Is there life after a stroke? While studies show that there are risks of becoming inactive following this life-changing event, an individualised rehabilitation plan may be able to help the patient recover and interventions that encourage physical activity can prevent another stroke. The other good news is that the brain has ‘neuroplasticity,’ the capability to reorganise its structure, functions, and connections after an injury such as a stroke. That means achieving recovery as well as a high quality of life post-stroke are both possible.
A stroke is a cerebrovascular disease where the blood supply to the brain is impaired, depriving the brain of oxygen and glucose. There are three major types: Ischemic, which is caused by the blockage of blood supply; Hemorrhagic, resulting from the rupture or bleeding of a cerebral vessel; and Transient Ischemic Stroke, also called a mini stroke which stems from the temporary blockage of blood supply. Ischemic strokes are the most prevalent, accounting for 80% of all cases.
In Australia, some 55,000 people have strokes yearly, with the financial costs reaching a staggering $5 billion annually. Roughly half of stroke patients remain chronically disabled so it is essential to make exercise a part of their treatment program. That way, they can enjoy independence in doing their daily tasks as well as have a higher quality of life.
The importance of Exercise Physiology and Physiotherapy exercises for stroke patients
Understandably, there may be apprehension about undertaking physical activity following a stroke such as the fear of falling. However, the benefits of exercise are much too important to ignore. The evidence suggests that people who had a stroke experience physical deconditioning and are prone to leading sedentary lifestyles. For stroke patients, exercise may help improve functional capacity, the ability to do activities of day-to-day living, enhance one’s quality of life, and reduce the risk of subsequent cardiovascular events.
Along with the reduction of sedentary behaviour and managing risks for secondary stroke, part of a good recommendation plan for stroke patients is placing an emphasis on low- to moderate-intensity aerobic activity and muscle-strengthening. It is in this area of exercise prescription where Physiotherapists and Exercise Physiologists can collaborate to help improve patient outcomes with the use of a multidisciplinary approach.
How Exercise Physiologists and Physiotherapists can work together for better outcomes?
While each expert has a role to play in improving the health of a stroke patient, Exercise Physiologists and Physiotherapists can collaborate to enhance the effectiveness of a stroke rehabilitation program, promote better patient outcomes, as well as promote long-term recovery through the following ways:
- Assessments – Exercise Physiologists and Physiotherapists can work together in assessing the functional abilities and health condition of stroke patients. They can evaluate the patient’s strength, balance, cardiovascular fitness, range of motion, and functional ability.
- Exercise prescription – The expertise of Exercise Physiologists lies in the prescription of physical activities that can help improve the strength, cardiovascular fitness, and endurance of the stroke patient. Collaborating with Physiotherapists, together they can design an exercise program that complements the interventions recommended by the Physiotherapist. This collaboration ensures that the exercise program is aligned with the stroke patient’s rehabilitation goals as well as ensures its safety and effectiveness.
- Functional training – while Physiotherapists can help in aiding the stroke patient to regain their balance and other functional abilities, Exercise Physiologists can be of assistance when it comes to recommending functional training exercises that resemble movements and activities in real-life scenarios. Together, EPs and Physiotherapists can help the patient transfer skills learned during rehabilitation into day-to-day living.
- Progress monitoring – EPs and Physiotherapists can work together in assessing and evaluating a stroke patient’s progress, making the necessary tweaks and adjustments as required to help optimise the rehabilitation process.
- Patient education – by working together, Exercise Physiologists and Physiotherapists can help educate a stroke patient by conveying information on self-management, recovery, and the importance of exercise.
Movement problems that may be addressed by EP and Physiotherapy treatment for stroke patients:
EP and Physiotherapy may be able to help address the movement problems that stroke patients may experience. These include the ff.:
- Weakness/paralysis down one side of the body – a stroke can cause weakness on one side of the body, making it difficult to balance, stand up, or walk.
- Changes in sensation – this may include a feeling of heavy limbs, pins and needles, and numbness. A stroke can cause loss of feeling, especially in the legs, increasing the risk of slipping or falling.
- Pain in the joints – a stroke may result in muscle tightness and affect the joints such as the shoulders. At times, this may even lead to partial dislocation.
- Muscle stiffness or spasms – a stroke can produce spasticity or muscle tightness, which can lead to pain.
- Balance problems – these can be caused by weakness on one side of the body, loss of sensation in the limbs, vision problems, difficulty in focusing, and even vertigo.
Exercise Physiology and Physiotherapy techniques for stroke patients
Following a stroke, you will be assessed by your Exercise Physiologist and Physiotherapist for what your challenges are, such as difficulty in movement, disturbances in balance, or sensory issues. Based on their assessments, your health experts will prescribe a customised treatment plan to address your difficulties and needs, to get you back on the path to recovery and help you to become as independent as possible.
Your Exercise Physiologist and Physiotherapist will make use of exercise to address your health concerns and achieve the following goals:
- Improvement of motor function – one important application of exercise is to improve motor function post-stroke. This is because a stroke can impair the ability of the muscles to generate force. Newer evidence suggests that strengthening exercises such as those using resistance bands or weights can improve strength without increasing spasticity.
Exercise Physiologists and Physiotherapists can recommend strengthening exercises alone and doing strengthening exercises while performing functional tasks. The latter may allow the facilitation of doing everyday tasks.
- Prevention of falls and secondary complications — Another application of exercise for stroke patients is for the secondary prevention of complications. As strokes can cause impairments such as uncoordinated movements, weakness on one side of the body, and loss of sensation, among many effects, this can put the stroke patient at a greater risk for falls and fractures. Strength training may also help in fat loss and improve bone strength. Exercise is also vital in helping prevent secondary complications such as a heart attack or a second stroke.
Your Exercise Physiologist and Physiotherapist may also recommend the employment of other modalities such as aquatic therapy or training in water. Studies suggest that aquatic therapy is effective in supporting balance and walking, building muscular strength, proprioception, and cardiorespiratory fitness even when compared with land-based interventions.
- Exercise for Functional Tasks — Physical activity can also be used to improve the stroke patient’s ability to perform functional motor tasks such as walking. Using repetitive task-specific exercises such as overground walking with physical assistance or the use of assistive devices may help patients improve their walking gait and eventually achieve the ability to walk independently.
- Exercise for Psychosocial Functioning – emerging research suggests that aerobic exercise may be used to improve depressive symptoms as well as cognitive function in older adults. As depression is prevalent among stroke patients, it can have a negative impact on a patient’s quality of life. Your Physiotherapists and Exercise Physiologists may prescribe a regimen of at least three 30-minute sessions of moderate intensity aerobic exercise per week to help ward off symptoms of depression.
Let our Exercise Physiologists and Physiotherapists guide and assist you on your treatment program after a stroke
At Healthstin, our experienced Physiotherapists and Exercise Physiologists collaborate in coming up with a multidisciplinary approach that can help stroke patients recover and improve their health. Our Allied Health Experts are well-trained to assess and come up with individualised treatment programs that optimise outcomes and address the unique needs and conditions of every Participant.
All our Allied Health Clinic locations, like our Physio clinic in Melton, are furnished with both a Hydrotherapy pool and gym space, for a holistic approach to training. In just one venue, you can access both water-based and land-based training facilities for strength and aerobic fitness. To know more about how we can be of help or book an appointment, call 1300 090 931 today.
A stroke can be a life-changing experience. However, there is life after a stroke. That exercise is an excellent prescription for improving your life post-stroke doesn’t really come as a surprise as physical activity has wonderful benefits for everyone regardless of health condition or functional ability. For stroke patients, exercise may help in being able to do everyday tasks, enjoy independence and a higher quality of life, as well as minimise the risks of stroke from recurring. Physical activity and rehabilitation can help build not only your strength but also your confidence as well as your capability to lead a productive life.