Methods of home rehabilitation after ischemic and hemorrhagic stroke. Gymnastics after a stroke

Many patients manage to return to work after a stroke and lead a normal life. The main condition is activity, perseverance, self-confidence. And the most important thing is movement, movement, movement. Even a bedridden patient after a stroke can and should do it at home restorative gymnastics. And if he cannot, due to complete immobility, then those who care for him should do passive gymnastics to the patient.
Here are several examples from the newspaper “Vestnik ZOZH”, how paralyzed bedridden patients after a stroke were able to fully recover from disabilities into full-fledged people. As well as advice on rehabilitation and care for paralyzed patients.

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Caring for paralyzed patients after a stroke at home - Doctor's advice.

In the first days after a stroke, a paralyzed patient is doomed to complete immobility. It is especially difficult to care for paralyzed patients at home. To prevent pulmonary edema, a bedridden patient should be turned in bed every 2 hours. If the condition improves, sit him down in bed for a few minutes. If the patient is conscious, it is necessary to force him to do breathing exercises; at home, they are most often given to inflate inflatable toys.
To prevent bedsores from forming in a paralyzed bedridden patient after a stroke, the skin must be wiped daily with camphor alcohol or a mixture of vodka and shampoo. If damage to the patient’s skin does occur, it is necessary to wipe them with a solution of potassium permanganate and lubricate them with rosehip oil.
With a paralyzed patient after a stroke at home, even if he is completely immobilized, it is necessary to carry out passive gymnastics, this prevents blood stagnation and thrombophlebitis. The patient's arms and legs must be bent, extended, lifted and massaged.
You need to constantly talk to the patient, even if it seems to you that he does not understand the words addressed to him. This will allow you to recover faster logical thinking and speech. Good care caring for a paralyzed patient will help avoid secondary stroke. (HLS 2001, No. 3, p. 8-, from a conversation with Dr. MN Kadykov A. S.)

Mental gymnastics after a stroke.
“Mental gymnastics” helps patients recover; even paralyzed patients after a stroke can do it in the hospital and at home. You can restore the central nervous regulation that controls the motor activity of the affected areas of the body by creating a mental image of a particular exercise.
Imagine that you clench your fingers into a fist, lift your feet up, and lower them down. The clearer the “picture”, the faster connections are formed with other parts of the brain, which will take over the functions of nervous regulation of the areas of the body affected by paralysis.
Each mental exercise leaves its trace in the brain; when repeated, a chain of such traces is created and formed new center nerve connections that control movement.
Depending on the severity of brain damage, the will of the patient, patience and perseverance, the process of building new connections can take a month or a year. You also need unconditional faith in the power of mental training. Whether this faith is true or false, it will work miracles. Set goals and go towards them. (HLS 2002, No. 13, p. 19. Boris Goryachev, doctor)

Where to start rehabilitation exercises after a stroke - Stages of rehabilitation
1st stage
From the first hours of the acute period of stroke, positional treatment is used to avoid contractures of paralyzed limbs. Also, relatives or medical staff perform passive gymnastics for a paralyzed patient.
2nd stage
By the end of the first week after a stroke, active rehabilitation exercises are prescribed, a set of exercises of which is developed by exercise therapy instructors in the hospital. It is first performed in isometric mode, without movement in the joints. An assistant lifts the sore limbs, and the patient’s goal is to hold the raised arm or leg. The arm must not be raised by the wrist. If the sore arm is raised by the sore arm himself, with the sore healthy arm, he should lift it by the elbow, turn the hand palm up; if an assistant raises the arm, then with one hand he grasps it above the elbow from below, and with the other hand he grabs the wrist from above.
3rd stage
The patient is taught to sit. They start with 3-5 minutes reclining, placing pillows under the back and head, after 2-3 days the patient is transferred to the floor vertical position.
Then they sit on the bed with their legs down, placing a bench under them.
4th stage
Strengthening the leg muscles. Exercises are carried out using an expander or a frog pump to inflate rubber mattresses. In a lying position, they do the “imitation walking” exercise - the legs bend and straighten at the knees, the soles of the feet slide along the sheet.
5th stage
Walking. The patient tries to stand up from a sitting position, holding onto a stable support - the headboard of the bed, a nearby chair or armchair. When the patient learns to stand confidently, he should begin to shift from foot to foot. Having mastered this exercise, you can move on to walking in place, holding the headboard of the bed. Then they try to walk in place without support.
Gymnastics for the arms after a stroke.
Simultaneously with exercises for the legs, you need to develop the muscles of the arms. To do this, they assemble and disassemble pyramids, children's construction sets, cubes, and mold them from plasticine. It is useful to shift objects with the affected hand, leaf through books, tighten nuts, fasten zippers, and tie ribbons.
To relax the muscles, it is useful to lie on your back and dangle your paralyzed arm and swing it.
Gymnastics after a stroke for the development of the shoulder joint:
1. lock your hands, raise them up, tilt them left and right
2. take the stick with both hands, lift it up, and lower it behind your head.
The sore hand is passive; it is pulled along by the healthy hand.

But the main thing in rehabilitation after a stroke is walking. Choose flat routes without climbs with benches to rest. Gradually increase the distance. The walking pace is slow - 40-50 steps per minute. Rest every 5-10 minutes.
Do not spare the paralyzed side, because non-working muscles cannot be restored, so they must actively work.
(Conversation with the chief physician of the Center for Recovery and Rehabilitation of the First Moscow State Medical University, Yu. K. Mokhrov from the newspaper “Bulletin of Healthy Lifestyle” 2011, No. 22, pp. 6-7)

Gymnastics after a stroke at home - Reviews about recovery.

Simple gymnastics for bedridden patients
A 58-year-old man suffered a stroke. He knew that the only way So that a bedridden patient after a stroke turns into a full-fledged person is daily physical exercise. There is no time to waste, you need to start studying right away, while still lying in bed, in order to overcome the consequences of a brain stroke.
You can start with the simplest exercises (1) and move on to more complex ones (10):
1. Raise the paralyzed arm, first you can help with the healthy arm, and even earlier the sore arm should be raised by those who care for paralyzed patients after a stroke at home.
2. Squeezing a clothespin with the affected hand will not work the first time, but it will succeed on the tenth or hundredth try.
3. Lying down, squeeze the mattress with your sore hand and hit it circular movements.
4. After you get stronger and begin to sit down, learn to write with your left hand.
5. Soak the cloth in water and wring it out. Wipe down your kitchen and bathroom tiles over time.
6. Squeeze the rubber ball with your hand to make it more pleasant - pierce it. Perform 100 repetitions.
7. Make balls from plasticine.
8. To develop your legs, use a rubber ball, round sticks - you need to roll them with your foot on the floor, gradually increasing the pressure.
9. Press your hands against the wall (if your sore arm doesn’t rise, help it with your healthy one), shift from one leg to the other.
10. Lean forward, touching the floor with your toes.
The most important thing is to overcome apathy, laziness, the belief that you are no longer good for anything and will not be able to return to a normal life.
The man has been doing these exercises for three years, and as a result, he has learned to take care of himself, walks around the apartment freely, and on the street with a stick, and has learned to write. right hand, in which, after a stroke, he could not even move his fingers. (HLS 2003 No. 17, p. 10)

Exercise after a stroke
After a stroke, the woman was taken home by her son and started doing gymnastics while still in the hospital - the doctors showed her a set of exercises. Soon the exercises seemed too simple. She asked her son to find more large buttons, and 17 were found. They were dumped into a pile, and the woman transferred them, one paralyzed hand at a time, to another pile at a distance of 30-50 cm. Then she did the same exercise with matches, then learned to put the spilled matches into a box.
A table was placed near the patient's bed so that she could learn to stand and walk by leaning on it. Over time, she was able to walk throughout the apartment, holding on to the wall.
After the stroke, the paralyzed arm swelled greatly, the woman bandaged aspen pegs to it, and the swelling went away. You can also tie a paralyzed arm to the neck so that it is smaller at the bottom, so it hardly swells.
The patient had a strict routine - exercises 3 times a day, exercises with buttons, exercises with matches, long walking around the apartment. She soon learned to peel potatoes and prepare soup for the children's arrival. To develop strength in her paralyzed arm, she carried first half a loaf of bread in a bag, then a whole loaf.
Now, 4 years after the stroke, her main exercise is “Kalmyk yoga”, doing 30 squats daily. Previously, they called an ambulance 2-3 times a month, but now the blood pressure has returned to normal and I managed to stop taking pills.
A message to stroke survivors: work slowly and hard, work and work within your capabilities. Movement is life, while we move, we live. The main thing is not to lose heart, always set a goal and achieve it. (HLS 2006, No. 23, p. 18,)

Walking and gymnastics helped to recover after a stroke
In 19955, a man was hospitalized with a diagnosis of stroke. Left-hand side was paralyzed. Memory disappeared for 8 days. I spent 41 days in the hospital after the stroke. I couldn’t sit, I couldn’t hold a spoon, I couldn’t eat, because my mouth almost didn’t open, I just drank, my head hurt badly.
When his hands began to work a little, he began to rise on the bed with the help of a rope with knots tied to the headboard. I sat there for about two minutes. After a while, I began to lower my legs from the bed, and immediately felt relief, because blood began to flow into my legs. I did this exercise several times a day. I started rolling the roller with my feet, plus a foot massage. I felt a little better and had an appetite.
When he was discharged home, he began to learn to walk, first around the house, holding onto the wall and using a cane. A month later I asked to go outside. There he decided to walk alone to the next entrance, somehow he succeeded, sat there on a bench and headed back. After that, his legs hurt all day, but the next day he walked twice as far, and every day he increased the distance. A week later I was already walking around the three-entrance house.
Then the patient asked to be taken to the village where he had a house built. There he is every day 100 m to the farm and 100 m back. His legs became more obedient, but he still fell often. Soon he began to train his left paralyzed arm - he carried a bucket with 2 liters of water. First with rest, then I carried it to the end without letting go, it was very difficult - my fingers unbent and the bucket tried to slip out.
Gradually I increased the distance - I did 5 walks daily - 1 km, then 2 km. His arms and legs became stronger, he began to work in the garden and at home, 12 years have passed since the stroke, the patient is now 70 years old, he emerged victorious from the battle with the disease.
(HLS 2007, No. 8, p. 8,)

Gymnastics after a stroke is a set of exercises for the arms and legs.
A 65-year-old woman suffered a stroke and her right side was paralyzed. At first she became depressed and wanted to die so as not to be a burden to the family, but her daughters convinced her to fight for life. And she began to fight.
At the hospital, doctors taught the patient to walk by moving a chair in front of her; at home she continued these lessons, and eventually was able to move independently.
Every day he does exercises for paralyzed arms and legs: exercises for the hand and finger motor skills, moving abacus knuckles, rolling sticks (smooth and spiked), rolling a tennis ball and rubber balls. He also collects pyramids with his right hand, puts 100 pencils from the table into a box, assembles dominoes, squeezes a wrist expander, moves the beads with his fingers, shakes right foot“frog” (foot pump for inflating chambers) 120 times, pulls the expander with the right hand - 200 times, sits and stands on high chair, holding the handrail - 50 times, reads aloud to restore speech.
There is a desire to reduce the number of exercises, but every time the woman pulls herself together and tries to increase them every month. Everyone is happy to celebrate small victories: now the hand has begun to clench into a fist, now it is possible to eat with a spoon in the right hand, etc... (HLS 2002, No. 10, p. 3)

Gymnastics after a stroke is a set of exercises for the hands and fingers.
1. Drum your fingers on the table.
2. Do a “split” with your fingers.
3. Spread your fingers wide and then close your fingers.
4. Place the brush on the table or bed. Lift each finger in turn, then raise the entire palm.
5. Holding the paralyzed one with your healthy hand, raise your sore hand.
6. Place your elbow on the table, hold your hand vertically, and reach your palm with your fingers.
7. Thumb hands press on each other finger of the same hand.
8. Place your palms together and place each finger in turn on the opposite one.
9. Elbows on the table, palms together. Extend and close your elbows, sliding them across the table.
10. Roll the rolling pin on the table with your palm.
11. Roll the foam with your fingers.
12. Take the stick in both outstretched hands and twist it, intercepting it, clockwise and counterclockwise.
13. Throw a stick from one hand to another.
14. Roll the ball with your fingers away from you and towards you.
15. As if twisting a light bulb, spin the ball clockwise and back.
16. Squeeze the ball between your palms and press on it.
17. Throw the ball from hand to hand.

A set of exercises for the arms and development of the shoulder joint.
1. Stretch your arms forward and place your sore arm on your healthy arm, bending it at the elbows. A “frame” is formed. We make turns, moving the “frame” left and right.
2. Lower and raise your arms in a lock, helping the paralyzed one with your healthy hand.
3. With your hands clasped together, make circular movements.
4. Without releasing your arms, rotate your shoulders back and forth.
5. Raise your clasped hands up, spread them to the sides and lower them.

Stroke - exercises for legs.
1. Sit on the floor, straighten and bend your knees, sliding your feet along the floor.
2. Sitting on the floor, legs extended forward. Move your legs to the side one by one, sliding your feet along the floor.
3. Raise your straight leg and place it on the other.
4. Pull one knee to your chest, then the other.
5. Lying on your stomach, toes resting on the floor, lift your knees off the floor.
6. Crawl on your bellies.
7. Sitting on a chair, roll your feet from heel to toe and back.
8. Sitting on a chair, spread your heels and bring them together. Then lower your legs onto your heels and bring your toes together.
9. Place the affected leg on the healthy one and rotate the ankle joint.

Breathing exercises after a stroke at home.

This breathing exercise helps with the most various diseases, in particular, cerebral vascular sclerosis and stroke. Just a month of practicing at home, and you will forget what sclerosis is, and stroke patients will gain hope for recovery. A 74-year-old woman, having read an article about this gymnastics, practiced for almost 2 years. As a result high pressure, which was not reduced by any medications, returned to normal, and my health improved significantly.

First you need to choose a position: either reclining in a chair or lying on your back. Relax and let go of all thoughts. Close your left nostril with your left hand and calmly, very slowly inhale through your right nostril. Inhale fully so that the chest rises. Then close the right nostril, freeing the left. Don’t breathe as long as possible, endure with all your might. This is the essence of the exercise. Then begin to exhale through the left nostril. Repeat the exercise 5-7 times. Then we do the opposite: inhale through the left, exhale through the right nostril, also 5-7 times. This is 1 cycle. Such cycles must be done 3-5 times.
After about a week, you will feel a slight tingling and warmth in the solar plexus area while performing the exercise. After 2 months, your abdominals will become as firm as a drum. All this suggests that the exercises are going well and are beneficial (HLS 2011, No. 9, p. 19)

Exercise “Kalmyk yoga”.
Many diseases of old age are associated with disorders cerebral circulation. Patients fight these diseases with the help of breathing exercises according to the methods of Strelnikova, Budeiko, Frolov. These systems have one thing in common: the carbon dioxide content in the blood increases, and this increases blood flow to the brain and heart and dilates blood vessels. The “Kalmyk yoga” exercise works on the same principle.
There are known cases when the “Kalmyk yoga” exercise completely removed the diagnosis of “diabetes mellitus”; many people significantly lower their blood pressure levels (from 190/100 to 140/90). But you need to practice every day for 2-3 years. This is a long time, but this exercise will not only protect you from a second stroke and heart attack, but will also completely rejuvenate and strengthen the body.
“Kalmyk yoga” is squats with holding the breath and the torso bent parallel to the floor. When doing the foundation exercise thumbs close the nostrils. You should do 10-15 sets of 20-60 squats.
A man suffered a heart attack, his wife showed him an article about Kalmyk yoga. He began doing exercises daily, gradually gave up all medications, his blood pressure returned to normal, and his health became ideal. (HLS 2003 No. 3, p. 23)

Massage after a stroke at home.

Acupressure after a stroke.
A man had a stroke at work. The right side of the body became paralyzed, and swallowing functions disappeared. Hospital, injections, tube feeding... 10 days passed, and there was no improvement. Then the wife got down to business and decided to use folk remedies. She gave 8 teaspoons of blue iodine in jelly every day during feeding. As a result, 4 days after this he began to swallow on his own. From Gavaa Luvsana’s book “Essays on Eastern Reflexology Methods,” she wrote down points on the meridians that should be massaged during a stroke. First, the right foot, which was icy, warmed up, then the right side began to function. As a result, the man went back to work (HLS 2000, No. 24, p. 7)

Massage after a stroke helped me recover.
A woman wrote to the newspaper who has been giving massages at people’s homes for 25 years. Her main patients are bedridden patients, paralyzed after a stroke. When she came to see another patient for the first time, she decided that no massage would help. The woman was very heavy - she did not speak, did not move, did not think, did not understand where she was and what had happened to her.
For the first six months after the stroke, the patient received massage daily. And then courses 2 times a year.
Three years have passed since the stroke, the patient’s speech and memory have returned, now she is learning poems and reciting them by heart, knitting socks, growing flowers, doing everything around the house herself, and doing gymnastics.
The masseuse had never seen such patients before; usually she encountered lazy patients who did little to heal themselves. In order to overcome the consequences of a stroke, you just need to not be lazy.
The editorial staff of the newspaper “Vestnik ZOZH” called this patient to find out the secret of her cure. It turned out that there is no secret, but there is amazing fortitude and perseverance. “I don’t give myself a minute’s rest, I’m busy doing something all day. Sometimes I’m so tired that I have no strength, I want to lie down, but I can’t, I have to move, move and move. The only indulgence is to lie down for 15 minutes after lunch,” the patient said over the phone. (HLS 2009, No. 9, p. 9)

Massage and gymnastics for stroke prevention
In Russia, 400 thousand strokes occur annually. The reasons are stress, deterioration of blood circulation in the vessels of the brain.
To control yourself and resist stressful situations, will help relaxation gymnastics. You need to sit comfortably, close your eyes and be alone with yourself for 10-15 minutes. Do this exercise 2-3 times a day.
To increase cerebral circulation and avoid stroke, it is useful to do head massage.
1. With your fingers clenched into a fist, you need to stroke your head from the forehead to the back of the head and neck, and then reverse direction(2-3 times)
2. Use your fingertips to pat your entire head for 1-2 minutes.
3. Use your fingertips to pat your temples and cheeks for 1-2 minutes.
4. Rub your ears with your palms.
5. Rub your left shoulder with your right hand
6. Rub your right shoulder with your left hand

To improve cerebral circulation at home, it is useful to do vibration gymnastics. Stand on tiptoes and lower yourself sharply, hitting the floor with your heels. 20 shaking-liftings with the head vertical, 20 with the head tilted to the right, 20 with the head tilted to the left, and 20 with the head tilted forward. (HLS 2002, No. 24, p. 12)

Healing rubs after a stroke.

Rubbing for those who have suffered a stroke.
This remedy helps restore body mobility to bedridden patients after a stroke. To prepare the rub you need to take the following dry crushed ingredients: half a cup of black radish peel, 1/2 cup of horseradish leaves, 2-3 pods of hot pepper, 1/4 cup of partitions walnut, 1/4 cup pine nut peels. Place all this in a jar and pour in 500 ml of alcohol or triple cologne. Infuse the mixture for 7-9 days. Rub the entire body of the paralyzed patient dry from head to toe. (HLS 2000, No. 14, p. 12)

You can limit the tincture to only black radish peel and hot capsicum (HLS 2010, No. 14, p. 19)

Rehabilitation after a stroke involves the implementation of rehabilitation measures in a complex - drug therapy, physical therapy, physiotherapeutic procedures, massages and non-traditional methods of influencing nerve cells. Physical therapy (physical therapy) after a stroke occupies a predetermining place in this entire list, since through physical impact on atrophied muscles it can make immobilized limbs, the speech apparatus, visual organs. The condition for the effectiveness of the recovery process is the rational distribution of the load on the muscles and regular performance of the exercises recommended by the attending physician.

The role of exercise therapy in the recovery of the patient

Physical therapy is an integral part of the recovery program after. Its benefits are as follows:

the ability to restore mobility of limb joints and return tense muscles to normal;
prevention of complications such as bedsores on the back, buttocks and feet in bedridden patients;
restoration of sensitivity and mobility of paralyzed limbs;
withdrawal muscle hypertonicity and prevention of the formation of contractures;
elimination of speech disorders by influencing facial and linguistic muscles;
restoration of hand motor skills, writing and drawing skills;
improved vision;
restoration of the functioning of the entire body.

For exercise therapy to be effective after a stroke, physical exercise must be combined with other recovery methods - taking medications, physiotherapy, and measures for social and psychological adaptation.

The post-stroke recovery period begins 3-4 days after the attack with passive gymnastics. Medical personnel or trained relatives perform the exercises instead of the patient, making own efforts to restore sensitivity and strength in the limbs.

Passive exercise therapy begins with a massage, which includes the following manipulations:

stroking movements in a circle;
impact on muscle tissue, starting from the upper back and ending with the legs;
tapping on the back;
impact on the chest muscles - from the chest to the armpits;
massaging the arms from the shoulder joint to the fingers, and the legs from the buttocks to the foot.

Initially, the healthy side of the body is massaged, then the one affected by the stroke.

Passive gymnastics can be performed both in a medical facility and at home. To do this, up to 3 times a day for half an hour, a health worker or person caring for the patient helps to perform the following exercises:

development of the hand - flexion of the fingers followed by extension, rotation of the hand, flexion-extension of the elbow joint, raising and lowering the shoulder;
development of a paralyzed leg - flexion followed by extension of the fingers, circular rotation of the feet, bending the leg at the knee and hip joint;
restoration of motor skills and grasping reflex - a round object is placed in the patient’s affected hand;
development of limbs in a suspended state - with a leg or arm suspended on a towel, rotational and pendulum movements are performed.

Is something bothering you? Illness or life situation?

Active exercise therapy after a stroke, when the patient begins to perform gymnastics on his own, is switched to after the doctor’s recommendation. Initially, the emphasis is on exercises in a supine position, then they include the development of limbs while sitting. If the described exercises are performed confidently, the patient is allowed to engage in physical therapy while standing.

Exercises while lying down

Straightening the affected limb - with force, the limb in the joints is straightened as far as possible (arm - at the elbow and wrist, leg - at the knee) and fixed for half an hour using a splint.
Head turns - slowly turn the head first to the left, then to the right, while fixing the gaze in front of you.
Flexion and extension of the limbs - in a flat position on the back, first bend the arm at the elbow, fix it for a few seconds, then extend it to its original position. A similar exercise is performed with the legs when bending them at the knee joint.
Bending the fingers into a fist - the exercise is performed up to 10 times per approach, alternately with both hands, first with the sick one, then with the healthy one.
Pull-up of the torso - lying on your back, you need to grab the headboard of the bed with both hands and pull yourself towards it, as if on a horizontal bar. In this case, the legs should be straightened as much as possible, and the toes should be extended.
Leg sliding - lying on your back with your legs straight, you need to bend them at the knees and pull them towards you, while your feet should not leave the bed.

Exercises while sitting

Rotate your head to the sides and bend over.
Leg swings - while sitting on a hard surface with your legs extended, you need to slowly lift one limb first, then the other.
Reduction of the shoulder blades - while sitting with your legs straight, you need to inhale and place your hands behind your back, clasp them for a few seconds and then slowly return to the original position as you exhale.
Exercise with a gymnastic stick - sitting on a chair, grasp the sports equipment with both hands and rest it on the floor. Breathing evenly, you need to swing your body different sides while leaning on a stick.
Throwing a tennis ball from one hand to another.

Exercises while standing

Raising your legs - resting your hand on the back of the chair, you need to lift your legs one by one and place them on the chair, and then return to the starting position.
Taking the leg to the side - in the same position, first one leg is moved to the side and fixed for 3-5 seconds, then the other.
Raising your arms - placing your legs at shoulder level, you need to slowly raise your arms up as you inhale, clasp them together above your head, and then lower them down as you exhale.
Torso turns - standing with your arms spread to the sides, you perform torso turns, first in one direction, then in the other.
Tilts - with your hands on your belt and your feet shoulder-width apart, you need to inhale, bend forward, hold for 3-5 seconds and then straighten up with an exhalation.
Squats – standing with a straight back, you need to inhale, stretch your arms in front of you and squat as you exhale. After this, in a sitting position, inhale and after standing up, exhale.
Walking in place - the exercise is performed for 20 seconds, after which a break is required to restore breathing.

For visual disorders caused by cerebral stroke, the patient is prescribed drug treatment And performing exercise therapy. The program is tailored individually for each patient, but there are a number of basic eye exercises suitable for each of them:

“Palm Press.” Cover the eyes with your palms, after which you perform several deep breaths through the nose and exhale through the mouth. Next, use your palms to lightly press first on the upper and then on the lower part of the eye socket. At the initial stage, the exercise is performed 3-5 times, gradually increasing the number to 15 repetitions.
"Closing your eyes." Both eyes close tightly, hold the position for up to 5 seconds, after which they sharply relax the eye muscles.
"Massaging the eyeballs." Closed eyes massage with fingers in a circle through the eyelids, while the pressure should be light.
"Exercise with a pencil." The pencil is placed in front of the eyes, after which they begin to move it in a circle, in different directions, bringing it closer and further away. When performing this exercise, the head should remain motionless.

Mandatory exercises when restoring vision after a stroke are eye movements - left and right, bevel diagonally, up and down, in a circle, bringing the pupils to the bridge of the nose.

Exercise therapy for legs after a stroke

Finger movements - flexion, extension, fingering.
Leg abduction - in a lying position, the leg slides along the surface to the side, while the arms should be located along the body. When performing the exercise while standing, a chair is used instead of a support, and the leg is moved up and to the side with the back straight.
Pulling up your socks – you need to pull your socks towards you as much as possible, resting your heels on hard surface.
Leg bending at the knees - performed in all body positions.
Raising the heels - sitting on a chair, the patient raises the heels, thus emphasizing the force of gravity on the toes. After being in this position for 10-15 seconds, you need to return your legs to their original position and rest your heels on the floor.
Jumping – for a minute you need to jump up.

Articulation and speech

To restore speech and articulation, a patient who has suffered a stroke must perform exercises from the first days after the attack that healthy person may seem too simple:

"Smile". Smile widely, exposing as many teeth as possible, hold in this position for 5-10 seconds, then close your lips.
"Swing". Stick your tongue out of your mouth, lift it up and try to reach the tip of your nose. After this, lower your tongue down, trying to reach your chin.
"Spatula". Stick your tongue out as far as possible, while lowering its tip down. Stay in this position for 7-10 seconds.
"Tube". The lips are rolled into a tube and pulled forward as much as possible.
"Groove". The tongue is stuck out and folded into a groove for 5-10 seconds.
"Nitting." The lips are bitten alternately with the teeth - first the upper jaw, lifting the lower jaw upward, then vice versa.

The exercise therapy program, which restores speech and articulation after a stroke, also includes pronouncing letters of the alphabet, words (from simple to complex) and tongue twisters.

After the patient has come to his senses and his basic vital systems begin to work stably, he needs to perform breathing exercises. Regular training of the respiratory system will strengthen it, normalize lung function and eliminate congestion, as well as reduce hypertonicity of the facial muscles.

Before starting the workout, you need to sit down, lean on a hard surface, put your feet on the floor or stretch them out on the bed, and put your hands on your knees. Exercises are performed from 4 to 8 repetitions depending on the patient’s well-being.

Exercise No. 1.

Hands are spread to the sides. At the entrance through the nose, bend forward, bringing your arms together in the form of hugging yourself by the shoulders. After holding this position for a few seconds, the arms are moved back to their original position, while exhaling through the mouth.

Exercise No. 2.

The palms are located on the thighs in the first third. While inhaling through the nose, the arms are straightened at the elbows, the chest is pulled up. After a few seconds, you exhale through your mouth, your arms relax and your torso leans forward.

Exercise No. 3.

The palms are located on the belt. While inhaling through the nose, the palms slide along the belt and close in front of the body with their backs as tightly as possible to each other, after which they lower down in this position. The chin at this moment should be pressed to the chest. As you exhale through your mouth, your arms are moved behind your back as much as possible, and your head rises up.

When performing breathing exercises, the eyes should be open. If dizziness, shortness of breath or nausea occurs, exercise should be stopped and further actions should be discussed with a doctor.

For the efficiency and speed of restoration of movement functions after a stroke, the following simulators are used:

Walkers are the simplest exercise equipment used to restore walking function.
An exercise bike is necessary to restore the functions of movement of the lower extremities, strengthen the cardiovascular system and improve the health of the body as a whole.
The “Bud” simulator is used to develop the hand, restore the grasping reflex, and the “clench-unclench” function.
The “Shagonog” exercise machine helps strengthen the muscle tissue of the legs in bedridden patients.
Verticalizer – helps restore the functioning of the vestibular apparatus, giving a vertical position to the body.
Robotic simulators are machines programmed to carry out commands from the brain with parts of the body.
Step platform – helps restore the function of walking up stairs and strengthens the calf muscles.

Before using any exercise equipment, you should consult your doctor. Only a specialist can recommend an effective model and degree of load on the body, taking into account the nature of motor dysfunction.

Contraindications to exercise therapy classes

Despite the effectiveness application of exercise therapy V recovery period after a stroke, there are a number of pathological conditions in which exercise is contraindicated:

If there is a history of the described diseases, the attending physician draws up individual program, selecting gentle exercises to restore motor functions. In case of acute conditions (for example, high temperature or hypertensive crisis), it is necessary to wait until your state of health returns to normal and only then begin physical therapy.

Stroke is a serious disease associated with impaired blood circulation in the vessels of the brain. Motor and speech skills are often impaired after a stroke.

One of the conditions for a person’s return to normal life is to perform physical exercises during the rehabilitation period.

A set of exercises for stroke was developed taking into account recovery periods. The intensity of training increases gradually, this has a beneficial effect on the restoration of brain function.

What does success depend on?

The duration and effectiveness of the recovery period largely depends on the patient, his positive attitude, dedication and patience. It is also important to understand the nature of the disease and the focus of treatment methods. Sometimes the patient and those around him do not fully understand the purpose of exercise therapy after a stroke and perceive therapeutic exercises as a procedure that strengthens muscle strength. This is mistake. The main goal is to restore the brain's ability to control human movements. In the initial recovery period, there is no need to pump up muscles. Also great importance have the following factors:

Restorative passive movements

In the first days after a stroke in a hospital setting, the treating staff performs passive gymnastics. In this case, the movements are performed instead of the patient so that he does not make any effort.

If possible carrying out exercise therapy no, in the hospital, one of the patient’s relatives, after consultation with a doctor, can carry out the complex at home. When selecting exercises, the doctor takes into account the patient’s condition, which parts of the brain were damaged, and which functions were impaired.

Physical therapy of the hands is carried out, starting with flexion and extension of the fingers of the paralyzed limb, and then moving on to the healthy one. The next movement is to rotate the hand in both directions. Then they bend and straighten their arms at the elbow joints, and at the end they develop the shoulder joints - bend and straighten them down and up, left and right, and make a turn.

Therapeutic exercise of the lower extremities also begins with flexion and extension of the fingers, then rotation of the feet. After this, the legs are bent and unbent at the knees, and finally, flexion movements are made in the hip joints.

Revitalizing active movements

Active physical therapy exercises after a stroke are first done while lying down, then those performed while sitting are added, and only after that include standing exercises. TO active exercises switch after consultation with a doctor. The intensity and frequency of exercises are increased gradually, based on the doctor’s advice and the patient’s well-being.

When a patient performs a set of exercise therapy exercises, it is advisable to have a second person present to prevent injury. dangerous situations. The patient is supported until he begins to behave confidently.

When moving to individual types active movements needs to be assessed general health the patient, and also focus on increasing the mobility of the paralyzed limb. As soon as, for example, a finger that was previously motionless begins to move, they try to make active movements with it. That is, at a certain stage, both passive and active gymnastics. When the doctor allows the transition to active exercises, the patient will independently perform passive exercises on the paralyzed limb with his healthy hand, and then active exercises on the healthy limbs. The number of movements begins with 3-5 times, gradually increasing. The exercises are done slowly, with restraint and diligence.

All exercises are aimed at restoring the mobility of paralyzed limbs: from 1 to 5 - for the arms, from 6 to 19 - for the legs. These exercises do not require significant physical effort, but provide an excellent start to returning to a normal lifestyle. Hand exercises can be done lying down, sitting and standing. This depends on the patient’s well-being and the extent to which the body’s strength has already been restored.

If you can’t immediately perform an exercise correctly, you need to do it as best you can. Over time, success will definitely come. For some, recovery occurs quickly, for others it is slower. There is no need to compare your successes with the achievements of other patients. Even small progress is an important step towards recovery. After you have mastered all the exercises from this complex, you can, with the permission of a physical therapy doctor, add to it various bends and turns of the head and torso, squats and other movements.

Physical therapy and exercises after a stroke

It's safe to say that main role Exercise therapy plays a role in the recovery of patients who have suffered acute cerebrovascular accident after a stroke. There is a physiological explanation for this, which is based on the peculiarities of the functioning of the nervous system.

Principles of exercise therapy in neurological patients

The brain is a collection of neurons that are connected through numerous connections to the entire body. Each group of nerve cells is responsible for regulating a specific function of organs and systems. For example, the motor area ensures a person’s ability to make voluntary movements, the brain’s center of vision and hearing ensures the correct perception and analysis of visual and auditory stimulation.

During a stroke, nerve cells die in the area of cerebral infarction or hemorrhage. Depending on which functions are controlled in this place, various neurological manifestations arise: paralysis, speech disorders, movement coordination.

The return of lost functions after a stroke occurs in 3 ways:

restoration of those structures of nervous tissue that have reversible damage, that is, they have not died, but are in a depressed state;
restoration of completely dead elements by replacing them with new ones;
transfer of responsibilities of dead neurons to neighboring nerve cells.

Exercise therapy for stroke helps speed up all these mechanisms and reduce the time to return lost functions.

Restoration of nerve tissue structures with reversible damage

These mainly include the restoration of the conductivity of nerve fibers of cells that did not die, but fell into deep biochemical stress. Physical exercise after a stroke, which the patient performs himself or with the help of an instructor, create a powerful flow of nerve impulses coming from the muscles to the brain. Due to this, oppressed nerve cells are awakened, and new pathways for transmitting excitation to the central nervous system are formed. nervous system. In this way, the foundations are laid for complete control of the brain over the functions of the body: the return of lost voluntary movements and speech.

Restoring dead elements to new ones

Here it is necessary to clarify that we are not talking about dead nerve cells located directly in the area of hemorrhage or cerebral infarction and not subject to restoration, but about the growth of processes of neurons that remained alive after an attack of the disease. Due to the formation of numerous new nerve fibers, the number of contacts between nerve cells and the organs controlled by them increases. All this helps to restore lost functions even with a small number of surviving neurons.

Gymnastics after a stroke increases blood flow to moving muscles, which means it increases nutrition and oxygen availability. All this leads to increased growth of new nerve fibers. Constant stimulation of the brain with nerve impulses that arise in the muscle during movement leads to an increase in the contacts of neurons with each other, which also has a good effect on the control of organs.

Transfer of responsibilities of dead neurons to neighboring nerve cells

As you know, “nerve cells do not recover,” so the focus of a stroke later turns into a scar. However, nature has built into the body an amazing function of transferring the responsibilities of dead cells to neighboring elements. In the brain after undergoing acute disorder In the blood circulation, the functions of destroyed nerve cells begin to be performed by their healthy neighbors. The transfer of authority occurs solely under the stimulating effect of nerve impulses. This is exactly what it is aimed at physiotherapy after a stroke, because muscle movements are a powerful source of nervous excitement transmitted to the brain.

Exercise therapy depending on the stage of stroke

The main goals of exercise therapy in patients with stroke are:

restoration of voluntary movements;
preventing the formation of adhesions in the joint area;
decreased muscle tone on the paralyzed side;
strengthening the body.

Depending on how much time has passed since the first signs of a stroke, the following periods of illness are distinguished:

acute (first 72 hours);
acute (up to 28 days);
early recovery (from 28 days to 6 months);
late recovery (from 6 months to 2 years);
period of residual effects (more than 2 years).

Each of these periods corresponds to a separate set of exercise therapy exercises.

The most acute and acute period

Rehabilitation exercises after a stroke are indispensable already in the first days of the patient’s stay in the intensive care unit. A physical therapy instructor or a trained relative conducts sets of exercises aimed at preventing respiratory complications and preventing the formation of contractures in the joints on the injured side.

For these purposes, breathing exercises, positional treatment and passive movements are used.

Breathing exercises

Recovery activities correct breathing begin on the 2-3rd day of treatment in the ICU. Breathing exercises after a stroke consist of a patient-controlled change in the pace and depth of inhalation and exhalation, following the commands of the exercise therapy instructor. This can be rhythmic breathing while counting, exercises to voluntarily reduce the frequency of respiratory movements; changing the type of breathing, for example, from thoracic to abdominal and vice versa.

Treatment by position

It is necessary to prevent the occurrence of contractures (stiffness) of the joints. Flaccid paralysis, observed in patients in the first 2 weeks after a stroke, gradually gives way to spastic paralysis. Due to increased tone, irreversible changes occur in the joints on the affected side, which lead to limitation of movements in them. To combat this complication, a physical therapy method such as positional treatment is used.

It is as follows: the diseased limb is placed in such a way that it is maximally extended and is in a position opposite to the action of the spasmed muscles. For example, on the hand increased tone after a stroke, it is most often observed in the muscles that adduct the shoulder and rotate the palm inward, flexing the fingers. Therefore, the treatment position in this case will be the following: the sore arm is straightened, moved to the side by 30-40⁰ (gradually increased to 90⁰), lies on a chair placed next to the bed; the palm is open, the fingers are straightened (to fix this position, use a bag of sand placed on the palm); the thumb is in a grip position (as if there is a small ball in the palm that he is holding).

Positioning treatment is carried out every 1.5-2 hours, and it is maintained until discomfort or pain occurs in healthy muscles.

Passive gymnastics

It is performed only after a positional treatment session when muscle tone weakens. Classes begin with a healthy limb, in which active movements are carried out (the patient himself performs the exercises), covering all types of movements in a particular joint (flexion-extension, abduction-adduction, rotation). Then they move to the sore side, the movements in the joints of which are performed by a physical therapy instructor. Passive exercises against stroke begin to be performed from the distal parts of the limbs (from the joints of the fingers), gradually moving upward.

However, despite its apparent simplicity, the movements must be performed according to certain rules, otherwise they can cause harm. An excellent illustration of the main methodological approaches of this section of exercise therapy is the video of passive gymnastics after a stroke:

An approximate set of exercise therapy exercises for stroke for bedridden patients

The total duration of the complex is 25-30 minutes. During the lesson, it is necessary to take breaks for 1-2 minutes, focusing on the patient’s well-being. The gymnastics should be completed by correctly positioning the paralyzed limb (position treatment).

Massage for stroke can be prescribed 2 weeks after the onset of the disease. It includes the simplest classical techniques: light stroking on the affected side and moderate rubbing and kneading on healthy muscles.

Early recovery period

Exercises for recovery after a stroke during this period, along with passive ones, include active movements of the affected limb. Even the slightest ability of muscles to voluntarily contract must be used to restore lost motor functions. Active muscle contraction training must be included in the daily routine. exercise therapy complex.

A exercise therapy complex using active movements, which includes exercises for the arm after a stroke, looks something like this:

The patient’s ability to maintain balance when sitting independently is a sign that it is necessary to diversify the exercises performed. The exercise therapy complex includes movements in the lower back and neck: bending, turning.

Preparation for walking begins with imitation of walking movements while lying on your back.

Late recovery period

A feature of exercise therapy during this period is the addition of exercises to overcome resistance to the complex of daily gymnastics. The effect of training directly depends on correct technique. To make it easier to understand exactly how to perform the movements, you can view an approximate complex physical therapy exercises after a stroke video:

Massage after a stroke plays a huge role in the formation of normal muscle tension and accelerating the process of returning motor functions. It should be carried out several times a year for 10-20 sessions.

The famous expression “nerve cells do not regenerate” is unfortunately true. However, even after losing a significant number of neurons in the stroke area, it is possible to achieve good recovery voluntary movements with the help of physical therapy.

Unfortunately, strokes in our country are being diagnosed more and more often and they affect not only older people, but also relatively young people. About 80% of all diagnosed strokes are ischemic strokes, which are a little easier and rehabilitation after them is faster.

It is possible to return a person to the normal functioning of the body thanks to exercise therapy, which is very effective, according to doctors. The most famous is the treatment program according to the method of Dr. Bubnovsky, which is actively used in practice.

The doctor independently developed a theory according to which it is possible to completely restore a person’s motor function by performing a set of exercises by Dr. Bubnovsky.

To speed up the process, you can also use special Bubnovsky simulators, which have passed all the necessary tests and meet all medical requirements. They can be used not only in specialized centers, but also at home.

Preparing for classes after an attack

Physical exercise is of great benefit to a paralyzed person, since any physical activity accelerates the blood, prevents stagnation in the body, restores muscle memory. However, you should not hope that just doing a set of exercises will help the patient fully recover.

Drug treatment prescribed by the attending physician must also be present. Exercises and medications together will give the expected result.

At first, the attending physician will help care for the patient and help him do certain exercises. But after discharge, all these worries fall entirely on the shoulders of relatives and friends. Therefore, they need to thoroughly know the basic principles of caring for a patient after a stroke during rehabilitation:

Rehabilitation after a stroke can be very slow, but at this time the most important thing is attention to the patient, patience, and constant training at home, which lasts at least 3 hours a day with breaks, and therapeutic exercises.

Remember, the set of exercises that will be discussed below is of a general nature; each case of stroke must be approached individually.

Before starting a set of therapeutic exercises, you must consult a doctor, get his recommendations, and listen to his advice. It will also help you calculate the intensity of your workouts and training time at home.

Massages and passive stress on the body after a stroke

Before you begin exercise therapy at home, you need to undergo a course of massages that will prepare the body for rehabilitation, relieve increased muscle tone, and relax them.

After you have warmed up the body, you can proceed directly to the healing passive massage at home. Here are some basic manipulations that relatives with paralyzed limbs of a patient can carry out:

Do not forget also about the systematicity of exercise therapy. Gymnastics must be carried out daily, at first 2 times, and after 2 weeks - 3 times a day, for at least 40 minutes.

Exercises after a stroke in a sitting position

The next stage of rehabilitation is performing a complex of physical training while sitting. It should be switched to when the patient himself was able to assume a sitting position. You can do the following exercises:

As soon as the patient's condition has improved, you can move on to trying to get out of bed using the backrest or tightened straps. It is also recommended to raise the limbs 3-4 times and bring the shoulder blades together. But all these exercises should be performed only under the supervision of relatives.

A set of physical therapy exercises in a standing position

After the patient was able to get out of bed independently, you can begin gymnastics for rehabilitation in a standing position. Let's consider basic gymnastics after a stroke:

It is very important to know what exercises to do after a stroke at home. A stroke is a disorder of cerebral circulation. A stroke occurs when there is bleeding in the brain or when blood vessels in the brain become blocked.

Treating a stroke is a long and complex process. During a stroke, the patient experiences paralysis of the limbs, that is, the person simply cannot move. You can restore limb function with exercises after a stroke at home. Physical therapy should be prescribed by a doctor. The doctor is developing a whole system effective treatment. But the exercises can be done at home. If a person is completely immobile, then training should be carried out by other people. Complex for immobile people:

Bend the arm at the elbow.
Rotation of the brush.
Bend the leg at the knee.
Clenching a fist.
Work with the feet (rotation, straightening, stretching, massage).
Finger gymnastics. It stimulates further restoration of motor functions.

An important factor in recovery is regularity of exercise. Gymnastics must be done at least 3 times a day. The patient also needs fresh air: every day the patient is recommended to organize walks, and the room should be regularly ventilated.

A seriously ill patient spends virtually all his time in bed. Make sure he is comfortable. The mattress should be hard and even. Make sure that bedsores do not form.

Preparing for physical education

Before starting classes, you need to warm up. Heat reduces muscle stiffness and lowers the pain threshold. You can take a bath or warm shower. A popular and effective way to warm up is a heating pad.

Passive gymnastics

From the first weeks after a stroke, you can already start exercising. For the first 2 weeks, patients comply with strict bed rest. Gymnastics begins with simple passive recovery exercises, gradually increasing the load. Relatives and doctors should help the patient carry out this complex. Passive exercises are performed while lying down. Here are some of them:

You need to hang a towel over the bed, then put your hand on it. Periodically, the arm needs to be bent and unbent. Also, the motionless arm should be moved to the side for 30 minutes with short breaks.
Alternate leg bending. This will help restore the functions of the lower extremities.
Exercise with a rubber ring (you can do it yourself). The ring is worn on both feet. Then move the elastic band. A useful activity There will be alternate lifting of the legs.
Unbend the bent upper limb from the fingers and attach it to a hard board. So the hand needs to be fixed for half an hour or even longer.
Exercise for the leg muscles. We place a cushion under the knees and increase the thickness of the cushion over time.
Eye gymnastics. Move your eyes around and to the sides. Repeat 10 times with closed and open eyelids.
Another eye workout: squeeze and unclench your eyelids tightly.

Active therapeutic exercises

When the patient feels better and has the first muscle reactions, then you can begin an active set of exercises. Therapeutic exercise should be accompanied by special procedures and massage. The first active type exercises can also be done in a lying position. Over time, the patient moves into a sitting position.

Initial active physical therapy:

Rotation, head turns, gaze fixation.
Eye training: eye movements, squinting.
Grab the headboard of the bed with your hands and try to pull yourself up.
Turn the torso to the sides.
Raising the pelvis (heels rest on the bed)
Train your fingers: drum on the table, do the splits, open and clench your fists.

Seated exercises are performed to restore arm movement, prepare the lower extremities for walking, and strengthen the back. Seated exercises:

Take a sitting position in bed, lean back on the pillow. Grab the edges of the bed with your hands and straighten your legs. Next, bend over a little, turn your head and inhale. Then lower your torso to the starting position and exhale. Do the exercise slowly. Repeat 5 - 7 times.
While in bed, slowly raise your legs one at a time (3 to 5 times each). Soon you can complicate the exercise: clap under your foot.
Place a pillow under your back. Bend your leg, pull it towards your chest and clasp your knee with your hands. In this position, hold your breath for a few seconds and exhale slowly.
Take your arms back. Try to bring your shoulder blades closer to each other. Tilt your head back. Accompany physical exercise with proper breathing.

After completing a set of exercises while lying down and sitting, you can begin active physical education while standing:

Place a small box on the table. Pick up the item and put it back. Then complicate the task and put the box on the floor. Repeat the steps.
Stand up straight and lower your arms along your body. Raise your arms up and try to pull yourself up.
Turn to the right and left, keeping your hands on your waist.
Tilt your body forward and backward.
Squat. First, a little at a time, gradually increasing the depth of the squat.
Fold your hands into a fist and move them away from your body.
Do the scissors exercise with your hands.
Swing your leg, you can supplement it with clapping under your thigh during the swing.
Walking in place.

Walking occupies a special place in the complex of physical therapy. First, you can try to lift yourself up using a rope tied to the bed. You can sit for 2 - 3 minutes. Next, try lowering your legs out of bed. Then roll the roller and massage your limbs regularly. Take your first steps around the apartment holding onto the wall, then walk with the help of a stick. After each such hike, your limbs will ache. But you need to overcome the pain in order to restore motor functions in the future.

Physical education should be done several times every day. Practice slowly and be sure to monitor your breathing. Training should become a habit and become an integral part of life.

Do breathing exercises. To do this, sit in a chair or lie on your back. Close your nostrils one at a time. Inhale through one nostril and exhale through the other. Breathe long while you have the strength. This is the essence of such physical education. Very soon you will feel warmth and a slight tingling in your chest. This means that gymnastics works. In a month, the abs will become more elastic.

There is such a type of class as Kalmyk yoga. This complex is aimed at combating cerebral circulation disorders. It is carried out at home not only after a stroke, but also during diabetes mellitus and increased blood pressure. You need to exercise every day.

Usually a yoga course lasts 2 - 3 years. The basics of Kalmyk yoga consist of squatting while holding your breath and bending your torso parallel to the floor. Do 30 - 50 squats several times a day.

"Mental" gymnastics

It is important to carry out not only physical activities, but also mental. “Mental” training helps restore central nervous regulation. Even completely bedridden patients can exercise in the first days after a stroke. Everything is very easy. You need to do physical exercises mentally. Thus, the nervous regulation that controls motor activity is influenced.