Stroke Recovery and Physiotherapy
It’s National Stroke Week, a time when we raise awareness of stroke’s symptoms and impact.
Physiotherapy plays a key role in helping you recover after a stroke. Research shows training and exercise can help you move and use your arms again, improve your balance and ability to walk after a stroke. Getting as fit as you can after a stroke is also important to minimise chance of having another stroke.
You’ll usually start physiotherapy soon after your stroke. That’s because the fastest recovery happens in the first six months. The brain continues to relearn and adapt for many years. Here are the answers to some of the most common questions about the role of physiotherapy in stroke recovery
Stroke Recovery and Physiotherapy: Your Questions Answered
This week at Neurospace, we're marking National Stroke Week 2020 by helping you learn more about stroke and by exploring the role of physiotherapy in stroke recovery.
Your arteries carry oxygen-rich blood to your brain, enabling the brain to fulfil its role as your body’s command and control centre.
Stroke happens when a blocked or burst artery prevents oxygen getting to your brain. That lack of oxygen may cause swelling which prevents cells in that part of your brain working for a while. It may also cause some cells to die.
Your home has different rooms that you use for different purposes. A fire in your bedroom means you’ll have to sleep on the sofa for a bit but you’ve still got full use of your bathroom and kitchen.
In the same way, your brain has certain areas that control certain functions. How a stroke affects your life depends on which area of your brain it injured. Stroke may affect the way you speak, swallow, think, move and behave. It can also affect senses like your sight and touch.
If someone's having a stroke, you need to think FAST:
- Is their Face drooping?
- Can they lift their Arms?
- Is their Speech slurred?
- Then it's Time to call an ambulance
Physiotherapy for Stroke Rehabilitation
The nerve cells that have died in a stroke won't recover. But intense and targeted rehabilitation can help you recover and adjust in other ways by training the brain to use different cells.
If you’ve had a stroke, you will probably be encouraged to have physiotherapy as part of your rehab. Here are our answers to the most common questions about physiotherapy and stroke recovery.
1. How does stroke affect your mobility?
Stroke can affect your movement (mobility) in several ways. It may make it hard for you to sit, stand, balance or walk.
That’s because stroke can cause weakness, paralysis, changes in muscle tone or loss of sensation. Your ability to control your movements may change, altering your balance and coordination. You may also experience pain, swelling, or pins and needles from lack of movement which make movement harder.
You have to concentrate so much harder to achieve simple movements. And that can make you very tired after a stroke, so you feel much less like doing activity.
2. How does physiotherapy help recovery from stroke?
Physiotherapy aims to improve your movement and sensation after a stroke so that you can do everyday tasks like dressing or cooking.
The exact form that physio takes depends on how stroke has affected you. It may involve hands-on techniques and a program of exercises to help you:
- Move and use your arms
- Recover your balance
- Manage pain
- Reduce the risk of another stroke.
A neurological physiotherapist is particularly skilled at working out exactly what has been affected by the brain damage, how this has affected your movements, sensation, balance and muscle stiffness/strength. They design a program to progressively address your individual impairments.
3. How soon can you start physio after a stroke?
Physio should start early because recovery is quickest in the first six months after a stroke and we want to avoid complications associated with any changes in movement such as neglect and disuse leading to muscle atrophy and stiffness.
Your physiotherapy will probably start while you’re still in hospital, either in a stroke unit or an acute ward. Physiotherapy will be provided wherever you go next too, whether that’s to an inpatient rehabilitation unit or back home.
Physiotherapy will usually continue for several months or even years after a stroke. It’s an important part of your recovery.
4. How effective is physio after a stroke?
Each stroke is unique, making it hard to give generalised answers about recovery.
However, many research studies show that physiotherapy can help improve arm function, balance and walking after a stroke. There are clear guidelines in place to ensure physiotherapists follow best evidence when helping you recover function after a stroke.
Some of it depends on you too. Generally, you’ll make better progress if you take an active part in your therapy sessions and commit to doing any exercises your physio may ask you to complete in between sessions.
5. What are the best exercises for stroke recovery?
Your treating physiotherapist will assess you carefully and identify the best exercises for your recovery. Your treatment might include:
- Task-specific exercises, designed to help you with the activities of everyday life
- Equipment like treadmills or video games to help you practice certain movements or a brace that supports your foot and reduces the risk of a fall
- Electrical stimulation to make weak muscles stronger.
Whichever specific exercises you’re prescribed, they’ll usually require an R&R approach:
- Repetition: you’ll repeat each small movement many times (e.g. 10-15 reps) to help you improve
- Regularity: you’ll make better progress if you do your exercises regularly, such as every day or even several times a day.
6. How long does it take for physio to work after a stroke?
Let’s go back to our example of the house with the burnt-out bedroom. Sleeping on the sofa creates a bed in the living room. It’s not the living room’s primary purpose but the sofa can work quite well as a bed once you get used to sleeping there.
In the same way, neurological physiotherapy is training nerve cells in your brain to take over from those that were damaged in the stroke. It’s forming new cell connections in your brain. This is known as neuroplasticity (the idea that your brain is mouldable and adaptable).
There’s not really a timeframe for recovery after stroke. We know that the fastest improvement is in the first six months but we have seen recovery and movement changes even after 10 years.
One thing physios love to do is measure. We take outcome measures which is good because it means you can see that you are making progress, even if it’s slower than you’d like at times.
How Can Neurospace Help?
We're neurological physiotherapists who pride ourselves on helping people with complex movement difficulties, including people recovering from a stroke in and around the Canberra region.
We will talk to you about your daily life after stroke, review your medical history, and carefully assess your movement. Then we can prescribe a tailored program of exercise and other therapies to help you regain as much of your function as possible and reduce the risk of strokes happening in the future.
Please make an appointment today.
All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion.