How can Physical Therapy help post-stroke?
Physical Therapists are trained medical professionals that are part of the stroke recovery team. They typically first intervene in the hospital and can continue to be a part of recovery into the later phases post-stroke. They can conduct assessments at each stage of recovery to develop a treatment plan that is right for you! They often include the following in their assessment:
Discuss symptoms in detail.
Review lab and other test results.
Observe your ability to walk, stand, move, perform bed mobility, etc.
Conduct a hands-on assessment. This includes testing muscle strength, coordination, and sensation.
From this assessment, your physical therapist will help to create a treatment plan to specifically address your post-stroke symptoms, as not everyone who has had a stroke presents with the same symptoms. The treatment plan will focus on addressing balance and strength deficits and improving mobility, balance, and walking. These treatments can even address pain if you have any. Your physical therapist can also recommend adaptive equipment changes or make recommendations of equipment to start using depending on where you are in your recovery.
Why do I need to keep doing PT/exercise?
You may be asking yourself how can outpatient physical therapy continue to help post-stroke. You probably received therapy in the hospital, maybe went to acute rehab, or had therapy at home too! Why is more therapy important? Continued therapy to work on motor skills will help to improve brain and body function through neuroplasticity.
Neuroplasticity is the ability of the nervous system to change the networks in the brain through the growth and reorganization of neural connections after injuries such as stroke or traumatic brain injury. This means that adaptive changes can occur over time after an initial injury. We can rewire the brain to work in a new way! This often occurs the best during what is acclaimed to be the “critical period” for neuroplasticity, or brain plasticity. This critical period is 3-6 months. During this time, it is important to work on activities to help regrow the neural connections within the brain to allow us to improve our function post-brain injury or stroke. Unfortunately, it is not as easy as 30 repetitions of an exercise. This occurs over thousands of repetitions of activities. This can be achieved through continued therapy and work at home! Is getting up from a chair difficult, especially with one of your legs? Practicing sit-to-stands with your therapist and then continuing to work on them at home can help to improve the motor pattern for this movement and help rewire the brain to allow this task to occur easier over time. Doing all of these repetitions will also improve your strength and ability to perform the task! This is not just addressing getting up from a chair, but also getting on and off the toilet, in/out of a car, on/off the sofa or bed, etc.! The possibilities are endless for this type of movement. Research is also showing that neuroplasticity can continue after this critically acclaimed “critical period” and extend into the chronic phase of the injury, such as one year or greater. This means that even though it may not be as easy to create these networks and improve your movement patterns, they can still be worked on!
What if I feel like I’ve hit a wall? Why should I keep going?
Just as I said above, research shows that continuing to work on these over time can help to improve how we move, allowing us to rely less on assistive devices and/or caregivers for assistance and allowing us to be more independent! Continuing to improve things can also help to make sure we do not lose the progress that we have made along the way. You hear the saying, “Use it or lose it.” and it applies to movement as well. Continuing to work on things after a stroke will help us maintain them.
If you have been working on things for a while and feel like you are not making any more progress, that does not necessarily mean you are going backward or losing what you gained! Plateaus can happen. They can often be frustrating, but that does not mean that you cannot or will not make more progress. During these times, it can be beneficial to take time off from therapy. This does not mean stopping everything you are doing altogether, but potentially taking a break from one-on-one physical therapy sessions may be beneficial. This does not mean it has to be forever, but some time off can give us time to reevaluate our goals. If new goals arise or if we lose some function over time, we may need to get back into therapy to improve it again.
Take Home Message:
Physical therapists are a big part of the stroke recovery team. Physical therapy is often an ongoing part of the recovery process and can be done in all phases post-stroke. Exercise will help to improve motor function after brain injury and has been shown to continue to help even months to years after injury, so keep going and keep working on things!
Interested in starting physical therapy? Wellness 360 specializes in neuro rehab! With multiple programs, including 1-on-1 sessions, group classes, and an online Wellness on Demand platform, we have multiple tools to help you reach your fitness goals. To learn more about Wellness 360, visit our website at www.wellness360fitness.com.