Recommendations for Stroke Survivors

Exercise

In April 2004, the American Heart Association (AHA) released a statement urging stroke survivors to exercise for at least 20 minutes per day, 3-7 times a week, to reduce the risk of stroke recurrence. Exercise can also strengthen muscles and improve mobility, which can help a stroke survivor perform daily activities, such as dressing, bathing, walking, and doing household chores.

A study, published in the April 22, 2004 issue of Stroke , found that a resistance-training program significantly improved lower extremity strength, as well as function and disability in older stroke survivors. The 12-week resistance-training program consisted of a variety of exercises designed to strengthen the lower body.

Before beginning an exercise program, stroke survivors should consult their physician, who may recommend adding handrails or harnesses to exercise equipment in order to make exercising safer.

Exercise sessions can be divided into 10-minute intervals and should include stretching, cardiovascular exercises, and strength training.

Physical, Occupational, and Speech Therapy

After a stroke, physical therapy can help restore some of the function lost in a stroke. Physical therapy for stroke survivors may include stimulating impaired limbs, stretching, and practicing motor tasks (ie, walking up or down stairs). People too weak to bear their own weight can perform physical therapy exercises in the water, supported by a harness. Goal-oriented activities, such as games, are often used to promote coordination. A new technology, called transcutaneous electrical nerve stimulation (TENS), generates an electrical current and stimulates nerve activity in impaired limbs.

Similar to physical therapy, occupational therapy is utilized in stroke patients to help improve motor abilities. Occupational therapy specifically targets improving motor skills that will help the stroke survivor perform activities such as housecleaning, gardening, arts and crafts, and even driving.

Speech therapy is often helpful for stroke survivors who are generally able to think clearly, but have problems speaking or understanding speech or written words.

Sensorimotor Training

A study in the March 4, 2004 issue of Stroke indicated that repetitive sensorimotor training of the arm during the first weeks after a stroke significantly improves motor function up to five years later. In this study, the participants were seated in a rocking chair for 30-minutes each day for six weeks, while an inflatable splint pushed them forward; they had to use their arm strength to actively push themselves backward.

Stroke patients should begin stimulation of their weakened arms soon after a stroke. Repetitive stimulation can result in significant improvements in future functioning.

Treatment of Anxiety and Depression

A study in the February 12, 2004 issue of Stroke found that depression and anxiety, which are common after a stroke, were associated with handicap two years after a stroke. The study’s authors suggest that treating depression and anxiety may help reduce the level of handicap in stroke survivors. A mental health professional can help determine the best way to treat anxiety and/or depression.

The Future of Stroke Rehabilitation

According to the author of an article published in the December 11, 2003 issue of Stroke , “Brain recovery after stroke is the area of scientific discovery with the largest potential for advances far into the next century.” As researchers gain a better understanding of how the brain is organized and how brain cells communicate with one another, they will be able to develop new rehabilitation therapies to help reverse post-stroke damage.