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Get back to… Exercise after a stroke

Musculoskeletal disorders are the biggest cause of disability. Despite the billions spent, the problem is just getting worse. Latest medical guidelines strongly recommend exercise therapy as the first-line-treatment for musculoskeletal disorders instead of much more expensive surgeries.

By Annika Järvinen

For patients recovering from a stroke, the right rehabilitation can be difficult to find. Nordic Health patient Kalervo shares his rehabilitation story after suffering two strokes.

Structured and personalised medical exercise therapy

Sixty-nine year old Kalervo has a history of health issues including two recent cerebral infarctions, or silent strokes. The strokes significantly decreased Kalervo’s motor skill capabilities, forcing him to rely on walking aids including a walker and walking cane.

After being discharged from hospital and given permission to begin active exercise therapy, a friend introduced Kalervo to Nordic Health for rehabilitation. 

Working with the Physiotherapist at Nordic Health, an individual treatment plan was created to guide Kalervo’s rehabilitation journey and he began visiting the clinic twice a week.

When his treatment program began, Kalervo could only walk around 200 meters with a walker, but as he progressed, he noticed improvement in mobility and pain levels.

“The device exercise therapy is good, and I enjoy it. After my last stroke, my overall mobility was very poor,’ Kalervo explained. 

‘The exercise therapy has been useful, and I feel I have made progress in my overall mobility. My current goal is to improve my walking.

‘I’m a lot more independent than I was a few months ago.’

Showing progress in a coherent patient report

The clinic Physiotherapists and Exercise Physiologists use the David devices (the same devices used by getback) to perform mobility and isometric strength tests with patients. Initial testing is done before starting a treatment program, with a re-assessment midway through the program, and outcome testing for final results at the end of the program.

Kalervo was tested before his two silent strokes in 2020, as well as in October 2021 during his current rehabilitation treatment program.

Kalervo’s latest report shows his strength and mobility nearing the levels they were at before his strokes. 

‘It shows he is making progress,’ says Hanna, an Exercise Physiologist at Nordic Health.

Hanna works closely with Kalervo during his training visits to the clinic. ‘The report shows that we need to pay attention to Kalervo’s strength balance, since his right side is stronger than his left due to the strokes.’

All testing data is automatically stored on the EVE platform. With a few clicks, the therapist can print out or email the report for the patient. Objective data from mobility and strength testing is important because it provides both a better understanding of a patient’s progression and motivation for the patient to continue as they see their progress in a clear, understandable way.

Medical exercise therapy and patients recovering from stroke

Device training during the rehabilitation stage can help stroke patients as well as other patients with neurological diagnoses.

According to the ACSM (American College of Sports Medicine) guidelines for individuals suffering a cerebral vascular accident, it is advised to ‘use equipment and exercise that improve safety in those with deficits.’ Device training is safe because it allows for structured training with distinct parameters including weight resistance and range of motion.

With David devices, this is made even easier because EVE automatically displays the correct weight for each exercise and the terminal screen shows the correct range of motion and speed the patient should follow.

study published by the American Heart Association recommends physical activity for patients recovering from a stroke. This includes muscle-strengthening activity. The study highlights that ‘physical activity goals and exercise prescription for stroke survivors need to be customised for the individual to maximise long-term adherence’.

With exercise therapy on the David devices, that customisation is guaranteed. 

As Hanna explains, ‘We continually customise Kalervo’s program by adjusting the weight resistance and range of motion to be suitable for his current situation. When he trains he gives feedback after each exercise and EVE adjusts the program based on his feedback.’ 

The clinic personnel also monitor Kalervo’s exercise on the EVE platform to check his compliance scores from each exercise and can intervene when they see possible issues.

References:

ACSM | The American College of Sports Medicine. (2022). Retrieved 17 January 2022, from https://www.acsm.org/

Billinger, S., Arena, R., Bernhardt, J., Eng, J., Franklin, B., & Johnson, C. et al. (2014). Physical Activity and Exercise Recommendations for Stroke Survivors. Stroke45(8), 2532-2553. doi: 10.1161/str.0000000000000022

This story was originally published on the David Health website – https://davidhealth.com/