Your Stroke / Brain Injury Recovery Starts Here


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Even you have hired the help of a trainer or a therapist to get you started (advised), you must have input towards your own rehabilitation and the way you want to go. Knowledge is power. My aim is to show you exactly how to achieve 6 things:

  1. Correct balance, co-ordination and posture over time
  2. Increase muscular, tendon and ligament strength and fitness over time
  3. Decrease spasticity and increase specific functional movement return over time
  4. Increase confidence and remove fear of the consequences of exercising
  5. Become progressively more self-sufficient
  6. Become productive in an occupation and be happy with life

Can you take up the challenge? These can all be achieved by you to a certain degree, however old you are, if you want them badly enough and are prepared to sacrifice some time and effort. Can a generic programme be created? For example, is there one ‘programme’ that will fit everyone? It would be much easier that way, right?

The simple answer is ‘no’. But there are many things that all stroke survivors must do, and many things that most will need to do. You will start with basic tasks that you need to master in order that you can work towards more complex tasks. Everything you do will rewire your brain: by doing more, you will develop more motor control and gain strength. You will ‘get nothing by doing nothing’.

Please understand that the degree to which brain repair, neural rewiring and neurogenesis happens can be influenced very significantly long after the short therapeutic window after stroke may close.

stroke survivor1 300x116 - 6 targets you need to have as goals after stroke - Stroke Exercise TrainingSo, I hope to emphasise to you with this post that the regain of functional movement with control, strength, flexibility, stability and essential physical coping strategies are highly individual, relying as they do on your own genetics, status of accompanying medical problems, attitude (drive, persistence, desire and motivation) and so very many other factors.

The longer you’re a stroke survivor, the more you’ll notice that you can ‘win’ or control (manage) many of these but others will have to be accepted. And, I have to tell you, that re-training efforts can never stop, throughout the rest of your life. Sounds like bad news?! Not so… I’ll show why, in a forthcoming post.

Long term stroke survivors reading this will be nodding to themselves. New stroke survivors will get to understand what I mean (just read my next posts. The good news? ‘Retraining’ can very soon phase into an enjoyable and social physical activity wherein you are actively rehabilitating. So encouragingly, it seems that ‘formal training’ is finite… but it must be done right so you can phase into a maintaining status quo in some areas and regularly improve in others (usually micro-improvements).

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Stroke is the commonest cause of physical disability in the world and although there are many excellent services to help stroke survivors, there is no doubt that the continuation of practice and exercise programmes is invaluable in enhancing recovery.

This is important because neuroimaging studies tell us that the brain is a plastic organ. In other words the brain’s structure, the way it is organised, and the way it functions can be influenced by practice and learning. This is the basis for at least some of the recovery that occurs after stroke. A major problem often encountered is that stroke survivors are not sure what exercises they can usefully or safely perform.

The secret is that ‘re-training’ rather than ‘therapy’ is the zone you need to think about now.

Did you know that what we call ‘task-oriented’ exercise programmes are the most promising? If not, you’ll get to love the effects of task-related training IF YOU CAN PROVIDE ENOUGH DOSAGE. By this I mean ‘time on task’… targeted repetition… drives plastic change by strengthening connections. Each rep you do counts.

Enhancing upper limb function is often an essential component of rehabilitation. Weakness in upper-limb musculature could impair stabilisation of proximal arm segments, limit reaching ability, confine hand usage, and affect upper-limb control and coordination. These factors have a direct effect on the use of the paretic (weaker) upper limb in daily activities, supporting the importance of paretic upper-limb strength.

constraint induced movement therapy tsf - The 3 most powerful ways to recover after stroke - Stroke Exercise TrainingLow grip strength in the stroke population can and should be corrected via strength training since grip strength is also a predictor of disability and mortality in older adults. This is why ARNI has, since inception 17 years ago, concentrated on task-training, strength training and the appropriate development of physical coping skills. We’ve done the same thing ever since.

The evidence base right now supports these THREE components that form of backbone of ARNI type training over all others – principles which training can be based around. In a post further on down the line I’ll show you what kinds of ‘interventions’ (those that operate concurrently with an effective dialled-in training programme) hold the most promise too, and that you should explore. It’s the best time in history to be a stroke survivor!



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