Stroke is an insidious disease that affects the structures of the human brain, causing serious damage to it. Pathology leads to the failure of various functions of the body and never goes unnoticed. Restoration of he alth during the rehabilitation period, in addition to drug therapy, is facilitated by constant, strictly dosed and individually selected physical activity. In the materials of our article, the reader will find answers to many questions. For example, what is the essence of exercise therapy after a stroke? Is the set of exercises prescribed by the doctor performed only during the period of stay in the hospital or continues at home treatment? What types of loads are applicable for such a diagnosis? And much more.
What is a stroke?
A stroke is an acute circulatory disorder of the brain structures, the symptoms of which appear suddenly and occur in separate foci or in the general structure as a whole.
This pathology is often fatal. According to statistics, after coronary heart disease, cerebrovascular diseases are in second place among the causes leading tomortality from pathologies of the circulatory system. Cerebral infarction and various cerebral hemorrhages are also a type of stroke.
If the manifestations of the disease can be detected in a timely manner and begin immediate treatment, the patient has a chance for life. However, pathology in most cases leads to a violation of the motor or sensory functions of the body, causes a deterioration in brain activity - a violation of speech, memory, orientation in space, thinking.
Depending on what type of stroke is diagnosed in a patient, the patient's chances for recovery and continuing a full life also vary. Thus, ischemic strokes, which make up 75-80% in the structure of the disease, are easier to treat. Hemorrhagic stroke is more severe and more difficult to treat.
Why is rehab needed?
Treatment of patients who have had such a disease is a complex process, consisting of many stages and requiring patience and a systematic approach. Therapy begins with resuscitation, where the patient is given direct treatment to survive. Further, the specialists of the neurological hospital are engaged in the restoration of the affected brain cells of the patient.
One must understand that the effect of drug treatment is not unlimited. However, there are additional techniques that can speed up recovery after a stroke. Exercise therapy is one of them.
Pathological changes in brain structures are irreversible - dead cells cannot be restored and this neurologic althe deficit is irreplaceable. Fortunately, brain activity and impaired motor activity are inextricably linked. Therefore, the restoration of the mental skills of the patient can occur after the return of motor function in the paralyzed limbs or throughout the body.
Movement prevents blood stasis in paralyzed tissues and restores muscle memory, as well as mobilizes the activity of other neurons not affected by pathological processes. Dosed physical activity will help restore brain function. Therefore, it is very important, after the patient is discharged from the hospital, to immediately begin a set of exercises aimed at improving the condition of the body as a whole.
The effect of physical activity
As noted earlier, the treatment and rehabilitation strategy should be implemented gradually, step by step and methodically. This means that until the goal is achieved, a lot of time will pass, desire and discipline will be required both on the part of the patient himself, and on the part of relatives or people caring for him. At the initial stage in the hospital, physical exercises and care are provided by doctors. Recovery procedures, such as massage and light physical activity, begin almost from the first day after the onset of the disease. Physical therapy and exercises after a stroke:
- protect the skin from pressure ulcers, especially in the legs - in the heel areas, where there is the greatest contact with the bed, and the body is subjected to increased pressure;
- decrease muscletone and general tension that occurs with paralysis due to a stroke; at the same time, increased excitability gradually passes;
- improve tissue microcirculation, gradually restoring normal blood circulation;
- help to resume subtle movements in the hands and upper limbs in general;
- Against the background of a stroke, contracture may occur - restriction of movement in the joint with stiffening of the muscles that are in constant overstrain. Physical exercise provides prevention of this phenomenon.
Where to start?
The question of how long it will take to partially restore lost body functions in the post-stroke period cannot be answered unambiguously.
Everything depends on the type of pathology, the size of the lesion and localization in the brain structures, as well as the time that has passed from the moment the disease manifested itself to the provision of medical care. Accordingly, the higher these indicators, the worse the forecasts. In any case, one should not lose heart and give up, it is necessary to fight for life and he alth. Before proceeding with the recovery procedures, it is necessary to consult a doctor - a set of exercises in each case will be different. For example, exercise therapy after an ischemic stroke differs from exercise in a hemorrhagic type of pathology.
At first, in case of paralysis of the patient (complete or one of the sides) within a week or two, it is recommended to act on the muscles by changing the position. To avoid blood stasis andpressure sores, it is recommended to turn the patient every 2-3 hours.
After the specified period of time, passive types of loads (massage) begin, which are feasible with the help of third parties. The purpose of these manipulations is to relax the muscles and prepare them for subsequent (active) loads.
Massage and passive exercise
There are certain rules when performing massage manipulations. To begin with, through circular movements, you should warm up the skin and ensure blood flow to the tissues. Efforts should not be excessive, rather an easy and pleasant procedure is needed. Massage (passive exercise therapy) of the hands after a stroke is performed from top to bottom - from the hand to the shoulder. Accordingly, the legs are kneaded from the foot to the hips.
When massaging the surface of the body, specifically the back, apply more abrupt movements with pinching and tapping. Massaging the chest, use soft pressure, movements are performed in a circle from the center out.
After massage procedures, passive loads begin. These include alternate flexion and extension of the limbs - arms and legs. The mechanism for performing the exercises is as follows. The patient is laid on his back, and the limb is lifted and bent at the joint so that when unbent, it slides along the surface of the bed. Through these exercises, exercise therapy after a stroke for the legs, as well as hands, gradually restore the motor memory of the body. An important indicator of success in this case is the systematic nature of the procedures - the exercises are carried out for 40minutes twice a day, starting from the second week - three times a day.
Mental physical education
As noted above, limb movement is controlled by muscle memory. To restore it, daily mental gymnastics is necessary. The following scheme is recommended. When performing physical exercises, it is necessary to repeat the command out loud many times. For example, when bending the arm, say: “I bend my arm, I move my fingers, etc.” If it is difficult for the patient to pronounce words at this stage, close people should do it for him. This technique is also good because it trains the patient's speech apparatus. Mental exercise therapy after a stroke (at home should be done methodically and constantly) leads to good recovery rates.
Throughout the course of treatment, it is necessary to praise the patient for any actions on his part, to encourage and encourage him in every possible way, to set him up for a positive outcome of the situation. Often, patients with a similar diagnosis are reluctant to engage in physical education, experience depressive states, and do not believe in their own strength. This is the wrong position. Psychological attitude is the key to success in any business. It is important to explain to a person that the result of treatment depends only on him, and no one but himself can help him.
Speech restoration
The consequence of a stroke can be not only a violation of motor function, but also a speech disorder of the patient. Such failures in the body last for a long time, from several months to several years, and require constant recovery measures. It is necessary from the patientperseverance, a constant desire to recover and methodical exercise. It is impossible to stop classes in any case, and then sooner or later the result and positive dynamics will appear.
Exercises for the articular apparatus are aimed at restoring the lost function of nerve cells located in the zone of the speech center. Firstly, in order for the patient's speech to return to normal, he must constantly hear it from others. The task of relatives and friends is to constantly talk with a person who has had a stroke so that in the future he can reproduce sounds on his own.
If speech is completely lost, one should start with the pronunciation of individual sounds, then syllables, then words, the volume of which should constantly increase over time. At the final stage, it is useful to read poetry and pronounce tongue twisters. Good results in treatment are given by music. It is useful for the patient to listen to singing, and also to try to sing songs himself - first simple, then more serious.
Articulation exercises. Memory recovery
As a result of a stroke, there is a violation of the mobility of the facial muscles, followed by their freezing. This phenomenon leads to the loss of a person's ability to speak. A set of exercises is provided for training the speech apparatus. The patient is recommended:
- push the tongue forward as far as possible;
- roll your lips into a tube, bare your teeth;
- lick lips with tongue from left to right and right to left;
- bite alternately the top andlower lips.
Memory is impaired in a stroke, and one of the most important tasks in rehabilitation is the restoration of this particular type of nervous activity. Along with drug therapy, specialists carry out functional and restorative correction with the patient. The technique involves training the brain by memorizing numbers, words, poems.
In addition, board games have a positive effect on memory recovery. In general, the game technique used in rehabilitation gives good results - the patient concentrates on the action being performed on the one hand, and is distracted from the situation and the surrounding reality on the other.
Reactive loads
When the first results appear and the patient gains confidence in his own abilities and a favorable outcome of the disease, you can gradually move on to active physical activity. During this period, as a rule, the patient is discharged, and changing the situation of the hospital to home walls helps to improve the mood and raise the “fighting spirit” of the person.
Exercise therapy exercises after a stroke (at home) are quite diverse. At first, it can be classes in bed, then - in a sitting and standing position. After success in these stages, you can move on to walking. It should be noted that in each case, the intensity of the loads may differ, and should be calculated by the doctor in accordance with the patient's history.
Loads should be daily and take separate intervals during the dayseveral hours.
Therapeutic exercise in a sitting position consists of a set of the following exercises:
- eye muscle training can be done by rotating the eyeballs in different directions - diagonally, from right to left, top to bottom, open and close the eyelids, such exercises help to normalize pressure;
- squeezing will help relieve tension after the above exercises, with a repetition of 10-15 times;
- stretch neck muscles allow head rotation in different directions and at different paces;
- after a stroke, it is necessary to develop the motor skills of the fingers, to train grasping reflexes. Expanders are used for these purposes;
- You can train the muscles of the legs and feet by stretching and contracting them.
Sequentially, in a sitting state, you can move on to more amplitude exercises - lifting the limbs, on your own or with the help of a belt.
Standing exercise
It should be noted that the standing position offers more opportunities for physical activity and training of the legs and arms.
Restorative gymnastics is based on basic exercises:
- Raising the arms: the starting position of the body is straight, the arms are at the seams, the legs are shoulder-width apart. It is necessary to raise your hands while inhaling, lower them down while exhaling. The course should be repeated 4-6 times.
- Squats without taking off the heels with stretching the arms forward. The purpose of the exercise is to maintain balance and train the muscles of the legs. The exercise is repeated 4–8 times.
- Tilts left and right withpulling up the opposite hand.
- Torso twists, which are slow torso twists. The exercise is repeated at least 5 times.
- In order to stretch the joints, they perform rotations with the hand and foot, bring their hands into the lock behind the back.
- To train both arms and legs at the same time, such an exercise helps - with an outstretched arm, swing the leg of small amplitude to the side. In this case, it is recommended to hold on to the support with your free hand and not hold your breath. Manipulation is repeated 7–8 times with each leg.
Simulators
After a person who has had a stroke gets a little stronger and gets used to the active load, you can move on to training on special simulators. The use of these devices will not only strengthen the muscular corset and restore motor function, but also improve the overall emotional state of the patient.
During the rehabilitation period, classes should be carried out only under the supervision of a doctor and using heart monitors - devices that can be used to track heart performance.
Depending on the functional purpose of the simulator, all devices will be conditionally combined into several groups.
- The verticalizer is a device that gives a vertical position to the body of a person who cannot do this on his own. Such a simulator supports a person and gradually prepares him for “upright walking”.
- Lokomat is a skeleton simulator for those who are learning to walk again.
- Mini-simulators - devices for training limbs and restoring motor skills of fingers.
- Active-passive exercise equipment helps to restore the function of the joints of the upper and lower extremities.
- Exercise bikes increase stamina and improve the general condition of the patient.
Important rules
Rehabilitation is an incredibly important stage in the treatment process, so there is no time to waste. There are some rules, the implementation of which will help to achieve success and achieve good results in the restoration of the body of a sick person.
First of all, you must strictly adhere to the advice of your doctor. This means that you cannot be self-employed. Remember, only a specialist with education and work experience can correctly select and calculate the amount and intensity of physical activity in each case, that is, draw up an exercise therapy program after a stroke. The complex of exercises is strictly individual.
Being active in physical education, you can not overwork. You should start with light exercises, gradually moving on to more difficult ones. It is important to understand that the purpose of physical activity is not to build muscle, but to encourage new brain cells to work.
Before performing any exercise (active or passive), it is extremely important to warm up the skin so that all tissues receive blood flow. This is especially true for bedridden patients.
People who are close to a sick person need to monitor his mood, gently demand from himfollowing the doctor's orders, celebrating any progress.
Do not forget about methodical and systematic rehabilitation measures. Exercise should be daily. Time is the best medicine.
