3 to 6 months after stroke is the golden period for stroke recovery as this is the time when the brain is most responsive to treatment. The earlier a stroke patient receives treatment, the higher the chances of recovery.
Hence, it is crucial for a stroke patient to continue a high-intensity recovery program at home after being discharged from the hospital.
As most stroke patients are bedridden, home physiotherapy will be very helpful in the early recovery stage of stroke in regaining strength, mobility, and independence.
So, what to expect for stroke rehabilitation therapy at home? Here are the 10 Essential Stroke Rehabilitation Therapies conducted by a home physiotherapist to help stroke patients get back on track of life.
1. Early Mobilization Exercise
Early mobilization exercise is an early stage of physio treatment to prevent blood clots from forming in blood vessels (deep vein thrombosis) and pressure ulcers due to long periods of bed rest without moving. Early mobilization exercise should be started as early as 24 hours after stroke, and 15-45 mins daily according to a study.
Early mobilization exercises include:
Passive / Active Assisted Side-to-Side Turning
Mobilizing exercise for each joint of upper and lower limbs – passive and active range of motion
Bedside Sitting
Trunk Mobility, assist with moving the trunk forward/ backward/ sideways/ rotation/multi-directional movement
2. Stretching exercise
The longer one stays inactive, the more the muscle and joint are prone to stiffen, therefore stretching exercise is important for a post-stroke patient to prevent joint stiffness and muscle contractures (Contractures: permanent tightening of muscle, tendons, or joint causing a deformity)
Stretching exercises can be various depending on the targeted muscles:
Neck Muscle Stretching: Cervical flexion/extension/rotation
Chest Muscle Stretching: Shoulder Overhead / behind back movement
Wrist Muscle Stretching: Wrist curl movement for flexor/extensor
Back Muscles Stretching: Knee to chest movement
Hip flexor muscle Stretching: Side lying hip extension movement
Hamstring Stretching: Knee extension with hip flexion movement
3. Strengthening exercise
A common after-effect of stroke is limb weakness. These exercises are designed to help the patient build strength in their affected muscles. They may involve the use of weights or resistance bands to provide added resistance.
Strengthening exercises include:
Elbow flexion movement with dumbbell for Biceps strengthening
Wall push training for Chest muscle & Triceps Strengthening
Hand gripping exercise for Flexor carpi strengthening
Squat/lunges training for Quadriceps strengthening
Hip sideway movement using Theraband for Hip muscle strengthening
Multidirectional trunk movement using Theraband for Core Trunk muscle strengthening
4. Cardio-respiratory training
As the weaker side of the limb & body may affect the breathing pattern, cardio-respiratory training helps to clear phlegm, reduce the effort of breathing, and prevent or improve areas of lung collapse. The physiotherapist will personalize the training according to the patient’s condition.
Cardio-respiratory training includes:
Deep breathing exercise
Percussions and vibrations – to loosen phlegm and make coughing easier.
Coughing and breathing strategies – to manage shortness of breath
For those patients with tracheostomy or Ryles tube, cardio-respiratory training helps them to stay comfortable during breathing.
5. Balance training
From lying to sitting and standing, stroke patients with one-sided stroke can lose their balance during normal daily activities. Hence, physiotherapist helps to train the patient to improve their balance and stability in different position, for example, sitting & standing. A delay in balance training may increase the risk of staying bedridden.
Balance training includes:
Multidirectional Hand Reaching in a sitting position
Sit to stand
Seated Marching
Heel to Toe Raises
Single leg stance
Side leg raise
6. Gait training
Gait training is physical therapy to teach patients how to walk normally again. Patients with one-sided strokes could have one-sided muscle paralysis or weakness, hence they are typically walking with hemiplegic gait - a decreased speed and asymmetrical step lengths. The training may involve the use of a walker or cane to provide support.
Gait training includes:
Hip raise-up training
Knee locking training
Ankle stabilization training
Swing phase training
Trunk synchronization with lower limb training
7. Coordination training
Coordination training is to help patients to train the upper limb, trunk & lower limb to synchronize when they do the movement. Most stroke patients are always able to move a single limb but they fail when trying to integrate the movement into complex activities.
Coordination training includes:
Upper Limb coordinated movement
Lower Limb coordinated movement
Remeds Physiotherapist demonstrated Coordination Training for Stroke Patients
8. Manual therapy
Manual therapy is the therapy involving massage, muscle release, and trigger point that helps as an adjunct to relieve pain or discomfort due to imbalance or incorrect posture of stroke patients and to improve blood circulation.
9. Lymphatic drainage massage
Lymphatic buildup and limb swelling occur in stroke patients due to bedrest, especially often seen in patients with kidney and heart failure. Lymphatic drainage massage is a specialized type of medical massage by a physiotherapist that helps to manually drain away lymph fluid accumulated at a certain congested area of the body, which then reduces the swelling.
10. Provide body support
Stroke often leads to complications such as asymmetrical shoulder joint drop, or the knee inverted in or out. With the assessment from a physiotherapist, suitable body support aids, such as an arm sling, shoulder support or knee brace can be recommended to prevent the deterioration of the patient’s posture.
In short, a home physiotherapist plays a crucial role in the recovery process of a stroke patient. They work with the patient to develop an individualized treatment plan that is tailored to their specific needs and goals and monitor closely the progress.
With the right approach and the guidance of a qualified home physiotherapist, stroke patients can make significant progress in their recovery and achieve their goals of regaining their strength, mobility, and independence, allowing them to live a more fulfilling life.
If you or your loved one has suffered a stroke and you're looking for professional advice and individualized treatment plan for stroke recovery from a physiotherapist who can treat at your home, speak to us now to get your Free Consultation today!
Content provided by: Physiotherapist En Azrul Naim
Edited by: Pharmacist Khang Phing Goh
Remeds Homecare specializes in providing home physiotherapy services to patients who require physiotherapy treatment but prefer to receive it in the comfort of their own homes in Northern and Southern Malaysia, including Penang, Sungai Petani, and Johor Bahru.
Learn more about our home physiotherapy service here.
Remeds Homecare also provides other home care services for the elderly such as hospital bed rental, home nursing, home wound care, and wheelchair repair services , to serve as a one-stop solution for post-discharge care at home in Malaysia.
Contact us : 010-8823994
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