1. Physiotherapy

2. Exercise

 Part 1 - Physiotherapy

After a stroke you are likely to need help to regain old abilities or cope with remaining disabilities.  This process is known as rehabilitation – and physiotherapy is one of its main tools.

Physiotherapy uses specific exercises, techniques and massage to keep muscles and joints in working order.  If your stroke has caused problems with your movement, balance or coordination, you will usually be prescribed physiotherapy.  The aim is to help regain as much movement as possible and cope with any remaining difficulties, such as walking, moving an affected arm and hand, learning to use both sides of your body again, or managing any pain or stiffness in the joints.

In Spain rehabilitation arranged by the National Health is very good.  Before leaving hospital it is best to check arrangements with the Hospital rehabilitation section and notify your GP.  Where needed ambulance transport is arranged and as each area varies a little in how this is organised so it is best to make enquiries as above.

Rehabilitation usually starts as soon as the recoverer is medically stable.  The therapist will work with the recoverer in the rehabilitation area or special physiotherapy gym accessing in more detail physical problems and will take into account physical fitness before stroke.  Goals will be set to build up muscles and confidence.   With consent the therapist will encourage a family member or main carer to become involved and provide simple instructions so exercises may be practiced between sessions.

Recovery tends to be most rapid in the first weeks after stroke, but it can continue for months or even years.  When treatment no longer produces any marked improvement it will usually end for the time being and reassessed again after a six month period. In the meantime the recoverer may be able to continue improving by continuing to practice the exercises learned.  If at any time problems arise you can ask your GP to refer you back to the rehabilitation Doctor for reassessment.     

You may wish to consult a private physiotherapist, for instance if you feel this could benefit after National Health prescribed course ends or you wish to supplement National Health treatment (let each know your plan both as a courtesy and to ensure continuity of goals).  Check a private therapist for previous experience of stroke rehabilitation and qualifications.

(Taken from Stroke Association in the UK Paper – Oct 2006)

At TSSG meetings we have a Physiotherapist and a Personal Trainer who attend 3 times a month for individual advice and exercise recommendations.

 Part 2 - Exercise

Exercise is important for all of us.  It is recommended that adults should aim for at least 30 minutes of moderate physical activity on 5 or more days a week.  Research shows that regular physical activity helps:

• Reduce the risk of stroke and heart disease
• Increase muscle strength and flexibility
• Reduce the risk of falls
• Reduce the risk of developing Type 11 diabetes
• Reduce and help control blood pressure
• Reduce stress and anxiety
• Improve balance and coordination
• Enhance quality of sleep                           

For stroke survivors, exercise has the additional benefits of helping with recovery and in preventing further strokes. (Taken from British Heart Foundation/UK Stroke Assoc.)

Walking as well and as much as possible is the ultimate aim of recoverers.  Exercise can be taken at any time of the day, but is best when fresh; and in relatively airy and spacious conditions.  Avoid directly after a meal.  A good time may be in the morning when still lying on the bed, remembering some of the early exercises in rehabilitation, for example:

• Bend knees and lift up and down one after the other – repeat 20 times
• Lift one knee up and down 20 times then repeat with the other knee – 20 times each
• With straight legs lift up and down one after the other – repeat 20 times
• Lift one leg up and down then repeat with other leg – repeat 20 times each
• Bend knees and gently turn them side to side, keeping the upper body flat – 20 times
• Point and flex toes and heels - repeat 10 times
• Lift arms up and down – with clasped hands for support where necessary – 20 times
• Lift arms up and down as above – then bent elbows and over head – 20 times
• Holding hands clasped, move arms from side to side as far as you can, trying to keep them straight as possible – 20 times
• Using both arms and legs - lift arms (hands clasped) and rise right knee, touch and return to place.   Then repeat using left knee – repeat 20 times
• Bend knees and firmly plant feet flat on the bed, hands and arms lying flat at the sides on the bed,  and raise up bottom and thighs – repeat 10 times, rest and repeat.
• Touch each finger to thumb on both hands – repeat 10 times

These basic exercises can be repeated more times as you grow stronger.  

At SAS once a month we enjoy other group exercises sitting in firm chairs and sometimes to music which can then be practiced at home. L. Killeen.  August, 2012.

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