Rehabilitation of patients who have suffered a stroke. Advice, recommendations, gymnastics, massage. Medical blog

How long will it take? First of all, it all depends on the degree of brain damage, age and general condition of the victim.

However, an equally important role in this situation is given to those around the patient: in order to pull him out of the disease and help him recover as fully and quickly as possible, we will need daily work, dedication and patience.

Diagnosis is not a sentence

Full functioning of the brain is impossible without a constant blood flow. In the case of a stroke, such flow is blocked due to a rupture or blockage of the vessels that feed it. As a result, oxygen starvation in the affected areas of the brain causes irreversible changes in them and the loss of certain body functions controlled by these areas.

Even severe forms of this disease do not always mean the inevitability of lifelong bed rest. Nature has created such compensatory mechanisms in the human body that allow the surviving nerve cells to partially or completely take over the functions of the lost ones. We are talking about temporarily inactive cells that are in close proximity to the lesion. They need to be made to work. This is best achieved with the help of daily exercises.

Physical exercises after a stroke

Therapeutic exercises, massage and exercises for speech restoration should be started as soon as the patient's condition allows. They should be carried out daily, with a gradual increase in the load and duration of exercises, especially in the first months after the stroke.

Massage

In order to prevent the development of complications such as muscle spasm and progressive stiffness in the joints of the extremities, from the first days it is necessary to carry out a massage, including relaxing stroking and light rubbing, which increase blood flow and lymph drainage in the muscles. It should be done daily, gradually increasing the duration from 10 to 20-25 minutes.

Gymnastics

Usually, a rehabilitation doctor can prescribe physical exercises (flexion-extension, adduction-abduction, rotation of the limbs) two to three weeks after a stroke. The main principle is constant exercise with a gradual increase in their duration and load. Such exercises are performed for 10-30 minutes twice a day, lying on the back or on the healthy side. At first, the patient may need your help to perform such exercises - hang his immobilized leg or arm on a towel and help him perform the necessary movements. Be sure to take short breaks from time to time.

Fine motor exercises

If at least a little mobility of the fingers remains, it can be strengthened by exercising with rubber rings and balls, hand expanders. It is also useful to work on the hand (flexion and extension) with the healthy hand. Do not forget about fine motor skills exercises - sorting through small objects in your hand (nuts, buttons, etc.), modeling with plasticine, tying and untying shoelaces, buttoning and unbuttoning buttons - they not only help restore muscle tone, precision of movement and joint mobility, but also contribute to a more active restoration of brain function.

Learning to sit

From the moment the patient is allowed to sit, it is important to help him do it correctly. In the first 2-3 days, simply lift his head and shoulders for 3-5-10 minutes, placing pillows under them and gradually moving him to a semi-vertical position. After a few days of such training, the patient will probably already be able to sit with his legs down. In this case, he needs to put a pillow under his back, a bench under his feet, and fix the injured arm with a soft cloth. The duration of such "sessions" should be increased: start with 5-10 minutes, again, gradually increase to 1-2 hours. It is good if during this time he can develop the leg muscles as much as possible with the help of simple exercises, thus preparing his body for mastering walking.

Learning to stand and walk

After the sitting skills have been mastered, you can move on to more complex tasks - standing and walking. Help the patient get out of bed, supporting him with your hand at the waist, and trying to fix his knee joint in an extended position with your foot. Make sure that he stands straight and evenly distributes his body weight on both legs. For the first time, it will be enough to stand for a little while - just 1-3 minutes. Daily training will gradually increase both the duration of such training and the patient's independence - over time, he will learn to do without your help, holding on to the back of the bed or a reliable bracket, which should be specially mounted in the wall for this purpose.

A very important stage is the restoration of active walking skills. For this, walking with the support of another person, in a mobile arena or a special wheelchair, walking with a stick are used. The final stage is walking up the stairs. If necessary, for example, if there is a drooping foot, select special orthopedic shoes or high lace-up boots for the patient. As soon as the patient's condition allows, be sure to take daily walks in the fresh air with him.

Learning to speak and understand speech

Speech disorders such as aphasia (difficulty expressing and understanding speech) and dysarthria (difficulty pronouncing sounds) are common consequences of a stroke. There may also be problems with the ability to count, recognize and remember dates and numbers. Unfortunately, the restoration of speech functions is a long process and can sometimes last up to 3-4 years. It is better if you solve this problem in cooperation with experienced doctors: a neurologist and a speech therapist. We will limit ourselves to only the most general recommendations:

• When addressing a patient, try to formulate your questions so that he can answer them in monosyllables: "yes" or "no".
• Speak clearly and slowly, using simple words and sentences. Wait patiently for an answer.
• Do various exercises with the patient every day to practice pronunciation of sounds and words, including exercises for the facial muscles, which should be done in front of a mirror.
• Teach the patient to clearly pronounce each sound in a word, focus consciousness on the correct pronunciation of words, speak loudly and slowly, control the rhythm of breathing during speech.
• Kindly and calmly ask the patient to repeat the words that you did not understand.

And a few more tips

• Try to provide the person who has suffered a stroke with the most comfortable and safe conditions for meeting his daily needs.
• Pay attention to the patient's sleeping place: the mattress should be hard and flat. Take care to combat bedsores if the patient is motionless; Ventilate the room regularly, but do not create drafts.
• It is important that the patient always has the opportunity to attract the attention of loved ones or call for help if necessary. This can be done, for example, with the help of a small bell, which can be placed on the bedside table.
• To help the patient distinguish between right and left, put a watch, bracelet or a bright ribbon on his wrist. In a similar way, you can make bright marks (stickers) on his sleeve, trouser leg, shoe.
• If he has difficulties with orientation in space, try to mark the path he takes daily around the house to the bathroom, kitchen, etc. with bright stickers on the walls.
• Do not leave a person who has suffered a stroke unattended. Often such people forget the way home and can get lost even in a familiar area. Make sure he always has a note with his name, address, and relatives' phone numbers.
• And one more, perhaps the most important piece of advice. Remember, no matter how severe the consequences of the illness, care, attention, and support of loving people can sometimes do more for the injured person than any medical procedures or medications!