What do they do if they do not walk well after a stroke, how to restore their skills?
Stroke is an acute disorder of the cerebral circulation. It provokes two situations that have their own characteristics. For ischemic stroke is characterized by blockage of the artery with a cholesteric plaque or thrombus, hemorrhagic differs when the vessel breaks. In any of the cases, the patient is dying of his tissues due to a lack of nutrition of the brain.
A person loses the ability to perform familiar actions - can not speak, move, see and hear badly. The stroke that occurred changes the habitual life of the patient and his loved ones. They require maximum efforts, a desire to restore lost health. If you do not walk well after a stroke, what should you do? Medical specialists have considerable experience in rehabilitation after a stroke, give recommendations for restoring the walking skill.
- When to begin rehabilitation, its stages
- What does passive gymnastics involve?
- The patient and active exercises
- How to move to the sitting position
- How to master the standing position
- What adaptations the patient can use in teaching walking
- Can I learn to walk after a stroke: teaching primary walking skills
- Auxiliary exercises to achieve results
When to begin rehabilitation, its stages
After a stroke, in most cases, the patient is completely or partially paralyzed. Its degree depends on the extent of brain damage that occurred during a vascular accident. In order for walking skills to return, it is required to begin rehabilitation actions quickly, immediately after the period treatment aimed at removing symptoms of a dangerous condition and primary normalization of health patient. The permission to carry out any manipulations with the patient is given by the doctor, all the lessons are under his control.
How can a patient learn to walk after a stroke? To achieve results, a step-by-step compliance with the rehabilitation action plan is required:
- control over the correct position of the patient lying down - the event is usually called passive gymnastics;
- the ability to sit correctly - it is required to teach the patient to take such a position of the body with external help with a gradual transition to an independent change in the posture;
- the development of the skill to get out of bed with outside help, then - without it;
- holding the body in a standing position, with help and independently;
- training for walking, for this purpose auxiliary support items are used - walkers, crutches, walking stick;
- independent walking.
What does passive gymnastics involve?
Passive gymnastics after a stroke assumes control over the posture of the patient, which takes his body during the period when it is immobilized. To avoid squeezing of tissues, uneven load on the vessels and improper blood circulation in them, it is required to change the position of the body every 2-3 hours. Thus it is important to pay attention that the extremities which are in the party of paralysis, did not sag and did not swell. To prevent these complications, the patient is placed symmetrically on the back - the immobilized side should lie just like a healthy one.
The patient is allowed to turn on his side. It is convenient to fix the patient's desired position with improvised objects - additional pillows, blankets rolled in a roller. It is important to correctly place the hands and feet of the patient - they should be parallel to the limbs of the other side of the body. Any changes in the posture should not be sharp, smooth and careful movement of the patient's body is required.
Such passive-type gymnastics begin early, often the doctor recommends a regular change in the position of the patient's body, his limbs, in the first days of treatment after a stroke. To assess the patient's condition and resolve the motor manipulation with it helps the instructor in physiotherapy exercises, which teaches relatives to correctly perform passive exercises:
- work with stops - flexion, extension, rotational movements;
- flexion and extension of the legs in the knee joint;
- achieving mobility of the hip joint - up and down, to the side.
The main result of actions on the passive stage of rehabilitation is the normalization of blood circulation in problem areas, prevention of the development of stagnant processes in the patient's lungs.
The patient and active exercises
If the brain changes that occurred during a stroke did not affect the patient's consciousness, it is important to explain that he should not only try to perform exercises with a problematic limb, but also send mental impulses with the urge to force it move. This psychological device becomes an important tool in the recovery. It can be used as follows - the patient performs the exercise with a healthy foot, while thinking how it is performed by another, immobilized, limb. In some cases, the desired effect occurs, the muscle tone begins to be felt in the problem area.
If the patient has progress after performing passive movements, and the exercises can be performed independently, a transition to active physical activities is recommended. The complex of exercises and the degree of exercise helps to choose a doctor. Movements should be smooth, slow, each exercise is first performed by a healthy foot:
- shifting the lower extremities through each other;
- alternating extension and flexion in the knees;
- lifting and keeping the legs (alternate and simultaneous);
- withdrawal of limbs to the sides;
- lifting of the pelvis;
- exercise "bicycle
- the body turns to the side.
It is important to take into account that the patient should not overwork, for everyone the maximum and minimum load is selected. All movements must be carried out correctly..
How to move to the sitting position
An important stage of rehabilitation after a stroke is the possibility of self-moving the body in a sitting position, keeping it in this state for a certain time. In order to achieve this result, you need to teach the patient to turn over in bed. To do this, from the supine position, he must move the bent knees to the desired side, then move the body with the hands.
The next stage of rehabilitation is the training of sitting habits on the bed - with outside help the patient gently releases his feet on the floor, rests on them. Then, a gradual transfer of its body vertically..
With such movements it is important to take into account a person's condition, if he has dizziness or signs of an increase in blood pressure, the action should be stopped..
Then the patient is asked to perform the exercise on his own - after lowering the legs he must rest his hands and lift the body. Secures the success achieved by fixing the pose. It is required to arrange legs, to rest them on the floor, slightly to tilt the body forward, while holding hands on the edge of the bed. When the patient begins to feel comfortable, he can sit confidently and for a long time, the doctors offer to master the next stage in restoring the walking skills - getting up.
How to master the standing position
When can I get up after a stroke? The answer to this question should be known to the patient and his relatives. An unsuccessful attempt to get up - a fall, can not only cause pain, but also become a psychological reason for refusing to take further measures to recover lost motor skills. In each case, the possibility of transition to this stage of rehabilitation is determined by the doctor.
To get up the patient should be prepared. Good results are achieved by the exercise - movement in a sitting position along the edge of the bed. The patient performs a gradual rearrangement of the feet, focuses on the hands and moves the body toward the movement. The result of such regular manipulation is the strengthening of the muscles of the limbs, back, balance of the body.
The condition necessary for the first attempts to get up is complete safety of the patient. It is provided with the help of relatives or health workers. The patient should pick up and hold on falling, provide stability or support. The implementation of this action is always accompanied by recommendations, detailed instructions and control of the physician.
Learn to walk after a stroke is possible when doing exercises in an upright position with or without a stop. The patient will prepare his legs for walking as much as possible if he does the following:
- "Shift" feet on the spot, the exercise is performed first without detaching the feet from the floor, then try to lift them;
- perform alternate retraction of the legs;
- to move the weight of the body from the heel to the toe and back.
What adaptations the patient can use in teaching walking
To a person after a previous vascular stroke could comfortably learn lost skills, including at home, there are devices designed for walking after a stroke. These are walkers, crutches, walking sticks and orthosis, the purpose of which is to fix the patient's knee joint in the desired position. Much attention in clinics and rehabilitation institutions is given to the equipment of wards in the hospital, corridors, public places. For maximum convenience of the patient, they are supplied with handrails, the floor covering is selected non-slip, without protruding surfaces.
Very helpful when moving the walker after a stroke. Which is better to choose, the doctor advises. The device for adults can be of several types:
- standard - in the process of moving make a step, then rearrange the device;
- walking - easy for elderly patients to use, they are moved from side to side in turn depending on step, such a device allows you to find a stable support, do not put extra effort into exposing devices;
- walkers with wheels are used when the patient has achieved good coordination of movements, often used for long walks in the street.
Patients who have suffered a stroke, doctors offer to choose a universal walker. They combine the characteristics of standard and walking species, they can switch depending on the dynamics of rehabilitation changes..
Can I learn to walk after a stroke: teaching primary walking skills
After the patient began to confidently get out of bed and stand on their feet, they move on to the next stage - teaching walking skills. At first, an assistant is needed, later the walkers of the recommended kind are used.
After the person has got out of bed, the insuring companion approaches from that party which is subject to paralysis. His actions consist not only in the insurance against falling, but also in controlling the movements necessary to develop the correct gait. Then the assistant goes to the side of the healthy leg and stays there to support the patient.
The physician on exercise therapy should evaluate the acquired skills, correct the patient's movements. The goal is to achieve mobility of the leg in all joints, its sufficient lifting in the step. To achieve results faster and without injury, the patient should fix the ankle joint (use a special shoe), the hand from the problem side is recommended to tie a kerchief. It is necessary that the hand does not sag and does not interfere with the movements.
Learn to walk anew every patient can have different times. It depends on many causes - the severity of paralysis of the limbs, the presence of convulsions, muscle spasms or their hypotrophy..
The development of diseases affecting the condition of the joints can significantly increase the time of rehabilitation of the patient..
To achieve a quick and qualitative result, the patient needs to regularly use an additional set of exercises. Experts advise to perform specific activities on the floor:
- Overcoming a given distance by rolling the body (from side to side along the axis);
- movements on all fours forward and back;
- crawling (in a plastic way).
Auxiliary exercises to achieve results
Immediate training of the patient walking, the implementation of the recommended set of therapeutic exercises should be accompanied by other restorative procedures and activities.
In rehabilitation centers special equipment is provided - simulators designed to take into account the characteristics of patients with stroke. The doctor recommends exercises on walking simulators. They are adapted, can be configured in synchronization mode of the leg movements and healthy, choosing the optimal load on the paralyzed limb. Another popular device is an exercise bike. Its use allows you to load not only on your feet, but also helps to strengthen the muscles of the hands, back, which is also important in the rehabilitation of the patient.
Great importance is given to water procedures. The recovery program can contain group and individual sessions with a coach in the pool. Patients are encouraged to develop motor activity of muscles in swimming, aqua aerobics. It should be remembered that visiting a sauna or steam room after a stroke is prohibited because of the risk of complications.
Recovery after a stroke will be more successful if in the physical and psychological rehabilitation of the patient is involved, he and his family and doctors.
On how to conduct rehabilitation of patients after a stroke, you can learn from the video:
You can learn about the mistakes made during the exercises from the following video:.. .