After a stroke, getting back on your feet can feel like climbing a mountain. Physiotherapy is like the trusty guide that helps you tackle this challenge, especially when you’re aiming to walk again.
The recovery process demands physical strength and rebuilding the connection between your brain and your legs. The physiotherapy exercises you’ll read about in this article don’t just build muscle but also help your body rebuild the neurological connections needed to walk again.
The Role of Physiotherapy in Stroke Recovery
Physiotherapy isn’t just about moving your joints and building muscle strength. Neurological physiotherapy has techniques that can help rewire your nervous system through a concept called neuroplasticity.
When a part of the brain is damaged by a stroke, other parts can learn to take over its tasks, but they need training—like teaching a backup singer to take the lead. Early and focused physiotherapy interventions can kickstart this process, laying down the pathways that will help you regain your walking ability. This targeted approach ensures that every step you take in recovery is a step forward, building the foundation for your return to independence.
After a stroke, your brain and body must find new ways to communicate. Physiotherapists act as translators in this process, guiding you through exercises that help re-establish these vital connections.
The exercises we prescribe aren’t just random movements; they’re carefully chosen to match your personal recovery journey, targeting the skills you need to walk again.
Bed-Bound Exercises for Early Recovery Stages
Let’s start with a basic range of motion exercises that you can do in bed or while seated. These help strengthen muscles and prevent atrophy (muscle loss), setting a foundation for walking again.
Upper Body Strengthening
It might surprise you, but your arms and shoulders play a big part in walking. They help you keep your balance and support a good posture. By doing exercises like arm lifts and shoulder blade squeezes in your bed, you’re not just working your arms; you’re building the upper body strength that’ll help you when it’s time to get back on your feet.
- Arm lifts: lift your arms above your head and bring them down to the starting position multiple times until you get tired. Use weights to make it more challenging.
- Shoulder blade squeezes: While sitting, bring your shoulder blades together as if trying to hold something in between them. Release and repeat.
Core Engagement
Your core is the central support of your body, and having a strong core is like having a sturdy pillar in the middle of a building. Exercises like abdominal bracing, pelvic tilts, bridges, and seated/lying leg lifts make this pillar robust. They help you stabilise your torso, which is super important for balance and walking. A strong core means a stable body, ready to move.
- Abdominal bracing: Tighten your abdominal muscles as if bracing for an impact, without holding your breath. Maintain this tension to strengthen the core.
- Pelvic tilts: Lie on your back with your knees bent. Gently arch your lower back, then flatten it against the floor, engaging your abdominal muscles to move your pelvis.
- Bridges: Lying on your back with knees bent and feet flat on the floor, lift your hips towards the ceiling by engaging the core and glutes, then slowly lower the hips back down.
- Seated/lying leg lifts: while sitting or lying, extend one leg at a time, keeping it straight at the knee, and lift it off the ground, using the core muscles to maintain balance.
Leg Muscle Strengthening
Your legs are obviously crucial for walking. After a stroke, you need to regain their strength. Exercises like heel slides, inner thigh squeezes, quad sets, and leg lifts target the muscles you’ll use every time you stand or step. These movements build up the power in your legs, preparing them for the day when you’ll need them to walk again.
- Heel slide: Lying on your back, slowly slide your heel towards your buttocks by bending the knee, then slide it back.
- Inner thigh squeeze: Place a pillow between your knees while lying on your back and squeeze, engaging the inner thigh muscles.
- Quad set: Tighten the muscles in the front of your thigh by pressing the back of your knee down into the bed, hold, then release.
Enhancing Joint Mobility
Flexible joints allow for smooth movements, which you’ll need when you start walking. Gentle ankle circles, hip abduction and adduction, and leg crossovers can keep your joints from getting stiff. These exercises ensure that when it’s time to move, your ankles and knees are ready to bend and rotate just as they should when you walk.
- Ankle circles: Gently roll the foot in a circular motion, moving only the ankle, to increase ankle flexibility and mobility.
- Hip abduction and adduction: Slide your leg outward away from the midline and then back inward while lying on the back, improving hip joint mobility.
- Leg crossovers: Gently lift one leg and cross it over the other, then return to the starting position, promoting hip and lower back mobility.
Coordination and Balance Training
After a stroke, getting your limbs to move together in a coordinated way can be challenging. Exercises that get your arms and legs moving together can retrain your brain and body to work in sync. This kind of training is crucial for regaining balance and coordination, both essential for walking and preventing falls.
- Arm and leg opposites: Raise one arm over the head while simultaneously extending the opposite leg, then switching to the other arm and leg, enhancing coordination and balance.
- Hand-to-knee touches: Touch your hand to the opposite knee in an alternating pattern while lying down, promoting cross-limb coordination and engaging both upper and lower limbs.
Progression to Supported Standing and Walking
Once you’ve built some strength with bed-bound exercises, the next big step is getting back on your feet – literally.
It’s super important to take this transition slow and steady, moving at a pace that feels right for you. Your physiotherapist will be your coach here, guiding you on when and how to add more weight and support, ensuring you’re safe and stable every step of the way.
Creating a Personalized Exercise Plan
No two stroke patients are the same, and that means no two recovery paths are identical either. Your exercise plan after a stroke should be as unique as you are, tailored to suit your specific needs and recovery goals.
Our physiotherapists can work with you to craft a routine that not only addresses your stroke-related challenges but also syncs well with your pace and preferences, making your path to walking again as smooth as possible.
Integrating Exercises into Daily Routine
Fitting the exercises for stroke recovery into your daily life can be a game-changer. Consistency is key—you’re building a new habit, new for your nervous system at least.
You can make exercises for stroke rehab a part of your routine by setting aside specific times of day or integrating them into activities you already do, like watching TV. Consistency will keep the momentum going, pushing you closer to your recovery goals each day.
Your Next Steps
The journey to regain walking after a stroke is a marathon, not a sprint. Each exercise, each step, is a building block towards regaining your independence and mobility. Stay diligent and patient with your regimen and keep in close contact with your healthcare team to tailor the approach as you progress.
If you need a personalised rehab plan or a physiotherapist to help you on your walking journey, book an appointment with our physiotherapy clinics in Eltham, Battersea or Norbury. Our physiotherapists specialise in stroke rehab and will get you sorted ASAP!
