According to the World Stroke Association, around 13 million people globally will experience a stroke. Of these, approximately 5 million will face life-changing disabilities. A stroke can affect people at any age.
During rehabilitation, your therapy package may include physiotherapy and speech and language therapy. At some point, however, that care will end. For many, it ends before they can explore what the right environment, exercises and coach could help them achieve. The residual effects of a stroke may last weeks, years or indefinitely.
A stroke is like a tattoo on the brain. Even if you remove it, the scar remains. The survivor has to adapt to a different way of life.
As a personal trainer, I have helped many clients who have experienced strokes of varying severity. I have also worked with people with other types of brain injury. In my experience, exercise and fitness can dramatically improve physical ability. They can also bring mental, social and emotional benefits.
So, which key areas do I believe we can work on to support a stroke survivor’s progress over time?
Fatigue
Fatigue is one of the biggest challenges my clients face. It varies between individuals, and their surroundings can also affect it.
Someone may want to keep going after a stroke, but their body may struggle to keep up. Concentrating takes effort and can tire the brain. So can the determination to do things as they did before.
One of the best approaches is to move and exercise in small, manageable chunks. Sometimes, this means just a few minutes at a time. Allow plenty of rest so the body and mind can recover. Schedule exercise early in the day, before tiredness sets in.
Speech
Talking requires considerable effort from the brain and can cause fatigue. The effects of a stroke on speech vary from person to person.
One simple technique is to introduce a regular reading schedule. Start with 5–10 minutes and gradually increase the time. Initially, choose books with larger fonts and wider line spacing to avoid eye strain.
Conversation can also help improve speech. Keep questions simple and allow plenty of time for the person to respond.
Another game I enjoy uses a pack of cards. I turn over one card at a time and ask the person to read it aloud. Their brain may want to respond immediately, but putting that response into words may take longer.
The key here is repetition, repetition and repetition.
Physical
In my opinion, physical rehabilitation is one of the most significant areas to work on. It can also be a slow process. Be patient and try not to let frustration take over.
The main areas to focus on may include balance, posture and strength. Everyday tasks, such as walking and standing up, can become challenging.
Basic movements can help a lot. These include sitting upright, standing up from a chair and performing standing knee raises.
When walking, take your time. Keep your head and back straight. Focus on lifting your feet and knees rather than shuffling across the floor.
Walking aids can help. Where appropriate, I work towards reducing reliance on them so the person can develop confidence in their balance.
Strength work should involve the whole body. Alongside leg exercises, equipment such as light dumbbells and stability balls offers plenty of ways to strengthen the upper body.
This strength can help with walking and everyday tasks that require you to support your body weight. Examples include getting in and out of bed, climbing stairs and getting out of a car.
Core strength matters, too. As the saying goes, a strong core gives you a strong body. This is particularly relevant when working on balance and posture after a stroke.
Once the person feels confident, I introduce floor exercises. These may include sit-ups and planks with their knees on the floor. As strength improves, we increase the time or repetitions.
The lasting effects of a stroke will influence each person’s physical abilities and progress. Confidence and self-belief also play an essential role. Building these is a vital part of my coaching.
Never say never. Stay consistently positive, try new things and build a strong relationship with your coach.
Neurological
Exercising the brain is invaluable. Activities might include memory games on a tablet, jigsaw puzzles or light reaction games, such as those from Blazepod.com or ReactiveX.io.
These activities can help improve brain fitness, hand–eye coordination and fine motor skills. Above all, they offer an opportunity to have fun!