Exercises after a stroke

It is important that the remaining residual functions are stimulated and trained as early as possible in order to maintain and promote them. In addition, other intact brain structures should be trained so that they can take over the tasks of any brain areas that have been disturbed. The choice of exercises is based on the current symptoms, the wishes and goals of the patient and his general condition.

Basically, the training is always done from rough skills (e.g. arm lifting) to fine skills (e.g. writing). In addition, basic functions must first be restored (e.g.

a stable circulation, balance, posture control) before specific training (e.g. gait training) can be started. If the affected person has severe limitations, the first movements are performed passively by the therapist, then assisstively (= with support) and then actively by the patient alone. The first exercises therefore consist, for example, of changing position and transfer (from lying to sitting, from sitting to standing, etc.)

If this works well, more difficult tasks can be started, such as walking on the spot with holding on, half knee bends or balance exercises such as : It is important that the exercises are selected and adapted according to the daily form. A comprehensive collection of many different exercises can be found here: Stroke exercises

Balance: The patient stands with his back leaning in a corner of the room. Now he is given the task of alternately lifting one foot off the floor for a short moment. Alternatively, a small stool can be placed in front of him, on which he is to alternately place one foot.
If the problems are mainly in the upper extremities, slight wiping movements on the table can be performed at first and later gripping movements (e.g. of bottles, large balls, etc. ).

Muscle stimulation

Stroke patients with hemiplegia benefit from targeted muscle stimulation: so-called EMG-controlled electrostimulation. In this case, the abbreviation EMG stands for electromyography and means that the electrical muscle activity is measured and recorded. The therapy is based on the idea of neuroplasticity of the brain.

According to this idea it is possible that healthy parts of the brain learn the functions of disturbed nerve cells, nerve connections or whole brain areas. EMG-controlled electrostimulation works as follows: Electrodes are attached to the muscle group to be trained (e.g. on the upper arm, forearm, thigh or lower leg). These measure the muscle currents, even if they are only minimal.

The patient gets the task to activate the paralyzed muscles. Often no movement is visible, so that the patient reacts frustrated and gives up. The situation is different with EMG-controlled muscle stimulation: The electrodes register the movement attempt and amplify it so that the movement is carried out.

In this way the brain receives positive feedback for its effort. After repeated success, this leads to a learning process that stimulates the formation of new synapses (connections) between the nerve cells. The procedure has been scientifically tested and, according to current study results, has a positive influence on rehabilitation after a stroke.It is not suitable if the extremity is completely paralyzed (=Plegy), the affected person wears a pacemaker, is epileptic or pregnant.