Exercise therapy after a stroke is the most important stage of the recovery period. Certain physical activity is necessary to improve blood circulation, normalize metabolic processes, and reduce blood stagnation in tissues. By itself, the course of taking medications is not capable of leading to similar results. Therefore, in order for the patient to return to a normal lifestyle, he and his loved ones must make a lot of effort and patience. Only through the daily implementation of therapeutic exercises in combination with drug treatment can the restoration of body functions be achieved.

All about the recovery period

Exercise therapy after a stroke has an amazing effect. Due to each movement performed, the blood is accelerated in the paralyzed limbs, which does not allow it to stagnate. In addition, it should be mentioned that remedial gymnastics helps to restore muscle memory.

The first time after a stroke, the patient receives treatment in a hospital, where exercise is monitored by specialists. After being discharged from the hospital, care for the patient and everything necessary to restore the functions of his body is taken over by his relatives. Relatives should remember a few basic recommendations:

1. With ischemic stroke, it is especially important to periodically change the position of the patient's body - in this way, it will be possible to prevent such unpleasant formations as pressure sores.
2. After a couple of weeks, you can start performing passive exercises, where the main thing is the participation of the person caring for the sick person. At the same time, its main task is to relax the muscles and prepare them for more serious loads.
3. Immediately after the first results (for example, movement of a paralyzed arm or leg), you can start active exercises. To begin with, these are restorative exercises for the arms and legs, which are done right in bed, then attempts to stand up and, finally, slow walks.

Physiotherapy after a stroke requires a serious approach. It is necessary to devote at least 3 hours daily to exercise (taking periodic breaks).

Rehabilitation exercises after a stroke given as an example are designed for the general case. It is important to understand that the calculation of the intensity should be individual for each patient and only a specialist should determine it.

Performing massage and passive loads

As already mentioned, rehabilitation exercises for stroke should begin only after a certain preparation of the patient. It is possible to prepare muscles with the help of massage procedures, which also require compliance with some rules:

1. Before proceeding with the exercises, it is necessary to take care of warming up the blood; to induce its flow, soft circular movements are made.
2. When massaging the affected arm, you should start with the hand, gradually moving to the shoulder. The foot massage begins with the feet and ends with the thighs.
3. By massaging the patient's back, you can perform sharper movements. In doing so, remember that you cannot use force when pinching and tapping the affected parts of the body.
4. Circular movements with light pressure work well to warm up the chest.

The second stage of physical activity

As you remember, the set of exercises includes several stages. So, after preparing the patient's body, you can start performing passive exercise therapy for stroke:

1. In order to restore the motor memory of the limbs, a flexion and extension exercise is performed. For this, the patient should be laid on his back, a slightly raised leg must be bent in the joint area so that, sliding along the sheet, it returns to its original position (i.e. unbent).
2. To perform the next exercise, you will need a special "simulator". You can do it yourself by stitching a wide (resembling an elastic bandage in its width) linen elastic band. The stitched ring should match the diameter of the legs. To work with such a simulator, put it on the patient's legs and start lifting him up, while it is necessary to massage the legs. A similar exercise is performed with the hands. Having lifted them with the help of an elastic band, ask the patient to make attempts to bend and straighten them in the area of ​​the wrist joint.
3. The following exercise is great for doing it yourself. Using a towel or tape, hang the affected limb of the patient so that he can move it in different directions and, if possible, perform rotational movements.

We must not forget that the main thing in remedial gymnastics is systematicity, so the time you devote to it should be at least 30 minutes (twice a day at the first stage of rehabilitation and three times when the patient gets a little stronger).

A little about mental exercise

As you know, in the control of limbs, a person owes a lot to muscle memory. In order to have an impact on the restoration of nerve cells in the brain, multiple repetitions of commands are required. In the event that this stage is difficult to master, relatives should voice the commands. Ask the patient to try to repeat them.

Post-stroke exercises for people who have learned to sit

Learning to sit again after a stroke is not so easy, mastering this stage takes a long time. Results usually become noticeable no earlier than the third week of the recovery period. For patients who have already achieved such success, there is a special set of exercises in a sitting position:

1. The first exercise is aimed at working with the eye muscles. Starting with up and down movements of the eyeballs, the patient must move to the right and left movements, then diagonally. The alternation of open and closed eyelids is very effective. Such exercises not only strengthen muscle memory, but also help to normalize blood pressure. To relieve tension after such gymnastics, the patient should close his eyes as much as possible and open his eyelids, repeating the action about 10 times.
2. In the next step, ask the patient to start rotating his head, this exercise is very useful for the neck. The direction of movement should be alternated. At the same time, it is very important not to make sudden movements, but to try to limit yourself to a slow pace.
3. If only one side of the body is affected, exercises for symmetrical movements should be included in the set of exercises. Lying on his back, the patient may attempt to simultaneously rotate or raise both arms.
4. In order to develop the motor skills of the fingers, it is necessary to take care of the patient's grasping movements. A set of expander bands that have different densities are well suited for this.
5. Work should also be done on the feet. Exercise involves stretching and contracting them towards you. If possible, the patient should strive to ensure that the movements of the feet are symmetrical.

Having mastered such basic exercises in a sitting position, the patient can begin to perform more serious options for exercise therapy. Ask him to make attempts to raise himself, while leaning on the headboard and strap. Particular attention should be paid to lifting the limbs (3-5 times are enough for the first few sessions).

Exercise therapy after a stroke is one of the important components of rehabilitation, which, like drug therapy, affects the prognosis. Rehabilitation measures after an ischemic or hemorrhagic stroke should be early and aggressive. They should be started immediately after the patient's condition has stabilized (usually for 2-3 days) and carried out daily for several months.

Regular exercise not only allows you to restore or improve motor functions, but also helps to reduce the risk of complications (congestive pneumonia, bedsores).

The main tasks of exercise therapy after a stroke:

A stroke often leaves the right or left side of the body paralyzed. Regular exercises in remedial gymnastics help to activate the reserve neurons of the brain and thereby partially or completely compensate for the manifestations of neurological deficit.

Physical therapy plays no less, and sometimes even more, in patient recovery and prevention of stroke recurrence than drug therapy. It should fit tightly into the life of every stroke patient.

The main tasks of physiotherapy exercises after a stroke are:

• prevention of complications associated with prolonged bed rest (muscle atrophy, congestive pneumonia, thromboembolism, progression of heart failure, bedsores);
• normalization of muscle tone;
• improvement of microcirculation and metabolism in tissues;
• restoration of physical activity;
• prevention of the formation of muscle contractures;
• improving the functions of internal organs;
• restoration of fine motor skills of the hands.

It is desirable to combine exercise therapy with other methods of rehabilitation, such as kinesiotherapy, massage, occupational therapy, social and psychological adaptation. Therefore, in the hospital, rehabilitation treatment is carried out by a team of specialists (psychologist, nurse, massage therapist, exercise therapy instructor, psychologist, speech therapist, kinesiotherapist), working under the guidance of a neurologist. Relatives of patients are actively involved in carrying out rehabilitation measures.

Exercise therapy and bed rest

The early recovery period lasts up to three months from the time of the brain accident. Some patients spend this time or part of it, observing strict bed rest. First, you need to give them the correct body position and change it - this is necessary to prevent stagnation and pressure ulcers.

After a stroke, muscle tone is disturbed, as a result of which the limbs occupy an incorrect position. For example, a paralyzed leg turns outward, the foot begins to droop. Spastic paralysis of the upper limb leads to the fact that it bends at the wrist and elbow joints, and the fingers are clenched into a fist. If you do not give the patient the correct position of the body on a healthy side or back, then over time he will develop muscle contracture, which will be very difficult to correct, and in some cases even impossible.

Regular exercises according to the Bubnovsky method help to improve joint mobility, restore the elasticity of the ligamentous apparatus and muscles.

In the first days after a stroke, the left or right arm and leg do not work well. Therefore, the patient is practically unable to perform active movements with them. To correct the situation during this period, a set of exercises for bedridden patients is performed, based on passive movements, that is, performed not by the patients themselves, but by an exercise therapy instructor or under his guidance by their relatives.

Depending on the type of joint, the following types of passive movements can be performed in it:

• rotation (rotation);
• adduction and abduction;
• flexion and extension.

At first, the amount of movement performed should be minimal. It is gradually increased, but does not exceed the physiological amplitude for the developed joint. Each movement is repeated 10-15 times. Passive hand exercises are performed first in the shoulder joint, then in the elbow, wrist, and then in the small joints of the hand. For the legs, they should be performed, starting with the hip joint, then moving on to the knee, ankle and joints of the toes.

Respiratory gymnastics is very important for the prevention of congestion in the lungs in bedridden patients. In addition, its implementation allows you to increase the saturation of blood with oxygen and thereby reduce the hypoxia of the brain, improve the metabolic processes occurring in it. The main exercises of breathing exercises are:

• take a deep breath and then exhale slowly through tightly closed lips;
• exhaling slowly through a cocktail tube into a glass of water;
• inflating balloons.

Patients should perform these exercises at least 10 times a day.

The Bubnovsky method helps to relieve pain, improve trophism of soft and hard tissues, and gradually restore motor functions.

An important stage in physical rehabilitation is the implementation of not only physical, but also mental exercises. Each movement has its own muscle memory. Therefore, if the patient's right half of the body does not work, then it is necessary to mentally imagine how the right arm and leg bend, the fingers and toes move. Repeated repetition of such exercises contributes to the fact that in the future it is much easier to restore the movements of the paralyzed limb. In addition, this technique allows the patient to form a clear goal, which also contributes to the acceleration of recovery.

Moderately extended semi-bed rest

At the next stage, the rehabilitation program is expanded. In addition to passive ones, it also includes active exercises that the patient performs on his own. If the patient is not yet allowed to sit down and get up, then he performs a set of exercises lying down:

• clenching and unclenching of the fingers;
• rotation of the fists in the wrist joints in one direction and the other;
• flexion and extension of the upper limbs in the elbow joints;
• raising the straightened arms above the head and lowering them along the body, that is, only the shoulder joints work;
• swing with straightened arms to the sides;
• flexion and extension of the toes;
• pulling the feet towards you and lowering them down;
• slow flexion and extension of the legs in the knee joints, while the feet are not lifted off the bed;
• bending the legs at the knee and hip joints, spreading them to the sides and slowly returning to their original position;
• a slow turn of the body in one direction or the other in the supine position;
• lifting the pelvis over the bed with emphasis on the feet, elbows, shoulder blades and the back of the head.

This complex should be performed 3-4 times a day. The number of approaches depends on the patient's condition. Initially, each exercise is repeated 3-5 times. With good tolerance to physical activity, the number of repetitions, gradually increasing, is brought to 15-20.

It is desirable to combine exercise therapy with other methods of rehabilitation, such as kinesiotherapy, massage, occupational therapy, social and psychological adaptation.

After the patient can take a sitting position, and this is allowed to him by the attending physician, physiotherapy exercises become even more active. To the exercises listed above, add the following, performed in a sitting position:

• head tilts from side to side;
• rotation in the cervical spine, first in one direction and then in the other direction;
• sitting on a bed without support under the back and with legs lowered (the duration of this exercise is at first 1-3 minutes, then gradually increases);
• arching the back back, leaning on the handrail of the bed;
• sitting on the bed with the legs extended forward and resting on the hands, alternately raise the legs above the surface of the bed and slowly return to their original position;
• in a reclining position (several pillows are placed under the back), one or the other leg is slowly pulled to the chest (if necessary, you can help with your hands).

In addition, patients should do hand exercises as often as possible. It is quite simple and is based on sorting through small children's toys, collecting and disassembling figures from a Lego-type constructor, classes with mosaics. Also, to improve fine motor skills of the brush, drawing, modeling, origami, and embroidery are recommended.

The proposed complex of exercise therapy after a stroke is common. If necessary, it can include other exercises aimed at restoring speech, friendly eye movements, writing and other functions.

Exercise therapy after a stroke: a set of exercises at home

Physiotherapy started by a patient who has suffered an acute cerebrovascular accident in a hospital must continue without fail after discharge from the hospital. You can ask the instructor to record a video of exercise therapy after a stroke on a disk or USB drive (flash drive) - such a video will help you do exercises at home in the correct technique, in the right order and without omissions.

The prognosis after suffering an ischemic or hemorrhagic stroke largely depends on the timeliness of the treatment begun, which includes not only medical methods, but also a number of restorative measures.

The complex of exercise therapy after a stroke at home includes exercises performed while lying, sitting and standing. All exercises in a standing position should be performed with the obligatory safety of the patient by an instructor, a relative, or with the use of additional support. An approximate set of such exercises:

• the patient tries to maintain balance in a standing position with his hands down;
• swing your hands;
• circular movements of the head;
• squats;
• torso tilts back and forth and left and right;
• turns of the body to the right and left;
• swing your legs.

After the patient learns to stand for a long time and maintain balance, and his muscles get stronger, the motor load is expanded again by adding walking.

Initially, the patient goes through segments no more than 10-15 meters long with the obligatory help of other persons or additional support. Then this distance gradually increases, and the support weakens as much as possible.

In the future, patients who have suffered a stroke are recommended long walks in the fresh air with a gradual increase in the pace of walking. Such physical activity is very useful for the cardiovascular system and can be practiced for as long as desired, preferably for life - daily walking in the fresh air, opposing physical inactivity, serves as an effective prevention of many diseases.

Bubnovsky method

The basis of restorative treatment according to the method of Dr. Bubnovsky is kinesiotherapy, that is, treatment with movement. At the same time, unique simulators with antigravity and decompression functions are used, which facilitate the implementation of movements by patients with limited functions after a stroke.

The Bubnovsky method consists in creating an individual training program for each specific patient, which takes into account the necessary parameters - the general state of health, the stage of the disease, the peculiarities of impaired motor function, personality characteristics, and motivation.

Each movement has its own muscle memory. Therefore, if the patient's right half of the body does not work, then it is necessary to mentally imagine how the right arm and leg bend, the fingers and toes move.

Regular exercises according to the Bubnovsky method help to improve joint mobility, restore the elasticity of the ligamentous apparatus and muscles. This contributes to the relief of pain syndrome, improvement of trophism of soft and hard tissues, gradual restoration of motor functions.

Physical therapy plays no less, and sometimes even more, in patient recovery and prevention of stroke recurrence than drug therapy. It should fit tightly into the life of every stroke patient.

Video

We offer you a video on the topic of the article for viewing.

Stroke Recovery: Directions, Approaches, Relapse Prevention

Despite the fact that the prevalence of acute vascular disorders in the brain (strokes) and mortality from them are quite high, modern medicine has the necessary methods of treatment that allow many patients to stay alive. What then? What conditions and requirements does the patient face in his future life after a stroke? As a rule, most of them remain permanently disabled, and the degree of restoration of lost functions depends entirely on timely, competent and comprehensive rehabilitation.

As you know, in violation of cerebral circulation with damage to the brain, a loss of various abilities of the body occurs, associated with the defeat of one or another part of the central nervous system. In most patients, motor function and speech are most often impaired; in severe cases, the patient cannot get up, sit, take food on his own and contact with staff and relatives. In such a situation, the possibility of at least partial return to the previous state is directly related to rehabilitation after a stroke, which should be started as soon as possible from the first days after the onset of the disease.

Directions and stages of rehabilitation

It is known that the number of neurons in the brain exceeds our daily needs, however, in conditions of trouble and their death during a stroke, it is possible to “turn on” previously inactive cells, establish connections between them and, thus, restore some functions.

To limit the size of the lesion at the earliest possible date, such drugs are prescribed after a stroke that are capable of:

• Reduce swelling around the affected tissue (- mannitol, furosemide);
• Provide a neuroprotective effect (Actovegin, Cerebrolysin).

Rehabilitation measures should be selected and carried out individually, depending on the severity of the condition and the nature of the disorders, however, they are carried out for all patients in the following main areas:

1. The use of physiotherapy exercises and massage for the correction of movement disorders;
2. Recovery of speech and memory;
3. Psychological and social rehabilitation of the patient in the family and society;
4. Prevention of delayed post-stroke complications and recurrent stroke, taking into account the existing risk factors.

Or a heart attack, accompanied by necrosis and death of neurons with dysfunction of that part of the central nervous system in which it developed. As a rule, cerebral infarctions with small sizes and hemispheric localization have a rather favorable prognosis, and the recovery period can proceed quickly and very effectively.

It deprives the life of most of those who have undergone it, and in surviving patients it most often leads to permanent impairments of various functions without the possibility of their complete or even partial recovery. This is due to the fact that with a hemorrhage, a significant amount of nerve tissue is destroyed, interactions between the remaining neurons are disrupted as a result of cerebral edema. In such a situation, even years of regular and persistent practice, unfortunately, do not always give the expected result.

Stroke recovery can take a long time, so the effectiveness of measures taken at this time depends on the patience and perseverance of relatives, friends and the patient himself... It is important to instill a sense of optimism and belief in a positive outcome, to praise and reassure the patient, since many of them are prone to manifestations of apathy and irritability.

With the defeat of some parts of the brain, asthenic-depressive syndrome is especially pronounced, so you should not be offended if a person close to you who has suffered a stroke is not in the mood, grumbles at family members and refuses to do exercises or massage. It is not worth insisting on their mandatory conduct; perhaps it will be enough just to talk and somehow distract the patient.

Disability after a stroke still remains a significant medical and social problem, since even with the most careful and timely treatment and rehabilitation, most patients never fully regain their lost abilities.

Therapy, which will help the patient recover faster, should be started early. As a rule, you can start it at stage of inpatient treatment... In this significant assistance will be provided by the methodologists of physiotherapy exercises, rehabilitation doctors, massage therapists in the department of neurology or vascular pathology of the brain. As soon as the patient's condition stabilizes, it is necessary to transfer him to rehabilitation department to continue restorative treatment. After discharge from the hospital, the patient is observed in polyclinic at the place of residence, where he performs the necessary exercises under the supervision of a specialist, attends physiotherapy procedures, massage, a psychotherapist or speech therapist.

It will not be superfluous to send a patient to a rehabilitation center, modern and well-equipped, designed for neurological patients, where there are all the necessary conditions for further correction of the lost functions. Due to the high prevalence of acute vascular pathology of the brain, which increasingly affects the young and able-bodied population, the creation of such centers, although costly, is fully justified, since it allows the use of the maximum possible number of methods of exposure with the fastest return of patients to their usual lifestyle.

Recovery of motor functions

Among the consequences of a stroke, movement disorders occupy one of the main places, since they are expressed to one degree or another in almost all patients, regardless of whether a heart attack or cerebral hemorrhage took place. They are expressed in the form paresis(partial loss of movement) or paralysis(complete immobilization) in an arm or leg. If both an arm and a leg are simultaneously affected on one side of the body, they speak of hemiparesis or hemiplegias... It happens that the changes in the limbs are not the same in severity, however, it is much more difficult to restore the function of the hand due to the need to establish fine motor skills and writing.

There are various methods of restoring motor function:

• Electrical stimulation;
• Using the biofeedback method.

Physiotherapy

The main and most affordable way to recover from paralysis is physiotherapy exercises (kinesitherapy)... Her tasks include not only the development of the previous strength, range of motion in the affected limbs, but also the restoration of the ability to stand, walk, maintaining balance, as well as fulfill ordinary household needs and self-care. Such familiar actions for us as dressing, washing, eating can cause serious difficulties if even one limb is affected. Patients with severe nervous disorders cannot sit up in bed on their own.

The amount and nature of the exercises performed depends on the severity of the patient's condition. In cases of deep violations, it is applied first passive gymnastics: an exercise therapy instructor or relatives exercise the limbs of a lying patient, restoring blood flow in the muscles and developing joints. As the state of health improves, the patient learns to sit down on his own, and then to get up and walk on his own.

If necessary, use a support - a chair, a headboard, a stick. If there is sufficient balance, it becomes possible to walk first around the ward, then around the apartment and even down the street.

Some patients with small areas of brain lesions and good recovery potential begin to get up and even walk around the ward within the first week after the onset of a stroke. In such cases, it is possible to preserve the ability to work, which is very important for young people.

With a favorable post-stroke period, the patient is discharged from the hospital for recovery at home. In this case, the main role is taken, as a rule, by relatives and friends, on whose patience further rehabilitation depends entirely. You should not tire the patient with frequent and prolonged exercise. Their duration and intensity should gradually increase as one or another function is restored. To facilitate the movement of the sick at home, it is good to provide him with special handrails in the shower, toilet, small chairs for additional support will not be superfluous.

Video: a set of active exercises after a stroke

Particular attention should be paid to the restoration of hand function with the ability to perform small movements and writing. It is necessary to perform exercises to develop the muscles of the hand, return the coordination of finger movements. It is possible to use special simulators and wrist expanders. It will also be useful, along with gymnastics, the use of hand massage, which helps to improve trophism in the muscles and reduce spasticity.

This process can take a lot of time and perseverance, but the result will be the implementation of not only the simplest manipulations such as: combing, shaving, tying shoelaces, but even cooking and eating on your own.

With a favorable course of the rehabilitation period, it is necessary to expand the circle of contacts and household duties of the patient. It is important for a person to feel like a full member of the family, and not a helpless disabled person. You should not neglect conversations with such a patient, even if he cannot fully answer questions. This will help to avoid possible apathy, depression and isolation of the patient with a reluctance to further recovery.

Ways to "stir up" the patient from the outside

Electrostimulation method muscle fibers based on the impact of impulse currents of various frequencies. At the same time, trophism in the affected tissue improves, muscle contractility increases, tone normalizes in spastic paresis and paralysis. The use of electrical stimulation is especially advisable for long-term patients in whom active restorative gymnastics is difficult or impossible. Currently, there are many different devices that allow this method to be used at home under the supervision of the attending physician of the polyclinic.

Using biofeedback method the patient performs certain tasks and at the same time, together with the doctor, receives sound or visual signals about various functions of his body. This information is important for the doctor to assess the dynamics of recovery, and the patient, in addition, allows the patient to increase the reaction rate, speed and accuracy of actions, as well as to observe a positive result from the exercises. As a rule, the method is implemented using special computer programs and games.

Along with passive and active kinesitherapy, a good effect is also given by the use of massage after a stroke, especially with a tendency to spasticity and long-term rehabilitation rehabilitation. It is performed using conventional techniques and does not differ significantly from that of other neurological diseases.

It is possible to start the massage even in the hospital in the early stages of the post-stroke period. A massage therapist in a hospital or rehabilitation center will help you with this. In the future, massage at home can also be entrusted to a specialist, or relatives themselves can master its basic principles.

Restoration of the function of speech and memory

Recovery of speech after a stroke is an important stage, first of all, in the social rehabilitation of the patient. The sooner contact is established, the sooner it will be possible to return to the usual life.

Speech ability is impaired in most stroke survivors. This may be due not only to impaired functioning of the facial muscles and articulation, but also to damage to the speech center located in right-handers in the left hemisphere. With the defeat of the corresponding parts of the brain, the ability to reproduce meaningful phrases, count, and also to understand the addressed speech may disappear.

A specialist - speech therapist - aphasiologist will come to the aid of the patient in case of such disorders. With the help of special techniques and constant training, he will not only help the patient, but also give advice to his family and friends regarding the further development of speech. Conducting exercises to restore speech should be started as early as possible, classes should be regular. The role of relatives in restoring the ability to speak and communicate with others cannot be overemphasized. Even if it seems that the patient does not understand anything, you should not ignore him and isolate him from communication. Perhaps, even without having the ability to say something, he perceives well the addressed speech. Over time, he will begin to pronounce single words, and then whole sentences. The restoration of speech also contributes a lot to the return of the ability to write.

Most stroke patients have memory impairment. They hardly remember the past events of their lives, the faces of relatives may seem unfamiliar to them. In order to restore memory, it is necessary to constantly train it with the help of simple exercises and techniques. In many ways, these exercises can resemble classes with young children. So, with the patient, you can learn nursery rhymes that are easy to remember and reproduce. First, it is enough to memorize one sentence, then a whole stanza, gradually complicating and increasing the amount of memorized material. When repeating phrases, you can bend your fingers, forming additional associative connections in the brain.

In addition to rhymes, you can recall events from the patient's life, how the day passed, what happened a year or a month ago, and so on. As memory, speech and cognitive functions are restored, you can proceed to solving crosswords, memorizing various texts.

It is useful to carry out memory restoration classes all the time: while eating, when cleaning the house, on walks. The main thing is that they should not give the patient anxiety and cause negative emotions (memories of unpleasant events from the past).

Video: exercises to restore speech with afferent aphasia

Psychological and social rehabilitation

In addition to caring for a patient after a stroke, restoring motor and cognitive functions, psychological and social adaptation is of no small importance. It is especially important in young and able-bodied patients with a small amount of brain damage, who are likely to return to their previous lifestyle and work.

Given the possible pain syndrome, the inability to perform habitual actions, participate in social life, as well as the need for constant help from others, such patients are prone to depression, bouts of irritability and withdrawal. The task of relatives is to provide a favorable psychological environment in the family, to support and encourage the patient.

Sometimes there are hallucinations after a stroke, and the patient can describe them to relatives. In such cases, you should not be intimidated: as a rule, the appointment of special medications is sufficient to eliminate them.

The performed rehabilitation measures must correspond to the real functional capabilities of the organism, taking into account the depth of neurological disorders. You should not isolate the patient, referring to the loss of their ability to speak normally or forgetfulness - it is better to prompt him the right word or entrust him with simple homework. For many, for effective recovery and an optimistic attitude towards exercise, it is important to feel needed.

In addition to creating psychological comfort at home, classes with a psychotherapist give a good effect, and, if necessary, prescribe medications (sedatives, antidepressants).

Social adaptation plays an important role in returning to a normal life. It is good when there is a possibility of returning to the previous work or doing another, simpler one. If a person is already retired or the violations that have appeared do not allow him to work, you need to look for other ways of socialization: visiting the theater, exhibitions, looking for a hobby.

A specialized sanatorium is another method of social adaptation. In addition to physiotherapy procedures, classes with various specialists, the patient sometimes receives such a necessary change of environment and additional communication.

Prevention of late complications and recurrent strokes

Most patients and their relatives are interested in the question: and its complications in the future? What treatment is needed after a stroke? To do this, it is enough to follow simple conditions:

1. Continuation of the started rehabilitation activities (exercise therapy, massage, memory and speech training);
2. The use of physiotherapeutic methods of influence (magnetic, laser therapy, thermotherapy) to combat increased muscle tone in the affected limbs, adequate pain relief;
3. Normalization of blood pressure (with previous hemorrhage and presence), appointment (with ischemic brain lesions);
4. Normalization of lifestyle with the exclusion of bad habits, adherence to the diet after a stroke.

In general, there are no strict restrictions and essential features in nutrition, therefore, after a stroke, you can eat anything that will not harm a healthy person.

However, it is necessary to take into account the concomitant pathology and the nature of the existing changes. In case of dysfunction of the pelvic organs, the supine position of the patient, it is advisable to exclude products that slow down the passage of intestinal contents, and to increase the proportion of vegetable salads, fruits, cereals. To avoid disturbances from the urinary system, it is better not to get carried away with sour, salty, and sorrel dishes.

Diet for cerebral stroke depends on the mechanism of acute cerebrovascular accident and the previous causes. So, with hemorrhages as a result, it is better not to eat salty food, drink plenty of fluids, strong coffee and tea.

It is necessary to adhere after an ischemic stroke (cerebral infarction). In other words, you should not give preference to fatty, fried foods, readily available carbohydrates, which contribute to the development of atherosclerotic lesions of the vascular walls. Better to replace them with lean meats, vegetables and fruits.

Stroke and alcohol are not compatible things , regardless of whether a heart attack or hemorrhage occurred in the patient. Drinking even small doses of alcohol leads to an increase in heart rate, high blood pressure, and can also contribute. These factors can cause a recurrent stroke with aggravated neurological impairment and even death.

Many patients, especially young people, are interested in whether sex is acceptable after a stroke. Thanks to a variety of studies, scientists have proven not only the absence of harm from it, but also the benefits in the rehabilitation process. However, there are certain nuances associated with a serious illness:

• Possible dysfunction of the organs of the genitourinary system, decreased sensitivity and potency;
• Taking antidepressants, irritability and apathy with decreased sex drive;
• Movement disorders that complicate sexual intercourse.

With a favorable course of the recovery period, a return to normal marital relations is possible as soon as the patient feels the strength and desire in himself. Moral support and warmth of the spouse will also help to improve the psycho-emotional state. At the same time, moderate physical activity and positive emotions will have an extremely beneficial effect on further recovery and return to a full life.

The consequences of a stroke for the general health of a person depend directly on the volume and location of the lesion in the brain. In severe and extensive strokes, complications from other organs are inevitable, the most common of which are:

1. Inflammatory processes of the respiratory system (congestive pneumonia in bedridden patients);
2. Dysfunction of the pelvic organs with the addition of a secondary infection (cystitis, pyelonephritis);
3. Pressure ulcers, especially with inadequate care
4. Decrease in intestinal motility with a slowdown in the movement of contents through it, which is fraught with the development of chronic inflammation, constipation.

When caring for a patient who has suffered a stroke, it must be remembered that a person who has suddenly lost his former way of life, the ability to work and communicate in his usual environment, requires not only moral support, but also affection and kindness.

In general, rehabilitation after an ischemic stroke is faster and easier than after a hemorrhage. Many patients return to their usual way of life early enough, and young and able-bodied people even restore skills at their previous work. The outcome and consequences of the transferred disease depend on patience, perseverance and the desire for recovery, not only on the part of the patient, but also on the part of his family. The main thing is to believe in a successful outcome, then a positive result will not be long in coming.

Video: how to restore movement after a stroke? Living Healthy Program

The consequences of a stroke are different in each case. It can be speech, memory or upper limb impairment. An experienced specialist will advise you on how to restore your arm after a stroke. In such cases, not only medications are used, but also special exercises, simulators, which you should be aware of.

Why is mobility and sensitivity impaired?

The defeat of the hand after a stroke occurs against the background of an inflammatory process in the left hemisphere of the brain. It is this part that is responsible for motor processes.

Disorders are considered to be partial or complete lack of motor activity, muscle weakness, tremors or insufficient response to certain environmental stimuli.

There are two types of paralysis that occurs after an ischemic stroke or cerebral hemorrhage:

1. Peripheral. Disorders involve individual nerves.
2. Central. Pathological processes affect the work of the entire nervous system.

After a stroke, which is due to thrombosis or swelling of the limbs, paralysis of the arm may occur. This is a serious consequence. The patient has a chance to recover if he undergoes a full course of drug treatment and rehabilitation, as well as performs the necessary gymnastics.

The hand may be numb. When pain receptors do not respond to stimuli, physical activity and reflexes are below normal. Such consequences arise against the background of damage to the left hemisphere of the brain, cerebellum or frontal lobe.

This is because nerve cells and peripheral nerves have suffered after a stroke..

Violations disappear after 2 months if the victim carries out treatment, attends massage sessions, acupuncture and reflexology.

Effective recovery methods

You can restore your right or left arm after a stroke at home. But before that, you should undergo a full diagnosis and a course of treatment. You need to do special gymnastics every day, exercise on simulators, visit the pool.

In addition, electrical impulses and acupuncture are used to restore hand function.

Gymnastics

It is necessary to perform exercises to develop fine motor skills of the hands, return them to sensitivity, increase muscle tone and strength. For example, lifting dumbbells, sculpting, swimming.

To develop motor skills, you should write with a pen more often. If after a stroke there is partial paralysis of the hands, doctors recommend doing morning exercises, doing race walking.

Exercises are done every day in the morning and in the evening, it is enough to devote 15 minutes to this. In the first month after a stroke, you cannot load the body, otherwise there is a risk of a second attack.

Classes will help prevent the formation of blood clots, bedsores, ulcers on the arm, followed by paresis, tissue death, and blood poisoning.

Taking medications

To restore a paralyzed arm after a stroke, doctors prescribe to their patients:

• nootropic drugs;
• pain medications;
• neuroprotective agents;
• stimulants.

Additionally, the patient takes drugs that purify the blood, as well as vitamins, antibiotics and antidepressants. To calculate the dose of the medicine and the duration of the course, the attending physician takes into account the individual characteristics of the victim's body.

In the first time after the attack, the patient is shown injections and droppers. It should take a couple of months before he takes the medication by mouth.

Other recovery methods

Modern medical centers offer a variety of treatments to restore arm movement after a stroke:

• mud wraps;
• art therapy;
• reflexology;
• acupuncture.

Such methods are very popular. During the acupuncture procedure, thin punctures are made on the body.

The electrical impulses arising in them affect the nerves, muscles, which are responsible for the work and mobility of the upper limbs.

Hand restoration exercises

A set of exercises:

1. Rub and knead each finger for 15 seconds.
2. Sit down, put your palms on your hips, fingers apart as much as possible. Raise each of them up, starting with the little finger and ending with the big one. Then turn your hands with palms up and do the same. Repeat the exercise at least 10 times. The worse it turns out, the more time you need to devote to such exercises.
3. Sit down, put your palms on your hips, closer to your knees. Rotate your fingers one by one. Turn the palms over and continue gymnastics with your fingers. This exercise trains fine motor skills, and this has a positive effect on the work of the brain. Should be done 7 times.
4. Spread all fingers as far as possible, then squeeze them into a fist. Repeat such exercises to restore the hand 5 times.
5. In a sitting or lying position, work with your toes. First, pull them towards you, spread them out, then tilt them in the opposite direction, squeeze. The exercise is repeated 10 times.
6. Clasp your hands with a lock and raise your fingers in turn. For example, a large one on the right hand, then on the left. Having finished on the little fingers, the exercise is continued in reverse order 10 times.
7. Flick your fingers in turn, starting with your thumb and forefinger. The exercise is repeated 5 times.

Doctors recommend using special accessories to warm up your fingers. There are massage balls that resemble a hedgehog. They can be thrown from the right hand to the left, massage the hands and fingers. Every day, a stroke victim should practice with this ball for at least 3 minutes.

The recovery of the right hand is positively influenced by an exercise with two balls that can be rolled in the palm of your hand.

Finger and Hand Rehabilitation Equipment

Besides gymnastics and special exercises, doctors recommend other methods to work out the upper limbs after a stroke.

1. The Rubik's Cube is good for flexing your fingers. During its use, a person trains the bends of the entire hand, stretches the phalanges, and strengthens the muscles. To some extent, such a simulator helps to develop the micromotor of the fingers. When turning the planes of the cube, different muscles on the arms are trained. The patient needs to use all fingers, clasping him, thus, more efforts will be needed.
2. It is recommended to sculpt figures from plasticine or assemble a children's construction set. This has a positive effect on the recovery process.
3. Doctors recommend to devote more time to checkers, chess. Games that help train not only the fingers, but also the hand itself. In addition, they are good at helping to develop memory and thinking.

During recovery, the hardest thing for the patient is to practice small movements. For development, you can use a variety of simulators to scroll with your fingers. You can scatter matches and buttons on the table every day in order to collect them later.

Traditional medicine

To restore the left arm after a stroke, you can use unconventional methods. But before resorting to such recipes, you should consult your doctor.

Among folk remedies, the following are highly popular:

• honey with royal jelly;
• ointment, which includes pine needles and bay leaves (the product should be rubbed into the hand that has suffered after a stroke).
• a tincture made from mountain arnica flowers;
• medicine from Japanese sophora;
• herbal preparations, which include motherwort, mint and St. John's wort.

During recovery, it must be remembered that all methods of treatment, among which are folk remedies, as well as rehabilitation measures should be aimed at restoring blood circulation in the hand. This is facilitated by a good massage, which will speed up recovery.

You can look for other methods of recovery, but it should be understood that everything should be controlled by the attending physician. He takes into account all the individual characteristics of the patient and, guided by them, makes a decision. Only in this way will the restoration of the hand after a stroke be effective.

Recovery forecast

Older people are most often affected by a stroke. It is they who have a complication in the form of hand paralysis. In most cases, complete recovery occurs. But this is provided that the patient complies with the recommendations of the attending physician, the rules of rehabilitation.

It takes 6 months to recover a hand after a stroke, sometimes 1 year... But after a second attack, it is not always possible to cure complications such as paralysis, numbness, or loss of sensation. Therefore, many patients remain disabled.

To prevent all these complications, it is necessary to seek medical help in a timely manner. He will make an accurate diagnosis, prescribe treatment, especially if the disorders develop at the initial stage.

Medicine has the necessary methods of treatment that allow patients to save life after ischemic and hemorrhagic stroke. But what is its quality if certain parts of the nervous system are affected in a person?

As a result of a rupture of blood vessels in the brain, a person who has suffered a stroke may lose motor functions of the arms and legs, and he may have speech impairments.

Timely and correct recovery of the body after a blow suffered will help to fully or partially return the patient's previous condition. You need to start it as early as possible so as not to waste time.

The most important component of the rehabilitation plan is exercise therapy after a stroke, which, in combination with taking medications, will help restore normal physical activity.

In addition to taking medications that reduce tissue swelling in the affected area and have a neuroprotective effect on brain tissue that has survived an attack, patients and their families need to know what the therapeutic effect of an exercise program is. It is selected individually, depending on the severity of the patient's condition and the possibilities that he has preserved.

With the help of physiotherapy exercises, it is possible to correct and eliminate disorders of the musculoskeletal system, accelerate the restoration of articulation and memory, and also eliminate neurological deficits that occur after a vascular accident.

It all starts with the preparatory period. This is the time when it is impossible to immediately switch to active physical actions, and in some cases it is simply impossible.

What does the preparatory period consist of:

• Giving the body the correct position in the early stages of the recovery period is very important. Frequent change of its position is encouraged, which is the prevention of pressure ulcers and the creation of stable post-stroke contractures.
• Passive exercises that can be done for different muscle groups and joints. They are performed not by the patient himself, but by the person who is with him. This is a complex of actions for flexion-extension, circular movements, as well as adduction-abduction of the limbs.
• Correct breathing exercises include exercises to develop the lungs.
• Mind exercises are designed to restore lost muscle memory.
• Massage and passive stress after a stroke are very important in the rehabilitation period. They improve blood circulation, prevent stagnation in the body and help the patient feel his body, preparing him for active exercise therapy.

Performing exercise therapy after a stroke has a number of features, there are rules, the observance of which is important to obtain a positive result:

• Listen to the recommendations of the attending physician, as he has information on what loads are useful during the rehabilitation period and will prescribe an effective set of exercises based on the capabilities and needs of the patient's body.
• Overwork and excessive stress is unacceptable, as it will do more harm than good.
• Do not neglect warming up the skin before exercising initially.
• Observance of regularity in classes is an important condition for efficiency.
• Patience and an understanding of the patient's mood will help correct the depressive state that is often present in patients after stroke.

Performing a set of exercises at home, you can significantly speed up the recovery period. Before you start the advanced exercises, you need to start with bending and balance. Then you can start walking, pull-ups, rolls, squats and bends. For a person with a stroke, exercise should become an integral part of life, like breathing, eating and sleeping.

Do the exercises prescribed by your doctor, read books, and watch videos about stroke recovery. This will help you deal with its consequences faster and easier. Give yourself a positive mental attitude for a quick and complete recovery.

Therapeutic exercises after a stroke: which exercises will help you recover faster

A set of exercises according to the periods of a stroke is prescribed by the doctor individually, depending on how much the brain has suffered, what disorders are present and what their localization is. At each stage, there are general guidelines that will be useful to most stroke patients.

In the supine position, the list of exercises is as limited as possible, but there is a way out! Therapeutic exercises for stroke for the upper, lower extremities and trunk, which must be done systematically, will help you.

The Hand Complex includes movements to help develop joints and improve circulation. It is necessary to perform rotational and flexion-extension movements in the hands, elbows, and shoulders. It is helpful to clench your fingers into a fist and then unclench them.

To train the legs, it consists of motor activity with the fingers, pressure with the feet on the "pedals", bending the legs at the knee joints, diluting them and bringing them together in the hip joints.

The set of exercises for the torso consists of turns in different directions, raising the pelvis with an emphasis on the head and feet, lifting its upper part.

The key to success is the regular and active performance of classes, then in a short time you will feel an improvement and can move on to the next stage.

We perform exercise therapy while sitting

On average, after 3 weeks, the patient can move to a sitting position. This is a set of simple exercises that a healthy person can easily do.

Therapeutic exercises while sitting includes:

• Head movements with the aim of developing the cervical spine.
• Sitting on the bed without support.
• Back bend while keeping the hands on the handrails.
• Raising the legs in a sitting position.
• Performing grasping exercises to restore hand motility.

Children's toys will perfectly help to develop fine motor skills, which will have a beneficial effect on the patient's speech.

We perform exercise therapy while standing

The first step at this stage is to try to get on your feet with outside help, and then without it. If possible, it is advisable to use special simulators that are available in rehabilitation centers.

Remedial gymnastics after a stroke is also possible at home. At first, special devices for creating a support will not be superfluous.

In a standing position, you can use the following exercises:

• An attempt to maintain balance in a position when the legs are shoulder-width apart, and the arms are at the seams.
• Swing arms and legs, lifting them, as well as squats.
• Tilts of the body forward, backward and in different directions.

This is just an initial set of the simplest standing exercises. When the patient feels confident in himself, he can diversify them, but this must be done in a balanced way. The main thing here is to do everything with an increasing level of load and slowly. Physiotherapy exercises should become a daily activity for people who have suffered a stroke.

Home Rehabilitation Exercises After Stroke

One of the most important methods of effective rehabilitation is recovery exercises, without which it is impossible to achieve the best results. You need to approach their implementation responsibly and be systematic.

The recovery process is quite long and the patient needs to choose exercises after a stroke at home after being discharged from the medical institution in which first aid was provided. Often during the recovery period, patients experience asthenic-depressive syndrome, which is manifested by irritability and apathy.

Those close to you need to come up with understanding to this state, and try to support the person. It is necessary to try to lift his spirit and instill faith and hope that the efforts made will be useful and return to normal life. You also need to make sure that the doctor's recommendations are strictly followed, since negligence in this matter is simply unacceptable.

The most important condition for the restoration of all lost functions is proper rehabilitation at home. Exercises for the patient should be scheduled, starting from the first day after the attack, and over time, this complex changes depending on what improvements are present in the patient's condition. On the website of Dr. Bubnovsky, you can find information that will be useful to the patient.

What is mental exercise

Our brain has a huge number of neural connections. As a result of a stroke, entire areas of it are affected, which are responsible for certain functions of the human body. Doctors prescribe medications to help relieve inflammation and protect the neurons that remain unharmed.

The patient, even having completely lost the ability to move, can do mental exercise before he can do exercises after a stroke at home. It will help the body recover much faster and regain its former activity.

Even if a man or woman has ceased to feel any part of the body, they can deliberately give her clear commands that stimulate movement, imagining how this happens. Such exercises can bring tremendous benefits to the body, and the amendment will occur many times faster.

Thought is a powerful tool for influencing the body... With its help, you can do a workout at home even when there is no physical opportunity for this at the moment.

With the help of stroke recovery simulators, the healing and rehabilitation process can be greatly accelerated. They can be used from the first days after the patient's condition has stabilized. Their disadvantage is that they are quite expensive and their use is usually limited to hospital conditions.

What you need to do in combination with exercises for a speedy recovery:

1. Recovery of speech One of the first priorities for the patient, the sessions with a speech therapist and stem cell injections will be very helpful.
2. Memory recovery is also an important condition for returning to a fulfilling life. Finger games, studying poetry and returning to memories of the past in a warm atmosphere of understanding and support of loved ones will help you to quickly cope with this task.
3. Restoring articulation is performed using a set of exercises for the muscles of the neck and face, as well as their massage. Speech therapy classes are also held to help restore the function of the speech apparatus and train it.

Recovery of the body after a stroke is a long and responsible process. It is necessary to go through it in order to regain the lost health and capabilities of the body, approaching the matter responsibly, since lost time can lead to irreversible consequences.