Physiotherapy after stroke aims to improve the quality of life, recover affected motor and sensitive functions, and is performed through passive mobilization, exercises, electrotherapy, restriction and aquatic therapy.
Rehabilitation exercises may include movements to recover coordination, muscle strength, flexibility and respiratory capacity, and should be customized according to each person’s needs.
Also read: Stroke: what it is, symptoms, causes, types, treatment and sequelae
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Rehabilitation sessions should be performed by a physical therapist, and it is essential to start as soon as possible and performed daily, as early stimulation accelerates recovery.
Stroke exercises
The main physiotherapy exercises after stroke are:
1. Strengthening exercises
The basic exercises of strengthening for a person who suffered a stroke are:
- Open and close the hand, which can be done by pressing a ball or opening a rubber band if the person has strength;
- Pulse and elbow flexion and extension;
- Raise the extended arm;
- Place a cloth in hand and ride circles on the table or wall;
- Move the foot, flexion and knee extension in the lying or sitting position;
- Keep your arms and legs raised as long as possible, alternately;
- Pelvic elevation;
- From the sitting position, take the trunk forward and return to the center, and the same on one side and the other.
It is important that the exercises are performed under the supervision of the physical therapist, as the first phase of stroke is usually marked by muscle sagging, but can rapidly evolve into rigidity, which should be avoided.
Exercises should not cause fatigue or tiredness, so the amount of repetitions should be adapted to the person’s ability.
2. Flexibility Exercises
Flexibility and stretching exercises are performed by a physiotherapist, which tenses the muscles passively to increase the amplitude of motion.
These exercises are performed mainly in people with spastic stroke, that is, who have a great muscle rigidity.
3. Balance and coordination exercises
Balance and coordination exercises for stroke are:
- Walk in a straight line;
- Maintain equilibrium with eyes closed, with variable hearing stimuli, unstable surfaces or even standing on one leg;
- Follow verbal commands, such as touching different parts of the body or grabbing objects;
- Follow an object with views, maintaining balance.
These exercises should be indicated exclusively by physical therapists, as there is a high risk of loss of balance during execution.
4. FINE MOTOR COORDINATION EXERCISES
Fine motor coordination exercises serve to recover movements and activities of everyday life, such as brushing teeth or grabbing objects.
The exercises that can be performed are:
- Separate beans, beans, chickpeas, lentils, according to one’s ability;
- Take sand with your hand and slow it down;
- Separate objects and put them into boxes;
- Take a spoon.
It is important to do these exercises several times a day, as they do not require specialized supervision and can be performed at home.
5. Breathing Exercises
Respiratory exercises are fundamental after stroke, as some people lose their strength to cough and expel secretions.
The following exercises can be performed:
- Inflate balloons;
- Blow inflated balloons;
- Bubbles in a bottle with a little water through an ice cream or straw.
These exercises can be done at home, however, if respiratory physiotherapy is required, the physiotherapist will indicate more complex exercises. Learn how respiratory physiotherapy is done.
Exercises with balls, resistance, mirrors, weights, trampoline, ramps, elastic bands and other equipment that favor the improvement of the person’s physical and mental capacity can also be performed.
During the rehab session, the physiotherapist can use the use of tens, ultrasound and hot water or ice bags as needed.
Also read: Tens: what it is, what it is for, how it is done and types
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Physiotherapy Techniques
In addition to exercises, after stroke physical therapy includes various techniques which depends on each person’s physical needs.
Thus, the physiotherapy techniques that can be used are:
- Sensitive stimulation along the dermatomes, in people with changes in sensitivity. Understand what they are dermatomous;
- Use of objects such as toothbrushes and superficially over the skin for sensory stimulation;
- Restriction therapy, which consists of immobilizing the healthy side to force the person to use the affected member;
- Functional electrical stimulation to induce muscle contractions, which helps increase the strength of the weakened muscles.
In addition, aquatic therapy or hydrotherapy is a technique that improves mobility, strength and reduces stiffness and pain in people with stroke.
Also read: Hydrotherapy: What is, Benefits and Exercises
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Results of Physiotherapy after stroke
Physiotherapy can bring many benefits, such as:
- Improve the appearance of the face, making it more symmetrical;
- Increase the mobility of arms and legs;
- Help walk;
- Make the person more independent in their daily activities, such as combing, cooking or dressing, for example.
Physiotherapy should be done regularly, ideally at least three times a week.
Despite the intensity of physical therapy work, some people may not experience major improvements, which may depend on various causes, such as the degree of neurological alteration or associated cognitive difficulties.
As one of the consequences of LCA is depression, these people may have a difficulty in participating in the sessions due to lack of encouragement, performing the exercises incorrectly, making their recovery difficult.
Therefore, it is necessary that a person who has suffered an LCA be accompanied by a multidisciplinary team composed of a doctor, nurse, physiotherapist, occupational therapist, speech therapist and psychologist.
How long do physical therapy
Physical therapy can be started immediately after stroke, stimulating the person to be out of the hospital bed. hospital.
Usually, individual treatment of neurological physiotherapy is recommended that lasts between 3 and 6 months.
The sessions last approximately 1 hour, with exercises performed with the help of the therapist or independently, depending on the capacity of the person.
In addition to the exercises performed in the office, it may be necessary to perform stretching and exercises at home to maintain daily muscle stimulation.
Games that exercise the whole body, such as Nintendo and Xbox, can be used to help maintain muscle stimulus.
It is important that physical therapy treatment is continuous and that the person receives sufficient stimulation to prevent muscle contractions to worsen and the amplitude of motion is reduced. This can leave the person lying on the bed and completely dependent on the attention of others
Source: www.tuasaude.com