Recovering Gait After Post-Stroke Paralysis
But what if you can’t exercise in a conventional way because of hemiplegia/post-stroke paralysis? This is where passive exercise and therapeutic modalities can help.
Passive exercise involves assisting your affected limbs through an exercise, either by using your non-affected side or receiving help from a trained caregiver or therapist. Although the movement is done for you, it helps stimulate the brain and spark neuroplasticity, especially when attention is paid to the movement.
Every time you move your affected side through therapeutic movements, and you bring this movement into your awareness, you help stimulate the brain and create positive changes. Results will come slowly – you may see twitches see Stroke and Muscle twitching - eHealthMe initially as your movement abilities return – and that’s a sign of progress.
Understanding What is the difference between active and passive exercise? (findanyanswer.com) is important when customizing a rehabilitation program to your unique needs.
ACTIVE PASSIVE
 
A physical therapist may also utilize different treatment options, such as electrical stimulation (e-stim) A Guide to Electrical Stimulation Therapy for Stroke Patients (saebo.com), to retrain the brain to activate the muscles needed for walking. E-stim involves placing electrodes on the skin and using an electrical current to stimulate the muscles to contract. Again, it tends to be most effective when purposefully focusing on the movement.
Now that you understand how rehabilitation works, let’s jump into the walking exercises.
Walking Exercises for Stroke Patients
Physical therapy exercises are the best way to improve your gait after a stroke. Your physical therapist can recommend some appropriate exercises for you based on your ability level.
Here are some example 5 Gait Training Exercises That Help With Mobility - Careasone Blog that your PT may recommend to help improve your ability to walk:
Leg exercises
When we think of walking, we often think of our legs. While there is much more that goes into your gait, targeting your legs is a great place to start. Ask your PT for exercises that help with walking and (s)he will likely recommend some leg exercises along with a mix of others.
 
A helpful leg exercise to begin with for gait rehabilitation is seated marching. From a seated position, lift your thigh up into your chest. If necessary, you can use your arms to assist with this movement. (This turns the movement into active assisted or passive exercise for individuals with hemiplegia or severe hemiparesis.) Adding an ankle weight can make this more difficult for those who are ready to focus on increasing strength and muscular endurance.
At Home Leg Exercises For Stroke Patients | Leg Strengthening Exercises (saebo.com)
Balance and core rehabilitation exercises
A strong core is essential for maintaining balance while you walk and preventing falls. Along with your leg exercises, incorporate core and balance exercises that target your trunk too.
One example is leg rotation (which, despite its name, focuses more on your core more than your legs). Start by lying on your back with your legs bent at 90 degrees. Then, let your legs fall to one side while trying your best to control the movement from your core.
Again, if you cannot do this movement independently, ask a trained caregiver or therapist for assistance to make the exercise passive. All movement is beneficial and helps rewire the brain.
Seated Trunk & Core Strengthening Exercises After Stroke - Bing video
Foot drop exercises
Foot drop is a Post Stroke Condition Exercises for Foot Drop: Get Back on Your Feet | Saebo that can make it difficult to lift the front part of your foot up — a movement known as dorsiflexion. This movement is critical for the ability to walk safely and reducing the risk of tripping and falling.
A good exercise for foot drop is ankle dorsiflexion. Cross your affected leg over your thigh and hold your foot in your hand. Then, assist your foot through dorsiflexion by moving the top of your foot back toward your shin and then back down. This can be done passively with assistance until you can practice it actively with no assistance.
Devices to Help Stroke Survivors Walk
Walking devices that are used following a stroke include front-wheeled walkers, platform walkers, hemi walkers, four-wheeled walkers, quad canes, and single point canes, along with a Foot Drop Device such as the NEW and IMPROVED SaeboStep. – JGH Rehab
  
Over time, your physical therapist may try to help you to transition to less stable walking devices, until you are able to walk without one at all.
It’s important to use any walking device your therapist recommends and also practice rehabilitation exercises consistently.
Following along to written sheets of exercises can be tough due to low accountability and potential boredom. If you struggle with motivation to exercise, then it can be worth exploring exercise devices to help you stick with a home therapy program and see better results.
Here are some exercise devices and machines that help improve your ability to walk after stroke:
Stationary Bikes
A good device for recovering your gait at home is a stationary / recumbent bike. These devices help with gait recovery by targeting your legs through bilateral movement: when both limbs are used in unison to contract the muscles.
 
This is particularly appealing for individuals with hemiplegia or severe hemiparesis because you can use your non-affected side to assist your affected side, which helps encourage neuroplasticity.
Stationary bikes primarily target your legs and core, so it’s important to combine it with other rehabilitation methods to target the full body.
There aren’t many affordable home therapy devices that are both motivating and target the full body. This is why we really encourage clients a rehab device that turns your physical therapy exercises into an interactive experience. The Wii Fit / Balance Board and Wii Sports. Incorporating the Wii into Occupational Therapy Treatment - myotspot.com It’s like having a virtual therapist available right from your Television. The Wii Fit and Balance Board, will show you exactly where your weight is being distributed. Wii Fit & Wii Fit Plus Beginning Without Wii Balance Board - YouTube
Wii Console with controller, all wires, sensor, Balance Board, Wii Fit – JGH Rehab
Constantly adjusting your body position, learning to distribute your weight evenly on both sides, will improve your gait, posture and walking style. Once you relearn the feeling of how your weight feels when it is correctly / evenly distributed, your overall walking style will improve, resulting in better balance and you will not have to work as hard to walk, resulting in more Stamina and Confidence.
Task-specific training
Once you are able to walk with assistance, you can start doing task-specific training, which involves directly practicing the skill you want to get better at: walking! The more you walk, the better your gait will become. However, it is important not to fall into bad habits, such as trying to increase time and distance at the expense of technique. Technique is the key to success. So start out with small mindful steps, concentrating on technique.
When I was learning to walk again Post Stroke, I would have to use verbal ques myself by saying out loud, Left, Right, Cane, or step with my left foot, then my Right foot, then move my cane. It took a while, and sometimes now, even 5 years later, I have to go back to the basics, to keep myself from picking up bad habits that could come back to haunt me through a fall.
Try to walk as much as you can – making sure to use any equipment recommended by your therapist, such as a walker or cane – without over exercising. Pushing yourself too hard can cause other complications such as Tired After a Stroke? Understanding Post-Stroke Fatigue - Saebo. Aim for your exercise to help you feel challenged but not exhausted.
 
Also, as you explore your ability to walk with less assistance, be extremely careful and do so in the presence of a caregiver or therapist to help prevent any tripping or falling, What Works in Falls Prevention After Stroke? | Stroke (ahajournals.org) could result in further reduced mobility and setbacks, so take all the precautions you can to avoid it.
Hope for Walking After Stroke
Your chances of regaining the ability to walk after stroke increase with regular rehabilitation. During inpatient and outpatient therapy, your therapist will help guide you through various exercises to improve your gait.
You will see the best results if you practice a home therapy program between outpatient therapy visits. 5 Easy Foot Drop Exercises for Beginners - YouTube This will help motivate you to accomplish the repetitions necessary to improve your gait.
Stimulating the brain with consistent, repetitive exercise is the best way to create results. We wish you the best of luck on the road to recovery.
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