessary care, it is here that the process of restoring physical capabilities begins.

After discharge, rehabilitation takes place at home, and the final result depends on how regularly and correctly the recommendations of specialists are carried out.

The choice of physiotherapy exercises after a stroke

Gymnastics after a stroke is aimed at restoring the functions of the paralyzed side of the body. The exercise you choose depends on which part of your brain is affected. So, when cells of the left hemisphere die off, the following is observed:

• complete or partial paralysis of the right side of the body;
• violation of the perception of this half of the body;
• disorientation;
• inhibition of reactions;
• violation of motor memory.

When the right hemisphere is affected, there is:

• complete or partial paralysis of the left side of the body;
• violation of the nervous regulation of the speech apparatus (speech);
• violation of language memory (the patient is aware, but cannot remember the words);
• slowness in behavior.

To solve these problems, a general complex treatment is used and, in addition, physical exercises aimed at training certain functions.

Rehabilitation depends on many factors, for example, the volume of the lesion of the affected area of ​​the brain, the timely provision of emergency medical care and the actions of the person himself. A positive result largely depends on the psychological attitude of the patient, and the task of relatives and friends in this case is all kinds of support and an optimistic attitude.

The tasks of physiotherapy exercises after a stroke

If there are positive predictions of doctors, then the main task of exercise therapy for stroke is the complete restoration of body functions. Since physiotherapy exercises are a combination of various methods of medical rehabilitation, it also contributes to the solution of other important tasks:

• helps to restore accuracy to movements;
• improves blood circulation in the tissues of paralyzed parts of the body;
• relieves muscle tension that is present with paralysis;
• promotes blood circulation in the body.

Features of the exercise

At the beginning of rehabilitation, therapeutic exercises should be carried out under the supervision of an exercise therapy doctor, who will explain all the subtleties of performing the exercises and select the appropriate complex in accordance with the type of stroke.

It is important not to overload the patient

It is necessary to perform classes regularly, gradually increasing the load. It is important not to overload the patient with excessive physical activity, as this can be harmful. It is recommended to start classes with the simplest movements, and it is imperative to warm up the body with massage before starting.

There are several types of exercise therapy exercises for stroke:

• complex of passive loads;
• active physical education;
• mental exercise.

Let's consider each type in more detail.

Passive physiotherapy exercises

Each exercise depends on the patient's condition. It is important that in the first time after a stroke, a person needs complete rest. But when the condition stabilizes, with the permission of the doctor, the patient will be able to perform passive exercises for the arm and leg after a stroke.

The purpose of these exercises is to restore blood supply to paralyzed limbs and relieve muscle spasms. Passive gymnastic exercises are performed with assistance, i.e. the other person flexes and unbends the patient's limbs.

Passive exercise therapy must be started with the fingers of the paralyzed limb, gradually moving to healthy ones. Continue gymnastics for hands after a stroke by rotating the hands, clockwise and counterclockwise.

After that, it is necessary to bend and unbend the arms at the elbows and, at the end, perform light movements with the shoulders (up - down and right - left). Exercises for the legs are performed in the same way.

With the help of passive gymnastics, muscle spasm can be relieved by fixing the limbs in an extended state for a short time. It is important that in this position the patient spends no more than 30 minutes a day and does not experience discomfort.

Mental exercise

This technique is also a type of exercise therapy. It is known that muscle memory is often affected as a result of a stroke.

In order to regain physical activity, it is necessary to perform not only physical activity, but also mental activity.

In order for the surviving nerve cells to perform the functions responsible for movement, they need to be taught this. A person should mentally imagine how he moves his arms, legs and fingers.

In addition, the patient should say it aloud and to himself. This technique allows the formation of a new motor center in the brain and contributes to the rehabilitation of the speech apparatus.

It is important to represent each movement in detail and believe that it is actually happening.

As already mentioned, an important role in the recovery process is played by the patient's attitude and the support of relatives who should help and praise him for any efforts.

Active exercise therapy

After the patient's condition improves and progress is observed, you can move on to more active activities. Active exercise therapy after a stroke, the set of exercises of which includes exercises in the supine position, sitting and standing, promotes rapid recovery. But you need to perform the exercises in stages.

In the supine position, the patient can perform simple exercises on his own, for example, to pull himself up with smooth movements and push off the headboard or alternately bend your knees, trying not to lift your feet off the bed (slide on her). Exercises should be moderately difficult and individually selected for the person.

When lying exercises are easier, then with the permission of the attending physician, you can proceed to exercises in a sitting position. Such physiotherapy exercises for a stroke are designed to strengthen the muscles of the back, the resumption of motor activity of the arms and legs. But the main goal of the classes is to prepare the body for walking. Sitting on the bed, you can do the following simple exercises:

1. Take the original sitting position, straighten your legs, and lower your arms. Slowly take your arms back, throw your head back and straighten your back. In this position, it is necessary to try to bring the shoulder blades together and fix for 1-2 seconds. Get out of the position slowly.
2. Sitting, holding on to the bed with your hands, alternately slowly and low to raise straight legs.
3. Sitting on the bed (a pillow under your back) slowly pull your knees to your chest and try to grab them.

The most difficult stage in active exercise therapy is a set of exercises in a standing position. They are recommended to be performed when the patient feels confident and easily performs movements lying and sitting. Gymnastics in this position is divided into 2 complexes: simple and increased load.

It is necessary to start classes with a simple complex, for example, to perform turns of the body to the right and left, while the legs should be shoulder-width apart, and the hands should be on the belt. In addition, you can perform squats and body bends to the left - right through a fixed position straight.

The increased load includes exercises such as "windmill", walking in place, jumping, etc.

During classes, you need to listen to your body and not make movements, if there is fatigue, you also need to monitor your breathing and heartbeat. If any discomfort occurs, it is best to pause your studies.

It is worth noting that both lack and excess of physical activity can lead to a deterioration the patient's condition, therefore, you need to regularly consult with your doctor and not add loads on one's own.

Thus, after a stroke, with the right approach, you can achieve partial and even complete recovery of the body. But it is important to remember that exercise therapy cannot be quit: classes must be constantly performed in order to prevent deterioration of the condition. Physiotherapy exercises contributes to the full or partial recovery of the patient after a stroke.

Source: https://LibidoGuru.ru/fizicheskaya-forma/lechebnaya-fizkultura-lfk-posle-insulta.html

Exercise therapy after a stroke: how does it improve the condition?

Stroke is an insidious ailment that affects the structures of the brain and causes serious disturbances in it. A stroke attack causes many systems to malfunction and never goes away without leaving a trace.

In addition to drug therapy, systematic, strictly regulated and individually selected exercise complexes help to restore at least partially its former activity.

But what is the peculiarity of exercise therapy after a stroke?

About the benefits of exercise therapy after a stroke

The treatment and recovery of people who have had a stroke is a complex, multi-stage process. It requires a systematic approach and great patience on the part of the victim and those close to him. Therapy begins in the intensive care unit, where doctors take measures to help the patient survive. Then neurologists start working with the affected brain cells.

Recovery of motor functions after a stroke

It is necessary to realize that the action of medications has its limits. But there are certain methods that help speed up recovery after an attack of a stroke, and the complex of physical therapy (exercise therapy) is one of them.

Alas, pathological metamorphoses in brain structures are irreversible, since dead cells are not restored and such a neurological deficit is irreplaceable.

However, the work of the brain and deviations in the motor function of a person are closely related, therefore restoration of the victim's thinking skills may result in the return of motor function paralyzed body.

In addition, a set of exercises (exercise therapy) performed after a stroke helps to avoid stagnation of blood in those affected paralysis of tissues, revives muscle memory and activates neurons adjacent to the affected cells.

Dosed exercise and post-stroke gymnastics can help restore brain function and reverse paralysis.

That is why it is so important to start home remedial gymnastics as soon as possible after a stroke victim is discharged from the hospital.

Preparatory activities

Rehabilitation after a stroke with the help of exercise therapy complexes begins with the preparatory stage. At this time, one cannot resort to active physical actions, and in certain cases, this is impossible. How is the preparatory stage for exercise therapy built and what external influences are possible at this time?

1. Correct body position. This is extremely important because it acts as a prevention of pressure ulcers and contractures.
2. Performing permitted passive exercises for different muscle and joint groups. They are performed by hospital staff and include flexion and extension, abduction and circular movements of the arms and legs.
3. Respiratory gymnastics aimed at developing the lungs.
4. Mental gymnastics to restore lost muscle memory.
5. Massage. This procedure gives the patient the opportunity to feel his body again, prepares him for more active LGA, normalizes blood circulation and acts as a prevention of congestion in the body.

Passive loads

Any activity after a stroke, including a set of exercises (exercise therapy), is prescribed by the attending physician in individually, taking into account how much the patient's brain has been damaged, what are the disorders and their place location. Often passive loads are introduced at first. These include massage, mental gymnastics, and articulation exercises.

Mental exercise

As already mentioned, all movements are carried out thanks to muscle memory. To restore it, you need to carry out mental gymnastics every day.

Experts advise during the mental exercise to clearly articulate what is being done: “I I bend my leg, I move my hands, etc. " If it is difficult for the patient to pronounce the words, then they do it for him loved ones.

This method is unique in that it also trains the speech of a stroke victim.

Throughout the course, you need to praise the patient for any achievements, encourage and tune in a positive mood. The fact is that patients with such a diagnosis do not like to do gymnastics, as they are depressed and do not believe in themselves. But this attitude is fundamentally wrong. After all, the results of therapy depend on the person himself and his mood.

Articulation exercises

After a stroke, not only motor function is impaired, but speech problems can also be noted. Such violations are quite long-term (from a couple of months to several years) and require regular rehabilitation exercises. Such physical exercises cannot be interrupted, because one day a positive result will appear.

Articulation exercises in the rehabilitation period

Articulation exercises are aimed at restoring the lost functions of neurons localized in the area of ​​the center of speech. In order for the patient's speech function to normalize, he must systematically hear the speech of others. Therefore, family and friends need to talk to the patient regularly.

Even if the speech function has disappeared entirely, you need to start with the pronunciation of individual sounds, after syllables, words, as their volumes increase. At the final stage, it is useful to read poetry and speak with tongue twisters. Music also helps patients. The stroke survivor will benefit from listening to songs, and ideally should try to sing himself.

Massage

Massage in the rehabilitation stage relieves the condition and helps to avoid new complications.

There are certain rules regarding massage for stroke patients. A session is started by warming up the skin, rubbing it in a circular motion. There is no need to use force as it should be an easy and enjoyable procedure.

During the procedure, the limbs are massaged from bottom to top: arms from hand to shoulder, and legs from foot to thigh.

When massaging the back, harsher movements, such as tapping or pinching, may be used. The chest is massaged using gentle pressure, performing circular motions from the center outward.

Active physical activity

After the appearance of the first positive dynamics and the patient gaining self-confidence, they often switch to active physical exercises.

At this time, the victim of a stroke is discharged from the hospital, and the change of scenery and family walls significantly improve the mood and morale of the victim.

Exercise therapy performed after a stroke (at home) is very diverse.

At first, these can be exercises in bed, and then, in a sitting or standing position. Once you are successful at these stages, you can practice walking. Such loads should be regular (ideally daily). You should do it several times a day, with breaks of several hours for rest and recuperation.

Lying exercises

Exercise therapy after stroke at home for bedridden patients is very limited. But the patient can still practice exercises for the arms, legs and trunk. The main thing is to do them regularly.

Therapeutic exercises for the upper extremities include movements that help develop joints and improve blood flow.

It is necessary to do flexion-extension and rotational movements in the hands, elbows and shoulders, as well as clench the fingers into a fist.

Exercises for the lower extremities involve motor activity of the fingers, pressing the feet on "Pedals", flexion-extension of the legs in the knee joints and their reduction-breeding in the hip area joints. The trunk gymnastics complex includes side turns, attempts to raise the pelvis, focusing on the head and feet, and lifting the upper torso.

Complexes from a sitting position

Usually after 21 days, the patient can start LHF in a sitting position. These are fairly simple gymnastic complexes that include the following exercises:

• training the muscles of the eyes (rotating them in different directions), which in addition normalizes the pressure;
• head movements that contribute to the development of the cervical spine;
• independent sitting on the bed without support;
• back bends, with hands fixed on the handrails;
• raising the lower limbs in a sitting position;
• performing grasping exercises for the hands or using an expander.

It is very important to develop the patient's fine motor skills. As a rule, children's toys are of great help in this matter.

Complexes from a standing position

First of all, at this stage, you need to try to get back on your feet: first with the help of health workers, and then, already independently.

For these purposes, special simulators are ideal, which is available in almost every rehabilitation center. Physiotherapy exercises after a stroke can be carried out at home.

However, in this case, at first, some devices to provide support will be useful.

Recovery LGA in a standing position includes these basic exercises.

1. Raises your arms. Starting position - standing, arms lowered along the body, legs are shoulder-width apart. Further, it is necessary to raise the arms on inhalation and lower them on the exhale. You need to do 4-6 repetitions.
2. Squats. The heels cannot be lifted off the floor, and the arms are extended parallel to the floor. This exercise not only trains the muscles of the legs, but also teaches you to maintain balance again.
3. Side bends with arms extended upwards.
4. Slow twisting torso turns.
5. To warm up the joints, rotational movements are made with the hands and feet, and also the hands are brought together in the lock behind the back.
6. Swing the upper and lower extremities with holding the breath.

This is the simplest set of exercises. As self-confidence grows, a stroke victim may modify it, but this must be done in a balanced way. It is very important that the load grows gradually.

Contraindications to exercise therapy

With all the benefits of therapeutic exercises for the recovery of a person affected by a stroke, it still has certain contraindications. So, restorative measures are not carried out by patients:

• in coma;
• if they have mental disorders;
• with a second stroke in an elderly patient;
• in case of seizures, symptoms of epilepsy;
• if the patient has a history of cancer, tuberculosis or diabetes mellitus.

Exercise therapy after a stroke, in fact, is an almost uncontested method of effective rehabilitation. Most of the exercises can be done at home, but it is best to practice under the supervision of an experienced professional in a rehab center. This approach will help to avoid mistakes and contribute to quick positive results.

Source: https://NervovNet.com/lfk-posle-insulta-04/