Stroke Exercises - Saebo

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Stroke ExercisesforYour Body

Table of ContentsStroke Exercises For Your Body 3Arm Exercises 7Balance Exercises 13Core Exercises 19Hand Exercises 26Leg Exercises 30Shoulder Exercises 37Reclaim Your Independence 43Stroke Exercises for Your Body2

Stroke Exercises For Your BodyStroke rehabilitation in America leaves much to be desired in terms of recovery and qualityof life. There is a serious gap between stroke patients being discharged and transitioned tophysical recovery programs. In an effort to improve recovery and quality of life, the AmericanHeart Association has urged the healthcare community to prioritize exercise as an essentialpart of post-stroke care.With the right recovery programs that prioritize exercise for rehabilitation, stroke survivorscan “relearn” crucial motors skills to regain a higher quality of life. Thanks to a phenomenonknown as neuroplasticity, even permanent brain damage doesn’t make disability inevitable.“There is strong evidence that physical activity and exerciseafter stroke can improve cardiovascular fitness, walkingability, and upper arm strength. In addition, emerging researchsuggests exercise may improve depressive symptoms,cognitive function, memory, and quality of life after stroke.”- Sandra Billinger, Physical Therapist at the University of Kansas Medical CenterStroke Exercises for Your Body3

How Your Brain Recovers Froma StrokeRecovery after a stroke is possible because the human brain iscapable of reorganizing and retraining itself through neuroplasticity.When you perform repetitive physical tasks, you tap into this ability by retraining unaffectedparts of your brain to perform functions that your damaged brain cells once performed. Insimple terms, neuroplasticity is the process of “rewiring” the brain to perform tasks throughdifferent neural pathways.Some “spontaneous” recovery does occur after a stroke, but it doesn’t continue forever.According to a study published in the Journal of the American Physical Therapy Association,spontaneous motor recovery only occurs during the first 6 months of recovery. Afterwards,rehabilitation is necessary to make further progress, especially if you need to learn new skillsand coping mechanisms.To overcome the leading cause of disability, a consistent exercise program is critical. Byusing the power of neuroplasticity, stroke survivors can regain mobility and function. If youwant to overcome the limitations of traditional recovery methods, you should know thatexercise is your most effective tool.Stroke Exercises for Your Body4

Benefits of Exercise After a StrokeExercise increases your chances of regainingfunction after a stroke. In fact, when strokesurvivors have trouble performing dailyfunctions, it isn’t always because of thestroke itself. Brain damage also causesproblems that indirectly lead to loss ofphysical function. After suffering a stroke,survivors who don’t begin an exerciseregimen will experience additional,preventable problems such as physicaldeconditioning and fatigue.They may also face a variety of obstaclesthat make it more difficult to beginexercising, such as: Lack of social supportFinancial instabilityDepressionSeverity of physical symptomsFatigueFrustrationConfusionLack of motivationThese barriers are precisely why a tailored,consistent exercise regimen is such animportant part of proper post-stroke care.When patients receive support, tools, andspecific instructions to keep them activeafter a stroke, obstacles such as fatigueand depression will get smaller and lesspowerful, making it easier to continue aregimen of aerobic and strength-trainingexercises.These exercises, in turn, give patients thepower to reclaim lost abilities and get backto the life they had before the stroke.According to the American HeartAssociation, exercising after a stroke is acrucial way to improve the following: Cardiovascular fitnessWalking abilityMuscle strengthFlexibilityCoordinationCognitive functionMental healthMemoryQuality of lifeStroke Exercises for Your Body5

Exercises for Stroke RecoveryAny amount of physical activity isa positive step for stroke survivors.Over time, even light activity suchas walking around the block ordoing laundry will contribute tophysical improvements and helpprevent the deconditioning thatleads to further deterioration.However, activities of moderateintensity are even more beneficialfor your health. If you want toreclaim a specific function, forexample, you can incorporate avariety of at-home exercises totarget individual body parts.Remember, a full recovery is only possible if you take direct action to reclaim function in themonths and years that follow. By following an exercise program that targets specific areasand functions, you can reclaim your coordination, strength, and range of motion throughoutyour body.Each of the following exercises is designed to condition your body and brain in specificways. The movements are recommended by trusted physical therapy professionals andcover the following areas of the body: shoulders, arms, balance, hands, legs, and core.Follow along with helpful illustrations as you work through the basic, intermediate, andadvanced versions of these post-stroke exercises.As with any exercise program, please consult your healthcare provider before you begin.If you notice increased pain, discomfort, or other troubling systems, stop these exercisesimmediately and talk to your doctor.Stroke Exercises for Your Body6

Arm ExercisesA stroke can often make it difficult to perform simple tasks like moving the arm forwardor grasping and releasing objects. Physiotherapist Simbarashe Shawe recommends eightsimple exercises to help restore strength and function in the arms of stroke survivors.Stroke Exercises for Your Body7

Basic Arm ExercisesStrokes are a frightening, life-threatening medical condition, but once you begin recoveringyou will experience the impact on your quality of life caused by neurological damage. It’spossible to retrain the brain to make up for this damage, but you must keep the affectedmuscle groups active. These basic level exercises are a starting point to add flexibility andmobility to your affected arm after a stroke.1Inner Arm StretchFor this exercise, place your hands palmsdown on the table and rotate your wristso your fingers point towards your body.Keeping your elbows straight, slowly moveyour body backwards until you feel a stretchon the inside of the arm. Lean on the tablefor support if you need to.2Wrist and Hand StretchFor this exercise, place your forearm on the table,with the hand over the edge of the table, palm down.First, drop the hand down, using your other handto gently stretch the ligaments and muscles. Then,leaving your forearm on the table, lift the wrist up,down and sideways, gently stretching the extendedwrist with the other hand.Stroke Exercises for Your Body8

Intermediate Arm ExercisesOnce you have gained basic flexibility in the wrist, hand, and inner arm, you are ready towork on a full range of motion for these joints. These intermediate-level exercises, whichwork well in conjunction with SaeboMAS and SaeboReach, can be the key to recovering theuse of your arms. They help retrain the brain to make up for the neurological damage youhave suffered.1Elbow StretchThe elbow stretch focuses on restoring arange of motion to the elbow. This exercisecan be done while sitting or standing. Holdthe arm at a comfortable position, thencarefully bend and straighten the elbows asif you are doing a dumbbell curl.2Crawling StretchTake up a crawling position with your elbowsstraight. Gently lean your body backwards, keepingyour arm position, until you feel a stretch on yourinner arm. Hold the position and repeat.Stroke Exercises for Your Body9

Intermediate Arm Exercises (cont.)3Wrist MotionWhen you are sitting or standing, extend the elbowand rotate your wrist through a full range of motion.Continue this exercise a few times to encouragegreater motion in the wrist.Stroke Exercises for Your Body10

Advanced Arm ExercisesMuscles damaged due to a stroke are often weakened, mainly due to inactivity. This is whyat-home exercise is so important. Once you have regained range of motion in your arm andwrist, you are ready to begin strengthening the muscles with these advanced exercises.1Elbow Weight TrainingIn a standing or sitting position, hold asmall weight in your hand. Gently bendand straighten the elbow. Repeat to yourendurance point. Over time, increaserepetitions as the elbow strengthens.2Finger WalkStand facing a wall or a door. Place yourfingers gently on the surface of the dooror wall. Walk your fingers up the surfaceusing a spider-like motion, then walkthem back down.Stroke Exercises for Your Body11

Advanced Arm Exercises (cont.)3Seated Push UpFinally, sit on the ground with your knees bent and yourpalms on the floor, keeping your fingers pointing forward.Push through your hands to cause your bottom to lift off thefloor slightly. Repeat as you grow stronger.Stroke Exercises for Your Body12

Balance ExercisesStruggling to walk or stumbling frequently is a common problem for stroke survivors, as theneurological components of balance have been damaged. Fortunately, balance is an abilitythat can be relearned after a stroke through therapy, rehabilitative products, and at-homeexercises. Physiotherapists Beth Thornton and Kathryn Smyth suggest nine exercises to helpregain stability and balance.Stroke Exercises for Your Body13

Basic Balance ExercisesBasic level exercises for balance may seem simple at first, but they require strong neuralconnections to successfully complete. Start with these simple exercises as you work torewire your mental processes. The repeated actions will build mental connections thatcan help restore balance. Remember, for these basic level exercises, always hold ontosomething to ensure you do not fall.1Heel Raises (Holding On)3 sets of 10Find a sturdy chair or countertop you can hold on tofor support. Hold on to the chair or counter, and raiseyourself up onto your tiptoes, keeping your kneesstraight and holding your upper body tall. Loweryourself back to the floor slowly, and repeat.2Side Stepping (Holding On)3 sets of 10 (1 rep both feet)Use a counter or ledge to hold on to, or ask someoneto give you a hand to hold for balance. Place tape onthe floor in a straight line. Step sideways to cross theline, crossing one leg across the front of the other leg.Reverse the motion to return to the starting point, thistime crossing a leg behind.Stroke Exercises for Your Body14

Intermediate Balance ExercisesThe intermediate level exercises use the same basic ideas as the basic exercises, butwithout something to hold onto. After practicing the basic level exercises for a while, youshould be able to perform them without assistance. However, for safety, always have acounter or chair nearby to grab if you start to lose your balance.1Heel Raises (Not Holding On)3 sets of 10Stand with your feet flat on the floor and your armsat your sides. Raise yourself to tiptoe, keeping yourupper body and knees straight. Slowly lower andrepeat.2Side Stepping (Not Holding On)3 sets of 10 (1 rep both feet)Perform the side step, crossing your legs acrosseach other as you move sideways across a straightline, but without holding on. Go slowly to avoid a fall,and be ready to grab a hold of something if you loseyour balance.Stroke Exercises for Your Body15

Intermediate Balance Exercise (cont.)3Heel-to-Toe Walking20 steps (10 for each foot)Using the straight tape line for side stepping,walk forward, placing the heel of your footdirectly in front of the toe of your other footas you walk. Continue to the end of the tape,turn, and repeat by returning to the startingpoint.4Squats Against Gym Ball3 sets of 10Place an exercise ball between your backand a wall, standing tall. Slowly lower into asquatting position, holding on with one handif needed or not holding on at all. Roll backup to a standing position and repeat.Stroke Exercises for Your Body16

Advanced Balance ExercisesOnce you start noticing improved balance, do not stop exercising. You are still building thoseconnections. Now it’s time to move on to advanced level exercises.1Single Leg Standing3 sets of 5Place both feet flat on the floor. Slowly lift one leguntil you are balanced on the other leg. Hold for acount of 10, and slowly lower it back down. Alternatelegs and repeat.2Backwards Walking20 stepsIn a room that is free from obstacles, walk backwardsslowly. Try to avoid looking where you are going,but use your sense of balance and slow movementsto avoid a fall. At first, perform this exercise withsomething close by to hold onto like a wall orcountertop until you gain confidence in your abilities.Stroke Exercises for Your Body17

Advanced Balance Exercises (cont.)3Weighted Ball Pass3 sets of 10Using a weighted exercise ball, slowly pass the ball fromhand to hand as you circle it around your body. Start bycircling the body in a clockwise motion. Then, repeat ina counterclockwise motion. Perform this exercise whilestanding.Stroke Exercises for Your Body18

Core ExercisesWhile the focus of stroke recovery is often on the limbs and facial muscles, without a strongcore, the rest of the body may suffer. By isolating and activating core muscles with nineexercises selected by Thornton and Smyth, stroke survivors can work to regain coordinationand strength that benefits their whole body.Stroke Exercises for Your Body19

Basic Core ExercisesStrokes are life-threatening events that can cause irreversible neurological damage, sothe recovery period is as much about retraining the brain as it is about strengthening themuscles. In order to regain use of your core muscles, you must keep them active in order tocreate the brain connections you need to improve after a stroke.1Knee RollingRepeat 10-20 timesLie on your back with your hands resting atyour side. Bend your knees and place yourfeet flat on the floor. Roll your hips so thatyour knees push to the left, then to the right,then back to center.2Single Leg Drop-OutsRepeat 5 times per sideLie on the floor with the hips and feet flatwith the knees bent. Keep the pelvis still,using the hands to keep it in place if needed.Inhale, and drop the left knee to the left,as far as possible without lifting the pelvis,keeping the knee bent. Exhale, and draw theknee back in.Stroke Exercises for Your Body20

Basic Core Exercises (cont.)3Pelvic Floor ContractionsRepeat the exercise 10 timesPelvic floor contractions, also known as Kegels, can helpstrengthen the muscles on the pelvic floor, which is themuscular base of the abdomen attached to the pelvis. First,find the muscles by imagining that you are trying to holdurine or stop from passing gas. Squeeze these muscles bylifting and drawing in, then hold for a count of three. Relaxthen repeat, gradually increasing the holding time untilyou can hold for 10 seconds. If at any point you feel thecontraction relaxing, let it relax completely and rest for 10seconds before contracting again.Stroke Exercises for Your Body21

Intermediate Core ExercisesOnce you begin building some strength, you are ready to progress in your exercise practice.These intermediate exercises will challenge a larger number of core muscles and build evenmore strength.1Single Leg BridgingRepeat for 10 repetitions, then switch legsLie on the exercise mat and place one legflat on the floor with the knee bent. Place theother leg on an exercise ball. Using the coremuscles, lift the pelvis off the mat and slowlylower back down.2Side Lying ClamsRepeat 5-10 times on each sideClams are a great exercise for your core aswell as your legs. Lie down on your side withyour knees bent, resting one knee on topof the other. Keeping your feet together, liftthe upper knee towards the ceiling and holdyour knees apart for 10 seconds. Next, slowlylower your knee back down. Be careful notto roll your hips back.Stroke Exercises for Your Body22

Intermediate Core Exercises (cont.)3Four-Point KneelingRepeat for 2-3 sets of 10 reps eachKneel on the ground and place your hands flat on the groundso you are in a crawling stance. Contract the pelvic floor andraise one leg while lifting the opposite arm. Hold for a fewseconds, and return to the starting position, repeating withthe opposite arm and leg.Stroke Exercises for Your Body23

Advanced Core ExercisesAs you continue to develop your core muscles, you will be ready to add more intensity.These advanced exercises increase the intensity of the intermediate exercises so you canregain a strong, healthy core.1Bridging with Arms AboveHead10-15 timesLie on the floor or an exercise mat with yourshoulders and lower back flat on the floor.Support your legs on an exercise ball. Liftyour arms above your head, then use thecore muscles to lift your hips off the flooruntil your body is in a straight line from heelsto shoulders. Slowly lower back down andrepeat.2Bilateral Leg CyclingRest and repeat 10 timesLie on the floor and lift the legs off of theground, holding them in a cycling position.Then, cycle as if you are riding a bicycle inthe air.Stroke Exercises for Your Body24

Advanced Core Exercises (cont.)3Superman PoseRepeat 10 times.Imagine superman flying through the air. Now, lay on thefloor on your stomach and take this same position, armsand legs extended. Hold to strengthen the core muscles inyour back, and relax. Hold the position for 2-5 seconds andrepeat 10 times.Stroke Exercises for Your Body25

Hand ExercisesWhen stroke survivors lose function and dexterity in the hands, simple daily tasks can seemlike insurmountable obstacles. Sarah Lyon, occupational therapist, advocates three simple,at-home exercises to help stroke survivors regain the use of their hands.Stroke Exercises for Your Body26

Basic Hand ExerciseA stroke often affects the ability of the brain to communicate with other areas of the body.While some of the neurological damage to the brain after a stroke is irreversible, it’s possibleto retrain some parts of the brain to take over the movements and activities once controlledin the damaged section.If you are struggling to move your hands, start with this basic-level exercise, aimed at helpingyour brain re-learn how to control the most basic hand movements. If you are struggling tomake a fist and release it, the SaeboGlove and SaeboFlex can help with positioning and reopening as you build up control with this simple exercise.1Make a FistTo begin retraining your brain and hands, make afist by wrapping your thumb over your fingers. Then,slowly open and spread your fingers wide.How wide you spread your fingers and how longyou hold the stretch will depend on your goal. Ifyou need to stretch the hand and increase range ofmotion, slowly make a fist and open it until you feela stretch, but no pain. Repeat this slow and steadymovement 10 times per session.If you have decent range of motion, but needto improve strength, open and close your fistrepeatedly and steadily for 30 seconds. Thengive your body the chance to rest, and repeat themovement for an additional 30 seconds.Stroke Exercises for Your Body27

Intermediate Hand ExerciseIf you’ve mastered making and releasing a fist and feel that some strength is returning toyour hand, then you are ready to move towards building the range of motion of the fingersthemselves. This intermediate level exercise helps achieve that goal.1Five Finger SpreadFor this exercise, place your hand in front of you withthe fingers straight and held close to one another.Carefully and gently spread them apart. When youare done with the movement, your hand will look likeyou just counted the number five on your fingers,with all of the fingers spaced apart from one another.Then, bring the fingers back together, and repeat theaction slowly 10 times.This exercise is called abduction and adduction. Ithelps the hand re-learn how to

Stroke Exercises for Your Body 15 Intermediate Balance Exercises The intermediate level exercises use the same basic ideas as the basic exercises, but without something to hold onto. After practicing the basic level exercises for a while, you should be able to perform them without assistance. However, for safety, always have a

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