Useful and necessary exercises after a stroke. Recommendations for exercise therapy after a stroke

Article publication date: 03/01/2017

Article last updated: 12/18/2018

From this article you will learn: how important gymnastics after a stroke is for restoring lost brain functions, what exercises contribute to the resumption of movements in paralyzed parts of the body.

The recovery process after a stroke can be quite lengthy. Physical exercise is an integral part of an effective rehabilitation program for patients with acute cerebrovascular accidents.

Doctors and scientists say that the most active recovery occurs in the first six months after a stroke. Unfortunately, it is impossible to predict the extent to which impaired brain functions will resume in each individual patient. In some cases, nerve cells are damaged temporarily, they can restore functioning after some time. In other patients, the brain manages to reorganize its work, switching lost functions to undamaged parts of it.

According to statistics, when carried out correctly, there are following results restoration of disturbed functions:

In 10% of people who have had a stroke, there is a complete recovery.
25% have recovery with minor impairments.
40% have moderate to severe dysfunction requiring special care.
10% - there is a need for constant extraneous care.
15% of patients die shortly after a stroke.

In case of refusal to rehabilitation activities, including special sets of exercises after a stroke, these indicators deteriorate greatly.

Rehabilitation must begin during the stay in the hospital, immediately after the patient can perform its activities. After discharge from a medical institution, exercises aimed at restoring lost functions are carried out in special conditions. rehabilitation centers or at home.

Typically, the training program is made up of rehabilitologists, physiotherapists, physiotherapists or neurologists.

Aerobic exercise

Aerobic exercise forces the body to use oxygen for energy. They are very useful for maintaining the health of all people, including stroke patients.

Aerobic exercise is good for the heart and lungs, helps control body fat, lowers blood pressure, increases stamina, and improves mood.

Even though stroke patients often have difficulty moving their limbs, it is important for them to continue to be physically active, especially at home. Examples of aerobic exercise are:

walking;
swimming;
a ride on the bicycle;
dancing;
caring for a garden or vegetable garden.

Types of aerobic exercise after a stroke

Every stroke patient should try to maintain aerobic physical activity to the best of their ability.

Gymnastics to improve coordination and balance

These physical therapy exercises help to reduce the risk of falls, restore balance and coordination of movements.

Exercises for coordination and balance:

Lite version	More difficult option
Stand on one leg for 30 seconds and then switch legs. For a more stable position, lean your hand on a table or chair.	Stand on one leg without resting your hand on a table or chair. Gradually increase the exercise time to 2 minutes.
Standing on one leg, take the other leg to the side at a 45-degree angle. Hold it in this position for a few seconds. To maintain balance, you can rely on any object. Then slowly lower your leg and repeat this movement 10 times.	Close your eyes while doing this exercise.
Being in lying position, stretch your right elbow to your left knee, and then your left elbow to your right knee.	Do this exercise while lying on an exercise ball to increase your range of motion.
In a standing position, place your right foot on the floor directly in front of your left, then your left foot directly in front of your right. Walk like this, maintaining constant contact between the heel of one foot and the toes of the other.	Do this exercise on an uneven surface.

Gymnastics for the body

Therapeutic exercise after a stroke includes exercises for the trunk, which are necessary to reduce the risk of falls, maintain balance and a stable body position.

Name	Description
Trunk twists	Sit on a chair, place your right hand on the outer surface of your left thigh. Keeping your back straight, use this hand to turn your torso to the left. Repeat the movement in each direction 15 times.
Side bends of the body	Sitting in a chair, lower your left shoulder towards your left thigh. Then return to the starting position, focusing on using the muscles of the torso. Repeat this movement to each side 15 times.
Torso forward bends	Sitting on a chair, clasp your hands together and straighten them out in front of you. Keeping your arms parallel to the floor, lean forward with your torso. Then straighten up using your back muscles. Repeat this movement 10 times.
Leg raise	Lying on the floor, raise your knees to your chest and wrap your arms around them. Holding one leg with your hand, lower the other to the floor. Then lift it back up to your chest, being careful not to use your leg muscles. Focus on contracting the muscles in your torso. Repeat 10 times for both legs.

Click on photo to enlarge

Gymnastics for the legs

Stretching exercises

These exercises help prevent injury, increase range of motion, and improve blood circulation in the muscles. Sitting too long causes numerous health problems.

Gymnastics for stretching the muscles of the legs:

Stand facing the wall and place your straightened arms on it at chest level. Then bend your elbows, leaning your whole body forward and keeping your feet pressed to the floor. At this time, you need to feel how the muscles of the back of the leg are stretched. Then align your arms at the elbow joints, pushing off the surface of the wall and taking vertical position.
Lie down on your back. Then, using your hand, move your left leg over your right to the other side of your body. Hold it in this position for a while, then return to the starting position. Repeat this movement with the other leg. This gymnastics relieves the stiffness of the muscles of the lower back.

Exercises to Improve Mobility

The purpose of these physical therapy exercises is to improve the mobility of the affected leg in the hip and knee joints. Examples:

Lie on your back, bend your knees so that the sole of the foot is on the floor. Keeping your legs together, tilt them to one side, then to the other. These movements help relieve stiffness in the joints.
Lying on your back, pull your left knee to your chest and lightly press it with your hands. Repeat this movement with the right limb. This gymnastics improves mobility in the hip and knee joints.

Exercises to restore muscle strength

To restore the strength of the muscles of the affected leg, the following exercises are useful:

Walking - simplest form physical activity to be done after a stroke. If you are still unable to walk on your own, try using a walker or cane.
The leg press is an alternative to walking. For this exercise, you need a special simulator in which, thanks to the strength of the muscles of the lower extremities, you lift a certain weight.

The leg press machine helps restore leg muscle strength after a stroke

Seated leg exercises

Seated exercise therapy exercises help comfortable recovery after a stroke.

Name	Description
Ankle turns	Sit comfortably in a chair and do 20 ankle rotations to warm up the ankle joint.
Hamstring stretch	Remaining in a sitting position, reach your hands to your feet. You need to bend in the hip joints, and not in the back. Hold this position for 20 seconds, then slowly straighten out.
Exercise for the inner thigh muscles	Clench your fists and place them between your knees. Then try to bring your hips together. Hold this contraction for 8 seconds.
Exercises for the quadriceps femoris	Sitting on a chair, slowly raise your right leg so that it takes a position parallel to the floor. Then slowly lower it down, but do not put your foot on the floor. Repeat this movement 10 times for each leg.

Gymnastics for hands

Passive hand exercises

Passive exercise- These are simple movements performed with the help of a healthy hand or an outsider. early start their implementation helps to prevent stiffness and spasticity of the muscles.

Name	Description
Shoulder flexion	Lie on your back and join your hands on your chest. Raise the affected limb up to the ceiling with your healthy hand as much as possible. Then slowly lower your hands to your chest. Repeat the lesson several times.
Strengthening of the shoulder girdle	Lying on your back with your arms vertically above your body, lift your shoulder blades off the floor. The movement should resemble lifting chest to touch the ceiling. Hold this position for a few seconds, then slowly lower your shoulder blades to the floor and repeat.
Flexion and extension of the elbow	Keeping your arms vertical above your chest, bend them at the elbows, lowering your clasped hands to your forehead. In this case, the shoulder should remain perpendicular to the body. Then slowly raise your arms to the starting position and repeat the exercise.

Active hand exercises

Active rehabilitation includes functional and strength exercises.

Functional exercises that improve muscle control while helping you regain independence at home:

Grab the fingers of the affected hand with the handle of the refrigerator or door. Practice closing or opening them.
Hold the bag in your hand and carry it around the house. As muscle strength improves, increase the weight of the bag.
Hold the tube of toothpaste in the affected hand and the toothbrush in your good hand. Try to squeeze the paste onto the brush.
Turn the light on and off with the affected hand.

Physiotherapy in the form of strength exercises involve the use of dumbbells or other objects. To perform them, a person must be able to hold them in his hands.

Name	Description
Bending the arms at the elbows	Sit on a comfortable chair and take dumbbells in your hands. Then bend your elbows and lift the weight towards your chest. Shoulders should be motionless and placed along the body. Then slowly lower your arms, straightening them at the elbows.
Strengthening the muscles of the shoulder girdle	Move your arms away from your body so that your upper arm is parallel to the floor and your forearms are vertical. The hands holding the dumbbells should be palm forward. Raise the dumbbells above your head with your arms fully extended. Then slowly lower them back to the starting position.
Abduction of hands	Sit on a chair, lower your arms with dumbbells to the sides of the body. Then, keeping the limbs straight, lift them to the sides to shoulder level. The body position should resemble the letter "T". Hold for 1 second at the top of the lift, then slowly lower your arms back to the starting position.

Gymnastics to improve hand mobility

Performing such exercises after a stroke at home will help restore fine motor skills and regain control over the hand.

Name	Description
Extension and flexion of the wrist	These muscle stretching exercises can be done passively (using your good arm) or actively. They help prevent stiffness of the affected hand. Place your forearm on the table, palm down, with your hand hanging off the edge. Then move the brush up and down, bending and unbending it. Then repeat these movements with your forearm palm up.
Flexion and extension of the thumb	Open your palm, extending all fingers. Then flex thumb towards the little finger. After that, straighten it to its original position. Repeat this movement several times.
Other hand exercises	Count coins. Unclench clothespins. Play Board games(checkers, chess). Collect puzzles. Play the piano.

Scientific studies have shown that rehabilitation gymnastics after stroke contribute to the improvement of physical and mental health, movements in the affected limbs, balance and endurance. In addition, they strengthen the cardiovascular system, improve the quality of life and improve mood.

Exercise therapy after a stroke is the most important stage of the recovery period. Certain physical exercise necessary to improve blood circulation, normalize metabolic processes, reduce blood stasis in tissues. By itself, the course of taking medications is not able to lead to such results. Therefore, in order for the patient to return to a normal lifestyle, he and his relatives must make a lot of effort and patience. Only by doing daily therapeutic exercises in combination with drug treatment, restoration of body functions can be achieved.

All about the recovery period

Exercise therapy after a stroke brings an amazing effect. Due to each movement performed in the paralyzed limbs, blood accelerates, which does not allow it to stagnate. In addition, it is impossible not to mention that therapeutic exercises help restore muscle memory.

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

At 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 bedsores.
After a couple of weeks, you can begin to perform passive loads, where the main thing is the participation of the person caring for the sick person. Its main task at the same time is to relax the muscles and prepare them for more serious loads.
Immediately after the first results (for example, the movement of a paralyzed arm or leg), you can begin active exercises. To begin with, these are recovery exercises for the arms and legs, which are done right in bed, then attempts to stand up and, finally, slow walks.

Physical therapy after a stroke requires a serious approach. Daily exercise should be given at least 3 hours (periodically taking breaks).

The recovery gymnastics given as an example after a stroke is 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 a stroke should begin only after a certain preparation of the patient. It is possible to prepare the muscles with the help of massage procedures, which also require compliance with certain rules:

Before you start doing exercises, you need to take care of warming up the blood, to call for its influx, soft circular motions.
Massaging the affected arm, you should start with the hand, gradually moving to the shoulder. Foot massage begins with the feet and ends with the thighs.
Massaging the back of the patient, you can perform more abrupt movements. At the same time, remember that pinching and tapping the affected parts of the body should not be used force.
Circular movements with light pressure are well suited for warming up the chest.

The second stage of physical activity

As you remember, the complex of exercises includes several stages. So, after preparing the patient's body, you can begin to perform passive exercise therapy for stroke:

In order to restore the motor memory of the limbs, an exercise of flexion and extension is performed. For this, the patient should be laid on his back, the slightly raised leg must be bent at the joint in such a way that, sliding along the sheet, it returns to its original position (i.e., unbent).
To perform the following exercise, you will need a special "simulator". You can make it yourself by sewing a wide (resembling an elastic bandage in its width) linen gum. 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 it up, while massaging the legs. A similar exercise is performed with the hands. Having lifted them with an elastic band, ask the patient to make attempts to bend and unbend them in the area of the wrist joint.
The following exercise is great for self-fulfillment. Using a towel or tape, suspend 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 therapeutic exercises is consistency, 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 physical education

As you know, in the management of limbs, a person owes much to muscle memory. In order to have an impact on the restoration of brain nerve cells, repeated repetition of commands is necessary. In the event that this stage is difficult to master, the commands should be voiced by relatives. Ask the patient to try to repeat them.

Exercises after a stroke for patients 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 special complex sitting exercises:

The first exercise is aimed at working with the eye muscles. Starting with the movement of the eyeballs up and down, the patient should move to the movements to the right and left, then diagonally. The alternation of open and closed eyelids is very effective. Such exercises not only strengthen muscle memory, but also contribute to the normalization blood pressure. To relieve tension after such gymnastics, the patient should close his eyes as tightly as possible and open his eyelids, repeating the action about 10 times.
At the next stage, 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.
If only one side of the body is affected, exercises for symmetrical movements should be included in the complex of exercises. Lying on his back, the patient may attempt to simultaneously rotate or raise both arms.
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 expanders that have different densities is well suited for this.
You should also work on your feet. Exercises involve stretching and cutting them on yourself. 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 get up on his own, while leaning on the back of the bed and the belt. Particular attention should be paid to the limb lifting exercise (for the first few sessions, 3-5 times are enough).

Stroke is a disease in which acute ischemia (impaired cerebral circulation) occurs as a result of occlusion (blockage) or stenosis (narrowing) of the main vessels of the brain. This is a severe pathology that requires a long recovery. Rehabilitation after a stroke at home involves exercise, physical exercise(physiotherapy), massage and medication.

Scroll exercise therapy exercises in case of a stroke, it is selected by a doctor based on the patient's condition, however, exemplary recovery complexes that are safe to perform at home can be given.

About the benefits of exercise therapy

Gymnastics after a stroke has a lot of useful properties:

Physical exercise is indicated to maintain joint mobility and normalization muscle tone(with a stroke, the motor function of the arms and legs decreases).
Prevents the formation of bedsores in the area of the feet, back and those places on which the pressure is greatest.
Helps to restore the work of the brushes.
Helps to relieve the symptoms of paralysis, restoring the functions of the limbs and body.
Removes muscle hypertonicity, normalizes the work of the affected muscles.

Exercises after a stroke are shown to people who have had this terrible disease.

Preparatory activities

Before using exercise therapy, it is worth preparing the patient.

How to do it:

It is necessary to constantly change the position of the lying patient (every 2-3 hours). Such measures are required to prevent blood stasis.
Then, with the same frequency, it is worth doing passive exercises: make movements with outside help. This technique allows you to relieve muscle tension.
After that, breathing exercises are added. They normalize gas exchange, improve muscle function.
At the end, they move on to physical activity of the active type. This includes walking after a stroke. They make it possible to return to a normal form and minimize the likelihood of subsequent relapses of the disease.

The rehabilitation complex is planned so that physiotherapy after a stroke was the final point of events. It is indicated only when the patient's condition is stabilized.

The goals of therapeutic charging

A set of exercises for stroke is designed to achieve several goals:

Prevent the formation of bedsores.
Prevent the development of congestive pneumonia.
Relieve spasm of the left and right sides of the body during strokes.
Stop the development of heart failure, and also prevent the atrophy of the affected muscles.

In severe cases, a person literally has to learn to walk again, use household appliances, and take care of himself. The solution of these problems is designed to help exercise therapy after a stroke at home.

Passive loads

Before performing a set of passive exercises, the patient is shown performing a massage. In short, it is based on the following principles:

Physical impact is performed with light stroking circular movements.
Massage is done starting from the upper sections (head, collar area). Then they move on to the legs.
The impact on the back is carried out by tapping movements.
On pectoral muscles act, starting from the center of the chest and moving to the armpits.
Hands and feet are massaged in this sequence. Arms: shoulders, forearms, hands, fingers. Legs: buttocks, thighs, shins, feet, toes.
Massage begins on the healthy side (left if the right side is affected and vice versa).

After performing the massage, you can start exercise therapy at home.

Exercises:

Take a rounded object, place it in the patient's hand. Help to hold the object in hand. Similar exercises for fine motor skills hands should be performed more often, they will help restore the work of the hand and fingers.
Bend and unbend your legs. It is necessary to make movements so that the limb straightens itself, having traveled along the surface of the bed. Even in passive exercises, the participation of the patient is important.
Squeeze and unclench the fingers of the affected hand.
Raise and lower your arms (movement falls on the shoulder joint).

There is another exercise of the passive type. The leg or arm should be hung on a towel or elastic bandage. Now you need to make rotational movements, as well as move the limb to the right and left.

Passive exercises for recovery after a stroke are designed to prepare the patient for a full-fledged physical education. They are performed 2-3 times a day (initially 2, then 3). Duration - about half an hour.

mental training

Treatment after hemorrhagic stroke(and ischemic "fellow") should be comprehensive and systematic. Therefore, one cannot do without mental stress. They help restore damaged neurons, train memory and restore normal thinking process. Patients develop aphasia after a stroke. Mental exercises for stroke help normalize speech functions.

Active physical activity

Lying exercises

Work begins in the acute period.

Grasp a distant object behind you with your hands (a headboard will do). On the count of “one”, perform a “pull-up”, straightening the legs and arms as far as possible. Then return to the original position.
With an effort to straighten the affected arm, starting with the fingers, then moving to the hands and forearms. With the help of a tire and an elastic bandage, fix the limb in a similar position for half an hour. This exercise allows you to restore hand function after a stroke.
"Slip". Done with effort. Lying on the bed, they try to alternately bend the legs at the knees so that the feet do not come off the surface of the bed. It is performed 8-12 times.
Make alternate turns of the head to the left and to the right. Exercise is necessary to relieve hypertonicity of the cervical muscles.
Lie down straight. Hands at the seams. The body is relaxed. On the count of "one", bend the right arm at the elbow, fix it in this position for a second or two. Then lower the limb onto the bed. For a count of two, bend the other arm. In addition to the above exercise for the hands, you can perform its complicated version. Suspend the limb with a bandage and perform all kinds of movements: flexion, extension, rotational movements.
Bend your fingers into a fist and unbend back. After a stroke, the function of the hands deteriorates sharply. Thus, fine motor skills will be restored and gradually the fingers will return to normal condition. To restore the power characteristics, it is permissible to use a ring expander.

Specified exercise therapy complex with hypertension and stroke should be performed with great care. However, the performance of these exercises is allowed in the acute period of the course of the disease. They are also suitable for the disabled.

Complexes from a sitting position

For treatment, classes are resorted to at the end of the acute period. The complex of exercise therapy for the treatment of stroke includes the following payloads:

Sit straight. It is advisable to use a chair with a back. On the count of "one" take a breath and bring the shoulder blades behind your back. On the count of two, return to the original position. This load is designed to develop the muscles of the shoulder girdle.
Rotational movements of the head. 8-10 times in each direction. When performing, it is important to adhere to safety precautions: a dislocation or fracture of the cervical vertebrae is possible, the movements are slow and smooth. The load is considered part of the vestibular gymnastics.
Take a stalk from a shovel or other similar stick. Place it perpendicular to the floor to form a fulcrum. Now you need to take hold of the "shell" with both hands. Leaning on a stick, make rocking movements back and forth, gradually increasing the amplitude. Breathing is even, it can not be knocked down. After a stroke, this load is designed to relieve excess back muscle tone.

Perform flexion and extension of the fingers.
Sit on a chair. Try to slowly bend back, bringing your shoulder blades together and moving your arms and head back. "Freeze" in a curved position for 2-3 seconds.
Take a sitting position on the bed. Legs should hang freely. Do swings with the lower limbs. You should start at a slow pace, gradually building up strength. Such exercise therapy after a stroke is necessary for the development of the lower extremities.

Complexes from a standing position

These exercises are ideal for the heart and blood vessels, but should be performed in the later stages of rehabilitation, due to their complexity for a patient after an ischemic stroke.

Stand up straight. Legs at shoulder level. For such exercise therapy (therapeutic gymnastics), you will need a fulcrum in the form of a chair back or something similar. On the count of "one" raise your leg, put it on a chair. Return to original pose. On the count of two, raise the other leg. Run 3-6 times.
On the account of "one", slowly raise the upper limbs above the head. Stay in this position. Put your hands down on the count of two. The rise is carried out on inhalation, lowering the arms - on exhalation. Such exercise therapy in violation of cerebral circulation is necessary for the development of hands after a stroke and the normalization of breathing.

False steps. Legs at shoulder level. On the count of "one" push the leg forward, making a false step, on the count of "two" put the limb back, on the count of "three" return to the starting position. Repeat 5-7 times for each limb, starting with a healthy one.
Pick up a tennis ball or other rounded object. Throw it from hand to hand. Therapeutic gymnastics of this kind with a stroke helps to restore coordination. It is better if such a load is performed in conjunction with an assistant.
Sipping. It is necessary to stand on your toes and stretch your arms up, as if wanting to reach the ceiling.
Walking in one place (30 seconds-1 minute).
Get up. Hands on the belt. Make a twisting turn to the right, spread the upper limbs. Repeat on the other side.
Doing squats. This exercise exercise therapy for ischemic stroke should be done with caution, as it increases blood pressure.
Get up. Hands on the belt. Make tilts to the right and left.
Perform forward lunges.
Legs at shoulder level. Raise your right leg. Do circular swings with a limb. Repeat the same with the other leg.

These exercises after a stroke can be performed at home, but it is better if the exercises are carried out under the supervision of a doctor, especially if exercise therapy is prescribed for chronic diseases of cardio-vascular system.

Eye Complex

Physiotherapy exercises are also shown to restore oculomotor functions in paresis of nerves and muscles.

The complex includes the following movements:

Left-right.
Up down.
"Eights".
Intense contraction of the eyelids.
Circles (first clockwise, then counterclockwise).
Frequent blinking.

Loads for hands

After a brain injury, the hands are the first to suffer. To restore motor functions, a set of exercise therapy exercises after a stroke is shown.

Among them:

Squeezing the fingers, followed by unclenching.
Free swings of the limbs (exercises, like a "mill" or "scissors" in a standing position).
Movements with brushes in a circle.
Flexion of the arms in the elbow joints, followed by extension.
Loads on the shoulder joints (up and down).

Loads for the legs

A set of exercises after a stroke for the legs includes:

Flexion and extension of the toes.
Abduction of the legs to the sides (movements begin with the hip joints).
Pulling socks towards you.
Flexion-extension of the lower extremities at the knees.

These sets of exercise therapy exercises are not contraindicated in cardiovascular diseases.

Complex for articulation

Complex 1

Pulling the tongue forward. In this case, the amplitude of movement should be maximum.
Clicking tongue (clicking movements up and down).
Curling lips into a tube.
Alternate biting of the upper and lower lips.

It is also necessary to lick the lips with the maximum possible amplitude, first clockwise, then counterclockwise.

Complex 2

Smile, hold the smile on your face for 5-10 seconds.
Try to roll your tongue into a tube.
Make circular movements with your tongue hanging out.
Say the alphabet in order.
Say simple words (mom, dad, etc.).
Pronounce Difficult words and tongue twisters (in the late rehabilitation period).

These exercises are most effective for restoring speech after a brain stroke. Speech therapy advises to perform these complexes 2-3 times a day for 15-30 minutes.

Breathing exercises

Difficult exercises are contraindicated, since the risk of an increase in blood pressure is high. The essence of the only allowable load is to make rhythmic inhalations and exhalations, change the frequency of respiratory movements, alternating abdominal breathing with chest breathing. Such breathing exercises with a stroke of the brain, it saturates the cells with oxygen and restores normal gas exchange. It is possible to inflate balloons.

simulators

Stroke rehabilitation equipment makes the recovery process faster and more efficient.

Exercise equipment after a stroke includes:

exercise bike. The exercise bike helps to quickly restore lost motor functions, gently trains the cardiovascular system, preventing the recurrence of acute ischemia of cerebral structures. The task of the exercise bike is not limited to this. It contributes to the overall improvement of the body due to effective aerobic exercise.
Mini exercise equipment for limbs. Arm simulator after a stroke, called "Bud". Leg trainer - "Shagonog".
Verticalizer. Suitable for vestibular gymnastics. Gives the body a vertical position, allowing you to prepare for "upright walking".
« Active-passive” simulators. You can’t do without them when it comes to restoring the affected limbs.
Simulator Lokomat. At its core, this is an exoskeleton that teaches the patient to walk again, facilitating the process of movement.
Walkers after a stroke. Needed to learn to walk again. Their use is indicated in violation of the functions of the lower extremities. According to the mechanism of action, they are similar to an exercise bike and Lokomat.

Exercise machines for restoring vital functions after a stroke are diverse and should be selected by a doctor.

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Total information

A stroke occurs when the blood circulation process in the brain is disturbed, which inevitably leads to cell death.

During this, a person loses one of the possibilities or several at once, for example:

paralysis of the whole body;
problems with pronunciation of sounds;
complete loss of the ability to speak;
paralysis of one side of the body;
hearing loss;
inability to see.

Which particular set of exercises after a stroke will be required in a particular case is determined by the doctor, judging by where exactly the lesion occurred and how extensive it is.

If, as a result of this pathology, the left hemisphere is affected, then the following processes occur:

Right side paralysis.
Misperception of space.
Motor memory is partially absent, for example, the patient cannot hold a pen or a spoon correctly, and so on.
impulsive movements.

When the right hemisphere is affected, the following occurs:

The problem with the speech apparatus.
Left side paralysis.
Slow behavior.

Lesion Variations

There is also mild form stroke - when there is a slight paralysis or the absence of external signs. In this case, medicines and physical exercises will help to recover in just a few months. But the situation is completely different with an ischemic stroke of the brain stem, here there may be no coordination disorder at all, but the pathology is hidden inside. Then the improvement is often not only visible, but also temporary.

The main task after a stroke is physical rehabilitation, that is, restoration of the sensitivity of the limbs. To this end, it will be necessary to restore to some extent the activity of the brain cells located in the affected area. But since dead nerve cells can no longer be restored, it is necessary to make others work instead of them.

But, gymnastics should be carried out only after the approval of a specialist and under his control at first.

There is a stroke with gross paralysis, which is much more difficult to cure. With due effort, the patient can begin to serve himself only after a minimum of six months of treatment. Often it is not possible to achieve a complete recovery or it occurs after a few years.

A stroke with acute and fairly persistent neurological disorders is very common - this is when complete paralysis of one side of the body occurs. The cure in this case is also difficult, it is limited by the ability to sit and it can happen even after a few years.

What exercise can help you achieve

Exercise therapy after a stroke is intended for:

prevention of muscle atrophy;
partial, and at best, complete return of the accuracy of all movements;
prevention of heart failure;
relief of muscle tension that occurs with paralysis;
return of normal blood supply;
prevention of congestive pneumonia;
preventing the formation of blood clots;
preventing the formation of bedsores.

If there are no special contraindications for the patient, then he can already begin to work out a set of exercises for a stroke even on the fifth day.

The decision to authorize a doctor is made up of several factors:

The complexity and timeliness of proper treatment.
The individual's ability to rehabilitate.
The extent of affected brain tissue.

Gymnastics after a stroke has a positive effect on the ongoing metabolism and blood circulation. Often even severe forms of stroke can be cured with the help of classes, people gradually begin to be able to draw, write and work with small details again.

The most acute period is considered to be the first three days after ischemic stroke, five days and seven days. If a person survived these days, then within six months, the processes of cell death continue to proceed in his body. But at the same time, physical education assistance under the supervision of a doctor is aimed at maintaining the ability of other cells to function, the same applies at home, the exercises here will be quite simple, but their effectiveness has been proven.

But classes should be continued at home, here you will need the active help of loved ones who are required to familiarize themselves with how to properly perform physical exercises in ischemic stroke. They should help and encourage the patient, noticing all his small victories.

All exercises are similar to how exercises are done in babies, but in this case it is aimed at tremendous progress.

Passive exercise

Although the body is currently motionless, the affected areas require active recovery.

After a stroke, charging is most possible only in a passive form, that is, instead of the patient, the limbs should bend and unbend outsiders:

The procedure is started with the fingers of the hand from the side of paralysis, then bending is done with a healthy hand.
Then rotate with a brush.
Bend the arms in the elbow area.
After that, you need to go to the legs, the lesson methodology is similar.

Another method for warming up is a recovery set of simple exercises, done with a piece of rubber, which should be sewn into a ring. The elastic should be put on alternately, first on the hands, then on the legs, the limbs should be spread and reduced. The rubber ring will also help restore the functionality of the fingers, for this you should put it on them and stretch it.

All exercises are performed for at least ten minutes, gradually increasing the time to half an hour, but breaks are necessary every ten minutes.

Another exercise partially resembles a bicycle, but without active participation sick.

It is important to pay due attention to the eyes, helping them with a kind of gymnastics:

Move your own gaze in different directions.
Make rotational movements. This must be done first with open eyes, well, and then with closed ones.

It is necessary to close your eyes and hold them longer in this position, then open and blink. It is necessary to blink strongly enough, clamping and unclenching the eyelids.
Turn your head, but at the same time the look remains in place.

Since stroke patients experience spasm of the limbs, fixing the limb in an extended form by tying it to a stick can help them. But such manipulation is carried out only for half an hour and only if the patient does not feel severe pain wherein.

Even when a person is not able to move independently, he must imagine during the recovery exercises after a stroke that he is doing it on his own. This will help to organize a signal to the brain that the body is doing this on its own and visualization helps to re-learn how to move.

Sitting exercises

As soon as the doctor allows you to sit, it is necessary to continue to exercise exercise therapy for a stroke:

Take a reclining position, then the patient takes the bed with his hands and straightens his legs as much as possible. Then you should bend a little so that his head rests on the pillow and take a deep breath.
In the same position, but completely sitting, it is necessary to alternately raise each leg, breathe slowly and evenly.
The leg should be bent and with the help of the hands pull it towards you, the head should be tilted slightly forward.
For rehabilitation after a stroke, the following is often used - it is necessary to hang a towel over the patient's bed, for which a person will pull himself up, while stretching his arms, gradually moving on to warming up the back muscles.

At home, exercises can also include this - sitting on the bed, you should bring your arms as far back as possible and at the same time straighten your shoulders, your head should be raised, after such tension you need to return to the starting position.

All exercises after a stroke must be carried out, carefully monitoring breathing and general condition patient, that is, he should not be in pain and the patient should not be very tired.

Exercises after a stroke at home imply, first of all, the support of loved ones and their positive attitude towards recovery, as well as active help.

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Preparatory period for exercise therapy

The benefits of exercise leave no doubt - any movement in the paralyzed part of the body accelerates the blood, prevents its stagnation, and at the same time restores muscle memory.

It is impossible to hope that only a complex of exercise therapy, or only drug treatment, will save from a stroke. It is necessary to adhere to a comprehensive rehabilitation course.

At the beginning of the hospital stay, physical exercises and patient care are carried out by doctors. However, upon discharge, the daily burden is shifted onto the shoulders of relatives. Therefore, it is recommended to save or learn a memo on how to properly assist the patient. Here are the rules for consistent physical impact after a stroke:

If the patient was paralyzed during an ischemic attack (even on one side of the body), the first 2 weeks it will be possible to influence the muscle complex only with a competent change of position.
Turn the patient over in bed every 2-3 hours to avoid bedsores and blood stasis.
After a week or two, they switch to passive types of exercise, produced by the influence of a nurse or relatives. Their goal is to relax the muscles and prepare for further stress.
As soon as the patient achieves the first movement in the paralyzed limb, they move on to active exercises. The first time is in bed, then getting up and moving on to slow walks.

In the rehabilitation period after a stroke, relatives require attentiveness and regular exercise. One must be prepared to devote at least 2-3 hours at intervals during the day to the patient's recovery program.

It is important to understand that the stroke exercises given below as an example are designed for the general case. And for each individual anamnesis, it is necessary to calculate their intensity.

Massage and passive exercise after a stroke

Before proceeding to exercise therapy, the paralyzed limbs of the patient are subjected to massage. There are rules for massage procedures that are common to all:

Before exercising, you should warm up the skin and cause blood flow with soft circular movements.
While massaging the hands, they move from the hand to the shoulder, the legs - from the foot to the hips.
The back is massaged using slightly sharper movements - tapping and pinching, but without the use of force.
Stretching the chest, you need to move in a circular motion from the center outward, applying light pressure.

Now that the patient's body is ready for exercise, they move on to passive physical education. Here are some basic manipulations for paralyzed limbs after a stroke, carried out by relatives:

Flexion and extension of the arms or legs: the patient should lie on his back. The limb should be raised and bent at the joint so that when it is extended, it slides along the bed. Thus, the legs restore motor memory.
Exercises with a wide linen elastic band help (the width is like that of an elastic bandage, 40 cm). A ring is sewn from it according to the diameter of the legs and put on both limbs. Next, move the simulator up, parallel lifting or massaging the legs. Or the same with the hands, in the upward position, with the rubber band on, the patient must bend and unbend the arms at the wrist joint.
On their own, the patient can do the following: a fixed limb is hung on a tape or towel so that the patient can wind or even rotate the limb in a loop.

It should be remembered about the systematic: any therapeutic exercises should be done for 40 minutes twice, and after the 2nd week three times a day.

Mental physical education

We must not forget that muscle memory controls the limbs. Remember the film by Quentin Tarantino, in which the paralyzed heroine Uma Thurman lived for hours on end with one thought: to make her toe move on her paralyzed leg. We know the outcome, because by the middle of the picture she was already running along the walls. This example inspires both hope and an incentive: you need to do not only passive, but also mental gymnastics.

Influencing the recovering nerve cells in the brain, you need to repeat the command many times. If it is difficult for the patient to master this yet, it is necessary for relatives to pronounce the command aloud and force the patient to repeat it: “I move my toe,” etc. This method of suggestion has another plus - the rehabilitation of the patient's neurological condition and speech apparatus.

Transition to exercise therapy in a sitting position

Around the third week of rehabilitation, it is time to start the exercises when the patient has taken a sitting position:

It’s worth starting with the eye muscles - moving the eyeballs from top to bottom, from right to left and diagonally. Alternate between closed and open eyelids. In addition to muscle memory, it normalizes blood pressure.
After the gymnastics for the eyes is completed, you need to relieve tension by closing your eyes tightly and opening your eyelids, repeat 10-15 times.
Next - head rotation and exercises for the neck. On each side, at a slow, not sharp pace, repeat 6-8 times.
If one side was affected during a stroke, you should try to perform symmetrical movements with a moving hand with a motionless hand. For example, lie on your back and try to raise both arms, rotate your hands at the same time.
Grasping movements are essential for finger motility. You can get a set of expanders of various densities.
The same for the feet: stretch and contract on yourself, trying to achieve movement in both limbs.

Gradually, in a sitting position, you can move on to more amplitude options: lifting yourself, with the help of a headboard and a belt. Lifting limbs, first 3-4 times. Reducing the shoulder blades in a sitting position - 5-6 times. And so on, under the supervision of loved ones.

We perform exercise therapy while standing

The options that physical education implies for arms and legs in a standing position are already much larger. Therefore, we present a complex of "basic exercises" on which all gymnastics is built:

Straight stance - hands at the seams, the position of the legs shoulder-width apart. Raising the arms on the inhale, circular lowering down on the exhale. The course of movements is from 4 to 6 times.
Turns of the torso - the legs are wider apart, inhale for a count of one, exhale for two and slowly twist the torso to the side. Repeat at least 5 times on both sides.
Squats: while exhaling, try to sit down without tearing off your heels. Hands are extended forward. At the bottom, inhale and on the second exhale rise. The goal is to maintain balance, stretch the muscle group of the legs. Repetition - from 4 to 8 times.
Tilts: feet shoulder width apart, hands on the belt. On exhalation, tilt to the right or left, the opposite hand stretches up.
A good exercise for arms and legs at once is swings: the arm is extended, with the leg to the side to do swing movements. The amplitude is small, it is desirable to lean on the back of the bed with the other hand, for example. Main principle- do not hold your breath, repeat on each leg up to 7-8 times.
Raising the legs on toes, rotating the hand or ankle, bringing the hands into the lock behind the back - these exercises knead the joints well.

The set of exercises for a stroke necessarily includes daily walking. To load your arms and give work to your legs, you can walk with ski poles in your hands. Thus, there is always support and an additional therapeutic cardio load is performed.

Regarding walking: doctors recommend starting walking with the support of a person on the paralyzed side, at first intervals of 15-20 seconds with a break, then increase the pace. Already in the late stages of rehabilitation, jogging is prescribed for patients, as a good means of dispersing blood, normal stress on the heart and all muscle groups.

Do not overdo it - do not load yourself more than the program requires. Rest is now important for the body, not sporting achievements. In the future, therapeutic exercises of the legs and arms will be needed for at least another three years. However, it is recommended not to start the exercises after healthy lifestyle life to avoid recurrence.

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Principles of action of exercise therapy in neurological patients

The brain is a collection of neurons that numerous connections connected to the whole body. Each group of nerve cells is responsible for the regulation of a specific function of organs and systems. For example, the motor zone provides the ability of a person to make voluntary movements, the brain center of vision and hearing provides the correct perception and analysis of visual and auditory stimulation.

With a stroke, the death of nerve cells in the area of \u200b\u200bcerebral infarction or hemorrhage occurs. Depending on the control of which functions is located in this place, various neurological manifestations arise: paralysis, speech disorders, movement coordination.

The return of lost functions after a stroke occurs in 3 ways:

restoration of those structures of the nervous tissue that have reversible damage, that is, they have not died, but are in a depressed state;
restoration of completely dead elements by replacing them with new ones;
the transfer of duties of dead neurons to neighboring nerve cells.

Exercise therapy for stroke helps to speed up all these mechanisms and reduce the time to return lost functions.

Restoration of structures of the nervous tissue with reversible damage

These mainly include the restoration of the conductivity of the nerve fibers of cells that did not die, but fell into deep biochemical stress. Physical exercises after a stroke, which the patient performs on his own or with the help of an instructor, create a powerful stream of nerve impulses from the muscles to the brain. Due to this, the oppressed nerve cells are awakened, and new pathways for the transmission of excitation to the central nervous system are formed. Thus, the foundations are laid for the complete control of the brain over the functions of the body: the return of lost voluntary movements, speech.

Restoration of dead elements to new ones

Here it is necessary to clarify that we are not talking about dead nerve cells located directly in the area of hemorrhage or brain infarction and not subject to recovery, but about the growth of neuron processes that remained alive after suffering an attack of the disease. Due to the formation of numerous new nerve fibers, there is an increase in the number of contacts between nerve cells and the organs controlled by them. All this helps to restore lost functions even with a small number of neurons that have survived.

Gymnastics after a stroke increases blood flow to moving muscles, which means it increases nutrition and oxygen supply. All this leads to increased growth of new nerve fibers. Constant stimulation of the brain by nerve impulses that occur in the muscle during movement leads to an increase in the contacts of neurons with each other, which also has a good effect on the control of organs.

Transfer of duties of dead neurons to neighboring nerve cells

As you know, "nerve cells do not recover", so the focus of a stroke later turns into a scar. However, nature has laid in the body an amazing function of transferring the duties of dead cells to neighboring elements. In the brain after suffering acute violation blood circulation, the functions of destroyed nerve cells begin to be performed by their healthy neighbors. The transfer of authority occurs solely under the stimulating action of nerve impulses. This is exactly what therapeutic exercises after a stroke are aimed at, because muscle movements are a powerful source of nervous excitation transmitted to the brain.

Exercise therapy depending on the stage of the stroke

The main goals of exercise therapy in patients with stroke are:

restoration of voluntary movements;
preventing the formation of adhesions in the joints;
decrease in muscle tone on the paralyzed side;
strengthening the body.

From how much time has passed from the first signs of a stroke, the following periods of the disease are distinguished:

acute (first 72 hours);
acute (up to 28 days);
early recovery (from 28 days to 6 months);
late recovery (from 6 months to 2 years);
period residual effects(more than 2 years).

Each of these periods corresponds to a separate set of exercise therapy exercises.

Acute and acute period

Restorative gymnastics after a stroke is indispensable already in the first days of the patient's stay in the intensive care unit. An exercise therapy instructor or a trained relative conducts sets of exercises aimed at preventing respiratory complications and preventing the formation of contractures in the joints on the injured side.

For these purposes, breathing exercises, positional treatment and passive movements are used.

Breathing exercises

Recovery activities correct breathing begin with 2-3 days of treatment in the ICU. Respiratory exercises after a stroke consist in a patient-controlled change in the rate and depth of inhalation and exhalation, following the commands of an exercise therapy instructor. These can be rhythmic breathing under the count, exercises for an arbitrary decrease in the frequency of respiratory movements; change in the type of breathing, for example, from chest to abdominal and vice versa.

Position treatment

It is necessary to prevent the appearance of contractures (stiffness) of the joints. Flaccid paralysis, observed in patients in the first 2 weeks after a stroke, is gradually replaced by spastic. Due to the increased tone, irreversible changes occur in the joints on the diseased side, which lead to limitation of movements in them. To combat this complication, such a method of exercise therapy as treatment with a position is used.

It consists in the following: the diseased limb is laid in such a way that it is maximally extended and in a position opposite to the action of spasmodic muscles. For example, on the hand increased tone after a stroke, it is most often observed in the muscles that adduct the shoulder and turn the palm inwards, bending the fingers of the hand. Therefore, the treatment position in this case will be the following: the diseased arm is straightened, laid aside by 30-40⁰ (gradually bringing it to 90⁰), lies on a chair placed next to the bed; the palm is open, the fingers are straightened (to fix this position, a bag of sand placed on the palm is used); the thumb is in the grip position (as if there is a small ball in the palm that he is holding).

Treatment with the position is carried out every 1.5-2 hours, while it is held until the onset discomfort or pain in healthy muscles.

Passive gymnastics

It is performed only after a treatment session with a position when muscle tone weakens. Classes begin with a healthy limb, in which they carry out active movements(the patient himself performs exercises), covering all types of movements in a particular joint (flexion-extension, abduction-adduction, rotation). Then they move to the diseased side, the movements in the joints of which are performed by the exercise therapy instructor. Passive exercises against stroke begin to be performed from the distal extremities (from the joints of the fingers), gradually moving up.

However, despite the seeming simplicity, the movements must be performed according to certain rules otherwise they may cause harm. An excellent illustration of the main methodological approaches of this section of exercise therapy is a video of passive gymnastics after a stroke:

An approximate set of exercise therapy exercises for stroke for bedridden patients

The total duration of the complex is 25-30 minutes. During the session, it is necessary to take breaks for 1-2 minutes, focusing on the well-being of the patient. Finish gymnastics correct styling paralyzed limb (treatment by position).

Massage for a stroke can be prescribed 2 weeks after the onset of the disease. It includes the simplest classical techniques: light stroking on the affected side and moderate rubbing, kneading on healthy muscles.

Early recovery period

Exercises for recovery after a stroke during this period, along with passive ones, include active movements of the diseased limb. Even the slightest ability of muscles to voluntary contraction should be used to restore lost motor functions. Training for active muscle contraction must be included in the daily exercise therapy complex.

The exercise therapy complex using active movements, which includes exercises for the hand after a stroke, looks something like this:

The ability of the patient to maintain balance while sitting independently is a sign that it is necessary to diversify the exercises performed. The exercise therapy complex includes movements in the lower back and neck: tilts, turns.

Preparation for walking begins with imitation of walking movements in the supine position.

late recovery period

A feature of exercise therapy during this period is the addition of exercises to overcome resistance to the complex of daily gymnastics. The effect of training directly depends on correct technique. To facilitate understanding of exactly how to perform movements, you can view an approximate set of physical exercise exercises after a stroke video:

A huge role in the formation of normal muscle tension and acceleration of the processes of returning motor functions is played by massage after a stroke. It should be carried out several times a year for 10-20 sessions.

The famous expression “nerve cells do not regenerate” is, unfortunately, true. However, even after losing a significant number of neurons in the stroke area, it is possible to achieve good recovery voluntary movements with the help of physiotherapy exercises.

Stroke is a severe pathology that requires long-term treatment and rehabilitation. This disease requires application big forces so that the patient can restore the skills necessary for life. Apart from drug treatment a large role is given to a special type of gymnastics, since only exercise therapy after a stroke is able to restore damaged nerve cells, as well as restore normal functional state muscular apparatus.

The main negative consequence of a stroke is a neurological deficit caused by a disruption in the connections between nerve cells, nerve cells and muscles, muscles and the nervous system. The restoration of these connections is beyond the power of even modern medicines, while physical therapy after a stroke is able to "start" the neurons of the brain and create a natural incentive to recreate new neurogenic connections.

Among the main tasks of the complex of exercises after a stroke are:

prevention of the negative consequences of prolonged immobilization in the form of bedsores, heart failure, muscle atrophy, congestive pneumonia;
improvement of blood circulation in muscles affected by paresis or paralysis against the background of a decrease in their tone;
decrease in pathologically high tone in muscles that are in a state of spastic paresis or paralysis;
prevention of muscle contractures and resumption of motor activity.

In addition, restorative gymnastics after a stroke helps to improve metabolic processes in tissues - this is necessary even with short-term immobilization. If we are talking about an extensive cerebral hemorrhage, being in bed can last several months. During this time, in the absence of exercise, irreversible changes will inevitably occur at the level of cellular metabolism.

To achieve maximum effectiveness of exercise therapy for stroke, it is recommended to combine it with courses manual therapy, massage, psycho-correction and classes in the socialization of patients.

Basic principles of exercise therapy after a stroke - success rates

The course of recovery after a stroke largely depends on how quickly physical exercises began to be practiced. In addition, both the patient and his relatives need to understand that exercise therapy is a means not so much for strengthening muscles, but for restoring the ability of the brain to control the body.

The success of medical gymnastics depends on the following factors:

Timely start - exercises must be done after the patient has come out of a coma (if any) or at the end of a critical period.
Consistency and regularity - it is necessary to practice daily, regardless of the patient's current well-being. To minimize complications, it is recommended to select exercises according to the level of complexity for each of the conditions. Even if the patient is not set up for classes, it is necessary to force him to do at least a minimal list of passive recovery exercises.
Duration - for the appearance of positive dynamics and its consolidation, it is necessary to practice exercises after a stroke for at least six months. This time is enough for the formation of new neural connections in the brain.
Sequence - exercise at the initial stage of the exercise for recovery after a stroke involve a minimum load, but over time they become more difficult. Transitions from one stage to another must occur at the right time - it has been proven that prolonging the period does not bring positive results. A greater effect is expected with a gradual increase in intensity and complexity.
Attention to the well-being of the patient - during the exercise, it is necessary to monitor the condition of the ward (this includes blood pressure, pulse rate, breathing). The emotional component is no less important - even insignificant success should be accompanied by praise and encouragement for further progress.

It is important to understand that with a stroke, a set of exercises cannot replace a full-fledged complex therapy with the use of drugs. These two methods complement each other well, allowing you to go through the recovery period faster and more successfully.

Exercises for the initial stage of recovery

At the first stage of rehabilitation, the use of exercise therapy after a stroke is welcome, but active movements, as well as physical activity, are strictly contraindicated. This stage involves the use of the following therapeutic measures:

body position therapy;
passive exercises for various groups muscles;
breathing exercises;
so-called mental exercises.

For each of them there are special methods, as well as rules and deadlines. The success of the rehabilitation as a whole will depend on the accuracy of their implementation.

body position therapy

This method is based on a systematic change in the position of the patient's body and giving it the correct position. The purpose of the procedures is to prevent complications in the form of bedsores, contractures and pneumonia.

Particular attention should be paid to the affected half of the body:

limbs that are in a state of hypertonicity must be straightened regularly, while doing a light massage (relaxing stroking);
it is desirable to lay the patient on a healthy side.

For each patient, recommendations may differ depending on the degree of damage to the brain tissue and the onset of consequences in the form of a neurological deficit. Before starting care, a consultation with a neurologist and a rehabilitation specialist is necessary.

Passive exercise

The performance of this group of exercises implies a lack of activity on the part of the patient - flexion and extension of the limbs are performed by the caregiver. At this stage, breathing exercises can be carried out - after a stroke, it is necessary to normalize breathing to eliminate congestion in the lungs.

Passive movements must be performed on the most early stages after an attack, preferably in the first 2-3 days after it. In this case, the amplitude of movements in the first day should be minimal with a subsequent increase. It is important not to exceed the maximum possible amplitude from a physiological point of view in order to avoid stretching or tearing of the ligaments, as well as dislocations of the joints. If there is resistance, you can preheat the joint with a massage.

All exercises for stroke related to passive are divided into 3 subgroups:

Flexion-extension - suitable for knee, elbow joints, feet and hands.
Rotational - used for feet, hands, shoulder joints.
Adductor-abductor - used for the hip and knee, shoulder joints.

Training should begin with 5 movements for each joint. As mobility returns to it, their number can be increased to 15. According to generally accepted standards, gymnastics for stroke should first affect large joints, and only then can you start warming up smaller joints. So, after a stroke, the arms begin to develop from the shoulder, moving towards the hands, and the legs - moving from hip joint to the foot.

Breathing exercises

Breathing training is carried out only after the patient has finally regained consciousness and can control the maxillofacial joints. To begin with, it is recommended to do more simple exercises- exhalation of air through tightly closed lips or through a tube into a glass of water. As the patient recovers, he can strengthen the respiratory system with the help of balloons.

Forceful exhalation helps eliminate congestion in the lungs and free them from sputum. In addition, these are excellent exercises for the face, helping to eliminate paresis of the facial muscles.

Exercises for the second stage of recovery

As the patient recovers, he gains the ability to independently do individual exercises after a stroke at home. All of them differ in that they can be performed in a supine position, but at the same time they require a certain degree of concentration on the part of the patient.

The following exercises for arms and legs are considered the most effective:

clenching the hands into a fist (10-20 times);
rotation of the hands clenched into a fist clockwise and counterclockwise (10-15 rotations each);
independently flexion and extension of the arms in the elbows (15-20 times);
lifting straightened arms perpendicular to the body and slowly lowering (15-20 times);
swings with straightened arms to the sides (15-20 times);
flexion and extension of the toes (10-20 times);
pulling the fingers towards you, as when walking on your heels, and away from you, as when pressing the pedals (15-20 times on each leg);
flexion and extension of the legs at the knees (10-20 times);
breeding to the sides of the legs bent at the knees, followed by reduction (10 times).

If there is a physical possibility, after exercises on the limbs, gymnastics for the body is performed. It consists of simple movements:

body turns to the sides without leaving the bed (10 times to the right and left);
lifting the pelvis (5 times is enough);
lifting the head with pressing the chin to the chest (5 times).

The last exercise, if you have physical capabilities, can be complicated - you can raise not only your head, but also your shoulders, and then the entire body. To facilitate the task, you can hang a handle over the patient's bed, which he will hold on to.

After successfully mastering the listed exercises, exercise therapy after a stroke at home is supplemented by exercises in a sitting position. The complex includes head rotations, sitting on the edge of the bed with legs lowered to the floor (necessarily without support behind the back), raising and lowering the legs, bending them with pulling the knees to the chest and extension.

To restore fine motor skills of the hands, grasping movements are recommended. For this, pieces of cloth or sheets of paper can be used, which must be taken and crushed into a lump, large cereals (beans or beans, for example) for shifting handfuls or one grain from one container to another.

Exercises for the third stage of recovery

At this stage of rehabilitation, you can begin to perform exercises in a standing position. First, they are recommended to be done with the support of outsiders, and then on their own. Ideally, this should be used special simulators, however, a standard set of exercises after a stroke at home can be done using improvised means.

For starters, a stroke survivor must learn to balance. This can be achieved while trying to stand with a straight back for 2-3 minutes. Then you can slightly increase the time.

A prerequisite is the presence of a fulcrum. This can be the back of a bed or chair, or a special machine.

head rotation;
swing your legs;
wave your hands;
lifting legs forward and backward or to the sides;
turning the body to the side.

Then the range of motion is increased by tilting the torso, squats, short walks.

The listed exercises should become an integral part of the patient's life, both in ischemic and hemorrhagic strokes. Often this area of rehabilitation is neglected, as a result of which the patient loses the chance to restore the lost abilities for self-service. That is why the relatives of a person who has suffered from a stroke need to tune in themselves and set the patient up for a long struggle with the consequences of the disease.

A stroke occurs when there is a violation of the blood circulation of the brain, which leads to the death of some nerve cells.

As a result, the human body loses one or more functions for which dead cells were responsible: paralysis, loss of hearing, vision, and speech defects may occur.

Various physical disorders when depends on where the focus of already dead nerve cells of the brain was formed, on their size and position.

Each area of the brain is responsible for different functions of the body, so limb paralysis occurs depending on where the cell death occurred.

The consequences of a stroke affect both patients and all family members. After everything that has happened, after all the worries and fears for the patient's life, there comes a time of temporary calm.

The native person is alive - this is the main thing. And what then? Are the adverse effects of a stroke going to stay forever?

According to statistics, 20% of the patients could not regain the mobility of their arms and legs and depend on outside help for the rest of their lives.

In order for a person to recover from a stroke, apply medications and rehabilitation gymnastics.

Move more - live longer

“If you do physical education, you will forget about illnesses” - and a lot more folk wisdom, which, by the way, reflects the beneficial effect of therapeutic exercises.

After all main task after a stroke is the restoration of sensitivity and ability to move the limbs.

To do this, it is necessary to return the activity to those brain cells that are located near the lesion. And also it is necessary to “force” previously inactive cells to perform the functions of dead ones.

All these actions are performed only through various restorative physical exercises and therapeutic exercises.

It is exercise therapy that is the basis of rehabilitation after a stroke.

Restoration of the lost function of the body - all means and forces are directed to this. If there are no contraindications, then the first exercises can be started already on the 5th day after a stroke.

Gymnastic exercises and exercise therapy are among the most accessible and effective ways recovery.

A set of exercises

There is nothing supernatural in health-improving gymnastics. We can say that this is a normal charge. But even the simplest exercises will give a positive effect, because everything ingenious is simple.

Lying position

This is the very first and simple set of exercises carried out in the acute period after the disease, when the muscles are fixed in a bent position and the patients are not able to unbend them.

It aims to reduce the tone and increase the range of motion of the limbs after a stroke:

Hand exercises. Not so much exercise as forcible straightening of the limbs to reduce spasms. Unbend the bent limb starting from the fingers to the hand and forearm, and wrap it with a bandage to a hard surface (plank). Leave your hand in this position for at least 30 minutes.
Eye muscles. Move your eyes up and down, left and right. Close your eyes and make circular movements in one direction and the other. As a rest, blink your eyes for 5-7 seconds. Make circular movements with open eyes also on each side. Relax your muscles by blinking your eyes.
Neck muscles. Gently turn your head to the left and right while fixing your gaze in front of you.
Fingers. In any comfortable position, bend and unbend your fingers 10 times. You can do the exercise both alternately on each hand, and simultaneously with both hands. Hang a towel over the bed in the form of a loop. Pass the fixed arm (or leg) through the loop and simply swing it with different amplitudes. From not very thick rubber of medium width, make a loop with a diameter of about 40 cm. Throw on an arm or leg and any other object (second arm / leg, headboard, chair, etc.) and stretch the elastic band with a sore limb.
Elbow joints. The whole body is extended, arms lie along the body. Bend your right arm at the elbow, lower it on the bed, bend left hand. Perform the exercise with each hand 10 times. Hang a fixed arm / leg on a strong fabric (diaper, towel) and then perform all kinds of exercises: bend, unbend, take aside, rotate. This exercise is performed from 10 to 30 minutes, taking 3 breaks. Rest time - 2-4 minutes.
Bent knees. Lying on your back, alternately bend your knees. Try to do so that you do not completely tear your legs off the bed, as if sliding them. Perform 10 times with each leg.
"Pull-ups". Lying on your back, grab the back of the bed with your hands. Do “pull-ups” by straightening your shoulders and straightening your legs with outstretched socks. Do the exercise slowly 6 times.

Exercise therapy for stroke: a set of exercises in pictures

If the patient can sit up

The following exercises are designed to restore movement of the arms and legs, strengthen the back, and prepare for walking after a stroke. All tasks are performed on 4 or 2 accounts:

Deflection No. 1. I.p. - leaning back on the pillow, it is convenient to grab the bed with your hands on both sides. Stretch your legs forward. 1.2 - slowly bend over, taking your head back, take a deep breath. 3, 4 - slowly return to the sp. Do the exercise 6 times.
Deflection No. 2. I.p. - sit down, legs straightened, arms lowered. Slowly take your hands back, throw your head back and straighten your back, trying to bring your shoulder blades together. Fix the position for 1-2 seconds. Return to I.P. and repeat 4 more times.
Move your legs. I.p. - legs extended, hands holding on to the edge of the bed. Do exercises at a slow pace. 1 - slightly raise the right leg, 2 - slowly lower it. 3 - raise the left leg, 4 - return to the sp. Repeat swings 4 times for each leg without holding your breath.
I.p. - lean on the pillow, raise your arms up, stretch your legs. 1,2 - bend the leg at the knee and clasp it with your hands, trying to touch your chest with your knee. In this position, fix, tilt your head forward and exhale. 3.4 - raise your head, remove your hands and slowly return to the sp. Do the same for the other leg. Do exercises 4 times.
Motor skills of the hand. Put items in a deep bowl different shapes and material. The size should be from small to large, but so that you can hold it in your hand. The “material” can be: buttons, cones, walnuts, beans, pencils, reels, plastic bottle caps, etc. Transfer all these items from one bowl to another with a sore hand, transferring them one by one.

What is it and what manifestations in the behavior and actions of a person does it entail. More details in the material.

Many have heard about the benefits of pine cones for stroke. How to cook an infusion of pine cones after a stroke -?

standing position

A set of exercises in a standing position is performed when the patient already feels confident and the previous exercises sitting and lying down are easy for him.

But this gymnastics also has its limitations and is divided into 2 complexes: simple and increased load.

Simple physical exercises are used if a person has not yet fully recovered from a stroke:

Sipping. I.p. - arms down, feet shoulder-width apart. 1 - raise your hands up while turning your palms outward. 2 - stretch in this position and take a breath. 3 - lower your hands down trying to describe a circle with them, exhale. 4 - return to sp. Repeat slowly 6 times.
Turns. I.p. - put your feet shoulder-width apart, hands on your belt. 1 - turn the body to the right, 2 - spread your arms to the side and take a breath. 3.4 - return to ip and exhale. Similarly, do the exercise with a turn to the left. Do exercises 5 times in each direction.
Squats number 1. I.p.. - arms down, legs apart. 1.2 - do squats, trying not to tear your heels off the floor, tilt your body slightly forward, take your hands back. Take a breath. 3.4 - slowly return to the sp. and exhale. Perform the exercise slowly 6 times.
Squats number 2. I.p.- arms lowered, feet shoulder-width apart. Do squats for 2 counts. Deep breath. 1 - sit down, resting your hands on your hips, exhale. 2 - return to sp. Sit down 4 times.
Tilts. I.p. - legs apart, put your hands on your belt. 1 - make a tilt to the left while raising your right hand up, inhale. 2 - return to sp. and exhale. Make tilts to the right, repeating 4 times in each direction.
Move your legs. I.p. - hands on the belt. 1 - stretch one leg forward, 2.7 - do circular swings with the foot. 8 - return to sp. Perform swings 4 times for each leg.
Lunges. I.p. - fix the legs shoulder-width apart, put your hands on the belt. 1 - stretch your left hand forward. 2 - take a right naked step forward. 3 - clench your fists and put your hands to your shoulders. 4 - stand in the I.P. Repeat all right arms and left legs. Perform the exercises slowly 4 times.
Walking in place. About 20 sec. do walking in place, then do some breathing exercises.

Complex with increased load:

Good for business

Although therapeutic exercises are relatively simple, for a patient who, in fact, after a stroke, begins to learn anew (trains new cells), these loads may seem difficult.

In order for physical education to benefit and lead to the speedy recovery of the body, a number of rules must be observed:

Adhere to the doctor's recommendations. Only a doctor can prescribe the right set of exercises, depending on which parts of the brain were affected. Only the doctor will tell you what loads can be applied during the recovery period.
Don't overwork. Because physical education is purely therapeutic in nature, then fatigue and overstrain should not be allowed. Start with the easiest exercises, gradually increasing approaches and connecting new, more complex ones. After all, the goal of training is not to pump muscles, but to make new brain cells work in the right direction.
Warm up the skin. This is especially true for bedridden, inactive patients. During this period, relatives should help them do the first exercises. To do this, you need at least a kind of massage. You should stroke, massage your arms and legs in the direction from the foot to the hips and from the fingers to the shoulders. All this is necessary for warming the skin and blood flow.
Monitor the patient's mood. Because many people after a stroke become depressed, feel like a “burden” and do not want to do any exercise. You should gently but persistently demand and make sure that everything is done correctly, constantly praise the recovering person, noting his successes.
Remember to be systematic. Therapeutic exercises should be daily for 40-60 minutes per day per session. At the first stage, it should be 2 times, and then - 3 times a day.
Stock up on patience. Time - the best medicine. And in this case, this statement is 100% true. After all, only daily training for several weeks will give a positive trend.

Trainers to help

After the patient's condition improves, you can start exercising on simulators.

They allow you to restore different groups muscles, strengthen weakened tissues, restore movement functions, relieve muscle tension.

They act on muscles with an adjustable load:

Comprehensive approach to treatment

Despite the fact that exercise therapy gives the most positive results, it will be more effective together with massage, which plays an important role in the prevention of complications.

For the most complete recovery, patients practice A complex approach to treatment.

Indeed, along with paralysis, the consequences of a stroke can be loss of memory, vision, hearing, or speech defects.

To do this, they resort to the help of speech therapists, an ophthalmologist - to help restore vision and an ENT - to regenerate hearing.

About how speech is restored after a stroke and what methods and exercises are used for this in question in the video.

To restore psychological rehabilitation in hospitals, a psychologist takes part, and at home - a loved one. All these measures will help to return to a normal lifestyle.

No matter how terrible the disease, but a stroke is not a sentence. Committed to speedy recovery, the help of loved ones, daily training and self-confidence provide an opportunity for a complete recovery of the body.