Physical Therapy for Stroke Rehabilitation

Physical Therapy (PT) is the most common rehabilitation method to treat problems with movement, paralysis or loss of muscle function after Stroke. Many studies suggest that early mobilization within 24 hours of the stroke, improves the chances of speedy stroke recovery. Generally, a ’45 mins per day, five times a week’ exercise schedule is recommended for stroke survivors to regain strength, coordination, balance, and control of movement.

While much of the improvement from strokes is observed within the first 6 months, significant improvements are often reported after the first 6 months and sometimes even several years after the stroke.

Understanding the importance of PT in speedy stroke recovery, almost every specialized stroke unit across the world has Physical Therapy clinic(s) to prevent post-stroke complications and re-hospitalization.

Short-term and Long-term Goals

Following a stroke, a therapist should be consulted for a comprehensive evaluation of the stroke survivor’s posture, strength, flexibility, walking endurance, balance and coordination competency. Based on the results, the therapist should work on an individualized exercise program, considering the stroke severity and the patient’s age, gender, history of illness and prior activity level. Short term PT goals for stroke include:

  • Alleviating pain in the arm, shoulder or any other affected part of the body
  • Mobilising the patient on bed
  • Enabling the patient to change the posture frequently
  • Preparing the stroke survivor for further ambulation

After the initial period of recovery, the stroke survivor is asked to use the skills he has learned in the first phase of stroke rehab. Long term PT goals aim at minimising the discomfort and maximising the survivor’s ability. These goals include:

  • Improving muscle strength
  • Maximising mobility
  • Improving the patient’s coordination
  • Helping the patient recover best of his physical ability
  • Improving the stroke survivor’s general health
  • Prevention of subsequent strokes

How does it work?

Over time, the survivor’s leg and foot may become stiffer after stroke due to inactivity. In some patients, the hand becomes tighter, causing pain. The physical therapist examines the survivor’s movements and prescribes certain exercises.

The prescribed exercise program activates the affected part of the body, and re-aligns muscles and joints. However, at times, it may be hard work to re-educate the patient’s brain and body through actual movement. This is why, in many cases, certain rehabilitation equipment are recommended to achieve speedy stroke recovery.

Common Physical Therapy Interventions for Stroke

Physical Therapy, primarily focusing on motor control relearning, may help the patient overcome postural instability and regain strength. Common PT interventions for stroke include:

  • Proper positioning and careful handling of the hemiplegic shoulder or arm (whenever in bed, sitting, standing or during lifting) is recommended to prevent any shoulder or arm injury.
  • Limb Physical Therapy includes passive, assisted-active and active range of motion exercises for the hemiplegic limbs. This helps in prevention of limb contractures and spasticity.
  • The stroke survivor is trained to focus on foot positioning to stabilize base for gait. Apart from gait re-education, recovery of independent mobility is an important goal for the immobile patient.
  • In order to normalize the movement, prolonged stretching, weight bearing, splinting, and casting are recommended. The manual stretch of finger muscles and pressure splints produce long-term improvement in motor control.
  • To handle the functional limitations of stroke patients, functional tasks (such as bridging, rolling to sit to stand and vice versa) are taught to them based on individualized movement analysis.