Physical activity after a stroke: how to properly carry out prevention

Svetlana Shcherbakova

Cardiologist

Higher education:
Cardiologist
Kabardino-Balkarian State University named after. HM. Berbekova, Faculty of Medicine (KBSU) Level of education – Specialist 1994-2000

Additional education:
“Cardiology”
State Educational Institution “Institute for Advanced Training of Physicians” of the Ministry of Health and Social Development of Chuvashia

Contacts

According to statistics, about 450,000 people in Russia suffer a stroke every year. Only 10-13% of this number fully recover and return to their previous work. A properly conducted rehabilitation process plays a vital role in recovery or minimizing the consequences of a stroke. Properly selected and regularly performed physical activity after a stroke is one of the main factors for the success of this process.

Exercise after a stroke

The rehabilitation program after a stroke should include physical activity for about thirty minutes daily. They can be:

walking;
run;
classes on special simulators;
swimming and so on.

It is best to alternate loads during a stroke. If a person is over forty, before doing the exercises, you should consult your doctor. If a person who has suffered a stroke suffers from cardiovascular diseases or a disorder of the musculoskeletal system, classes should be selected individually for each person and take place strictly under the supervision of specialists.

Every day, you should start with a light load. A couple of simple exercises:

stretching;
squat;
bend forward - backward
right left.

They will help restore your body, charge you with energy and positive emotions for the whole day. However, a person suffering from hypertension may need special antihypertensive drugs, which must be prescribed by a doctor, otherwise the exercises will not be beneficial and, on the contrary, may provoke a new stroke.

Each rehabilitation center selects individual loads for each patient. Walking and light jogging are incredibly effective. Experts recommend getting to work on foot and using minibuses and cars less often, unless work is nearby, of course. Clean fresh air and a properly selected set of exercise will help strengthen the functioning of the musculoskeletal system, cardiovascular system and other functions affected by stroke.

Morning and evening jogging are no less beneficial for health. However, you should not rush to start running on your own; first, get examined by a doctor, and then make such decisions. After all, for many people, running is strictly contraindicated.

Some clarifications

Rehabilitation without drastic changes If a person who regularly smoked and drank alcohol has a stroke, then after abruptly stopping the use, he may: • the functioning of internal organs be disrupted; • he will complain of indigestion; • he will be bothered by headaches and nausea.

Statistical physical exercises Exercises can be divided into two types: statistical and dynamic.

Dynamic exercises include, for example, running and walking. Thus, they consist in frequent changes in the state of a person’s muscles.
Statistical exercises include exercises involving a barbell, exercises with weights; under such loads, a certain part of the muscles remains under quite long, or even constant tension, especially if the weight is held for some time.

The rehabilitation period for stroke should consist of two types of loads, which should be selected individually for each patient. This approach will make it possible not to harm the human body, but, on the contrary, to improve its condition.

Rehabilitation includes regular monitoring of the victim’s health. And physical therapy is one of the best ways to improve the functioning of the cardiovascular system, and is also not a contraindication if a person suffers from cardiac arrhythmia. Exercises help to quickly pump blood. But in the case of arrhythmia, too much intense exercise can cause complications of the disease and harm health.

Physical activity In the ischemic type, the patient needs: • hospitalization; • hospital treatment; • full care; • symptomatic therapy;

In the case of ischemic cerebral infarction, the patient will not require neurosurgical intervention. Therefore, almost from the first days of the disease, a person needs to start doing physical therapy.

It should also be noted that there are simply no effective drugs for the treatment of cerebral infarction. Medicines, of course, improve cerebral circulation, help prevent recurrent strokes, and some serve to combat complications of the disease. However, the basis of treatment is:

proper patient care;
symptomatic therapy;
combating complications that have arisen;
use of medications.

Loads for arrhythmia

People who have heart problems, or more precisely, those suffering from arrhythmia, need to do physical exercises only in the presence of a doctor (rehabilitation specialist), and also seek help from a physical therapy methodologist, who will select a special series of exercises.

A person after a stroke can begin constant exercise only with the daily supervision of the attending physician; the intensity can be increased over time, but this must be done smoothly and extremely carefully. With properly selected and regular exercises, the blood vessels will reflexively dilate and heart contractions will increase. All this will make it possible for the body to develop resistance to overload.

If you have heart arrhythmia, you need to regularly do morning exercises. Physical exercises for each victim must be selected individually, since there are a large number of different complications.

Read also: Complications of ischemic stroke

Experts say that a patient suffering from cardiac arrhythmia simply needs physical exercise. They will make the human body more resilient and stronger. A person suffering from arrhythmia needs to start training with moderate walking over a short distance. Daily walks will strengthen a person’s heart muscles and prevent another stroke.

Loads should be carried out regularly, and gradually increase their intensity. Only in this case can you achieve the necessary results and increase your performance. While walking, you should think about something good; it is bright thoughts that help strengthen the nervous system.

The force of the load during walking is quite easy to determine. To do this, you will need a heart rate monitor, or you can count the number of beats of your pulse by placing your finger to your neck or wrist. Regular moderate intensity exercise will help restore the human body after illness.

Fifteen minutes will be enough to do the exercises, but they must be done regularly. To strengthen the functioning of the heart, you can do additional procedures (your doctor will tell you about them). You should enjoy training, and not have a terrible desire to finish everything as soon as possible.

What benefits do they bring?

Physical activity strengthens not only the cardiovascular system, but also the musculoskeletal system, they are the strongest healing factor, and also release the hormone of happiness, endorphin, into the blood. According to experts, light exercise leads to a positive result and restores the human body after a stroke.

Researchers also claim that mental and physical exercise will help the body become stronger and give strength for a speedy recovery. Physical activity will help a patient suffering from arrhythmia feel cheerful, because during the training the heart muscles are trained, and this is what makes it possible to maintain good health, and after a stroke, training will help to return to work.

In other words, moderate exercise works better than any drug. However, if they are irregular, they are unlikely to help fully. The patient needs to gain strength and patience if he wants to recover from an illness, because sometimes the exercises need to be done for quite a long time.

However, before starting a course of physical exercises, you should consult a doctor, because often, for every disease, especially after a stroke, certain exercises are contraindicated for a person. Only desire, compliance with all doctor’s advice and regularity will help bring benefits from them.

Drawing conclusions

Strokes are the cause of almost 70% of all deaths in the world. Seven out of ten people die due to blocked arteries in the brain. And the very first and main sign of vascular blockage is a headache!

Headache
Increased heart rate
Black dots before the eyes (floaters)
Apathy, irritability, drowsiness
Blurred vision
Sweating
Chronic fatigue
Swelling of the face
Numbness and chills in fingers
Pressure surges

Attention! If you notice at least 2 symptoms, this is a serious reason to think about it!

The only remedy that gave significant results. READ MORE. >>>

Exercise after a stroke

Kabardino-Balkarian State University named after. HM. Berbekova, Faculty of Medicine (KBSU)

Level of education – Specialist

State educational institution "Institute for Advanced Medical Studies" of the Ministry of Health and Social Development of Chuvashia

Save yourself from a stroke. Is it possible to avoid a blow and what to do if it happens?

Stroke - an acute disorder of cerebral circulation - is one of the most formidable ailments that overnight turns a healthy person into a frail disabled person. Every year in Russia more than 500 thousand

residents suffer acute cerebrovascular accident (stroke). 50% of them die, 70% of survivors become disabled.

What do you need to know to avoid joining their ranks?

Deputy Director of the Scientific Center for Neurology, Professor Marine Tanashyan, tells the story .

Is it possible to cause a stroke? The notorious former TV journalist admitted that he had a “board of honor” hanging above his desk, on which he noted people who had a stroke after an interview with him. – Stress, especially long-term, chronic stress, is one of the main provocateurs of stroke.

During traumatic situations, there is a jump in blood pressure and the release of the stress hormone (cortisol), which can cause a brain catastrophe.

However, it is impossible to cause a healthy person to have a stroke. There is always a “mediator” between stress and stroke.

Most often this is arterial hypertension (constant pressure is usually above 120/80), atherosclerotic plaques on the walls of blood vessels (which creates a condition dangerous for the occurrence of a stroke - narrowing of the lumen of the arteries supplying the brain) and atrial fibrillation (in which blood clots form in the atrium - Any of them can “shoot” in the head).

For acute stress to result in a stroke, the presence of one of the factors is sufficient. If all three are combined, a stroke can occur even in a calm state.

Why does the blow happen suddenly? Recently, a plane with 400 passengers made an emergency landing - the pilot of the aircraft suffered a stroke. Why didn’t the doctors notice anything during the mandatory pre-flight examination of the crew? Global statistics are as follows: the cause of up to 40% of strokes remains unclear. Especially often “young strokes” (under 45 years of age) become a mystery. They arise due to rare causes - blood diseases, dissection and pathology of the vessels feeding the brain, in which pressure drops during takeoff and landing can be critical. It is impossible to identify them during preventive screening; this requires in-depth specialized research. However, such reasons are the exception rather than the rule. Usually, doctors easily identify their potential patients during preventive examinations. Narrowing of the lumens of the arteries supplying the brain is shown by ultrasound of the brain vessels, high cholesterol (the cause of the appearance of atherosclerotic plaques) and blood sugar levels will be revealed by a finger prick blood test, persistent hypertension - regular monitoring of blood pressure. The suddenness of a stroke is also often a myth. Despite all the rapidity, the disease often sends “notifications” that patients either do not notice or ignore. Neurologists warn: in no case should you ignore sudden causeless dizziness, memory loss, numbness of a part of the face or body, difficulty speaking (even if it lasted several minutes), intolerance to bright light or loud sounds. These are classic signs of a transient ischemic attack, which in most cases quickly develops into a major stroke. Excessive patience and hard work with such symptoms can cost your life. A severe, sudden headache should not be tolerated under any circumstances. Most of those whose strokes were caught at an early stage were those who went to the doctor because of an unbearable headache.

The blow is often inherited. Therefore, people whose close relatives (parents, brothers, sisters) suffered a stroke before the age of 60 should be especially attentive to such symptoms.

What rules will help avoid a stroke? There is no such thing as a zero risk of stroke. It can occur in anyone. However, 3 out of 4 strokes are preventable. Moreover, you don’t need to make a lot of effort for this.

Physical activity reduces the risk of stroke by 15-20%.
The absence of bad habits (in the case of a stroke, smoking is the most harmful) reduces the likelihood of a brain catastrophe by 20%.
If a person controls blood pressure, heart rate, cholesterol and blood sugar levels, the likelihood of a stroke is reduced by 50%.

What to do if you get hit? Surveys show: 80% of people know what a stroke is, 50% know the symptoms, but only 20% are aware of what to do if they occur. Only 3 out of 10 patients call an ambulance.

The rest prefer to lie down and wait for it to go away on its own. However, a stroke is an emergency condition in which the most effective treatment is possible within the first 3-5 hours.

Therefore, you need to immediately call emergency help, warning the dispatcher that it is a suspected stroke.

Article from the newspaper: Weekly “Arguments and Facts” No. 6 02/07/2018

Source: https://www.neurology.ru/nauchno-populyarnye-stati/spastis-ot-insulta-mozhno-li-izbezhat-udara-i-kak-byt-esli-proizoshyol

When to start rehabilitation

After a stroke, complex processes occur in the brain. In adults, nerve cells are not able to divide, but restoration of functions lost during a stroke is still possible due to the formation of new connections between surviving neurons. That is why, in order to stimulate recovery processes, it is important not to delay the start of rehabilitation, which necessarily includes available physical activity. The recovery process is most intense in the first month. If the patient's condition allows, rehabilitation should begin in the first days after the stroke. The first year after a brain disorder is considered the most favorable for rehabilitation. Although the process of functional restoration slows down over time, efforts to improve the condition after this period are not futile.

Only a doctor can prescribe the exact timing of when to start therapeutic exercises; it all depends on the patient’s condition. What exercises to perform is determined by what functions are impaired and how deep the impairment is. There are no, and cannot be, general solutions here. Efforts are made to restore the ability to move.

The role of sport in stroke recovery

A stroke is primarily characterized by rupture or blockage of blood vessels in the brain. This violation rarely goes away without a trace, in some cases it can even lead to death.

As a result of the disease, the brain is affected, and, therefore, many body functions are disrupted. The prognosis depends on the location of the pathological process and its severity. Cerebral infarction requires a very serious approach both in treatment and in subsequent rehabilitation.

Stage I is an acute period of stroke, lasting from the moment of occurrence until 21 days;
Stage II – lasts up to 6 months from the onset of the disease;
Stage III – lasts up to 12 months;
Stage IV – the stage of residual effects begins after 1 year has passed since

What to do

In cases where a person is completely immobile, assistance will be required to change the position of the limbs. Be sure to move your arms and legs to avoid blockage of the veins. If motor functions are not completely lost, the patient must perform the prescribed exercises himself. Activities include: training the eye muscles, finger movements, rotation of the hands and feet, bending and rotating the head, breathing exercises.

After this, exercises are prescribed that train the ability to stand, walk and coordinate movements. Only then are more complex types added, which include: raising arms, legs, squats, bending the body to the sides, “scissors” with arms and legs. Specific exercises, number of repetitions, and total training time can only be determined by a specialist. It is very important that all exercises are performed smoothly and carefully. The most important thing is regularity. Such training should become a habit, like brushing your teeth. Typically the total execution time is at least 30 minutes. There are many special simulators that help restore the ability to move after a stroke. However, they are most often available to those who undergo rehabilitation in specialized centers.

Static and dynamic loads

There are loads that have excellent effects and do not require complex equipment. Such physical activities recommended after a stroke include:

walking;
Nordic walking;
swimming;
a ride on the bicycle;
run.

These are all dynamic loads. There are also static ones, when a certain muscle group is under tension for some time. Experts are not unanimous on the need for static training using weights, barbells and other weights when recovering from a stroke. In any case, alternating dynamic and static loads requires an individual approach. This is usually done by specialists from rehabilitation centers, but such services are paid. If there is no opportunity to use the services of the center, it is better to prefer dynamic training. They are simple, useful and, in addition to the physical, have an excellent psycho-emotional effect.

Nordic walking

This type of health walking, also called Finnish, Nordic, or northern, is rapidly gaining popularity. There is nothing surprising about this because, despite its extraordinary effectiveness, it is very simple and accessible to everyone. All you need is a solution, a suitable place with clean air and two poles, very reminiscent of ski poles. This type of walking got its name because it was Finnish skiers who were the first to use this walking technique. Their goal was to stay in shape when it was not possible to ski. It turned out that this method of walking has advantages compared to regular walking, running, and cycling. What is so wonderful about Nordic walking?

This type of movement has the following effects:

The load is distributed more evenly, 90% of all muscles are involved in the movement.
The cardiovascular system and blood pressure are normalized.
Increases endurance.
Relying on sticks allows you to relieve the joints of the lower extremities.
More energy is burned than during race walking and cycling. This allows us to recommend it for maintaining normal body weight.
The ability to maintain balance and coordinate movements is restored.
The respiratory system is strengthened: lung volume increases.
Metabolism and intestinal function are normalized, bones become denser.
Cholesterol levels decrease.
The effect of stress is reduced and mood improves.

Medical studies have shown that Nordic walking after a stroke promotes speedy recovery.

While walking, you need to breathe properly. Breathing should be calm, first through the nose, then, when more oxygen is needed, you need to breathe through the mouth. There is no need to be afraid of this; intense breathing is always done through the mouth. Nasal breathing is not intended for this. The duration of inhalation should be 1.5-2 times less than the duration of exhalation.

The intensity of the load is quite simply controlled by the pulse. During rehabilitation after a stroke, heart rate (number of heart beats per minute) at the end of training should not exceed the initial value by more than 20% - 30%. It is enough to start with 20 minutes, increasing the time of each workout by 5-10 minutes. Medical studies have shown that after 3-4 months of training, the pulse decreases by 8-10 beats/min, and blood pressure stabilizes. This characterizes an improvement in the condition of the cardiovascular system. For Finnish walking you only need poles. You can calculate the length of the stick by multiplying the height by a factor of 0.68. The permissible interval is ±5 cm. It is better to get acquainted with the walking technique in a club, on YouTube, or learn from those who have already mastered this technique.

Contraindications: viral diseases, recent surgery, hypertensive crisis, arrhythmia.

How not to harm yourself

If you experience heart/side pain or dizziness while jogging, something has gone wrong. You need to stop, take a breath and count your pulse. Normal number of beats per minute for different ages:

✓ 30 years – 162;

✓ 40 years – 157;

✓ 50 years – 152;

✓ 60 years – 147;

✓ 70 years – 142;

✓ 80 years – 137.

You can't run on a full stomach. While jogging, you need to monitor uniform breathing and correct posture, and periodically reduce the pace.

There are contraindications for jogging:

atherosclerosis;
bronchial asthma;
thrombophlebitis and varicose veins;
hypertension;
heart attack suffered earlier than 12 months;
uncompensated diabetes mellitus;
stage 3 obesity;
viral and infectious diseases in the acute stage;
chronic lung diseases;
liver cirrhosis etc.

I run correctly after a stroke: technique

When running, the insides of the feet should be parallel to each other, with the toes slightly turned outward. You need to place your foot so that the weight is redistributed from heel to toe. When moving your legs, you need to make sure that your shins are relaxed, that is, the main load falls on your hips and knees.

To reduce wear on the joints, you need to straighten your knees smoothly, do not raise them too high, and do not sway from side to side.

You should move easily, with medium steps, keeping your body vertical (let's say a slight lean forward). Your arms should be bent at right angles, your gaze directed forward about 30 meters. Shoulders and neck need to be relaxed.

Scrupulous execution of the technique will reduce tension in joints and muscles, and also prevent injuries during jogging.

Swimming after a stroke

Swimming after a stroke is useful, but you can start swimming no earlier than 4 months after it. Swimming allows you to fully control the intensity of the load based on heart rate values. The recommendations are the same as for Nordic walking. The likelihood of injury while swimming is very low, which is important for people who have had a stroke. Like any dynamic load, swimming has a positive emotional effect, which contributes to a speedy recovery.

Swimming is ideal for people who are overweight and find it difficult to exercise or even move around. Regular swimming helps:

normalization of the cardiovascular system, and as a result, blood pressure;
acceleration of metabolic processes;
strengthening the respiratory system;
normalization of body weight;

To obtain a good rehabilitation effect and reduce the likelihood of a stroke reoccurring, you should swim at least 2-3 times a week. Therefore, it is advisable to purchase a subscription and not miss visiting the pool.

Contraindications: viral diseases, recent surgery, hypertensive crisis, arrhythmia, skin diseases.