Rehabilitation aims to maximise life after stroke.
Rehabilitation helps stroke survivors relearn skills that are lost when part of the brain is damaged. After damage to the central nervous system, neuroplasticity is the key to functional recovery.
Neuroplasticity refers to the capacity of the nervous system to change in response to experience. Following a stroke, physiotherapy rehabilitation can provide the ‘right’ experience to optimise recovery. (Neuroplasticity is nicely explained in this podcast by the Stroke Foundation).
The ‘right experience’ is about choosing an activity that is challenging enough to tap into the process of neuroplasticity and rewiring the brain without being ‘too easy’ or ‘too hard’. An experienced neurological physiotherapist will have skills to assist you to select an appropriate functional challenge and give you feedback, cues and prompts to adjust the difficulty of the challenge accordingly.
Applying the principles of neuroplasticity in rehabilitation
- Choose a meaningful task to you – if it’s important to you, you’re more likely to be motivated and more likely to enjoy the hard work involved in rehabilitating.
- ‘Just the right challenge’ – once you know what you can and can’t do, then start working at a level that is neither too easy or too hard. A therapist can assist you to set ‘the right challenge’ and progress the tasks as you improve.
- Practice, practice, practice – repetition is required for neuroplasticity to ‘hard wire’ newly acquired skills.
- ‘Use it or lose it’ – because the nervous system changes in response to experience, continued use is necessary.
- Meaningful goals – will keep you motivated and allow you to see and measure the progress you make in the long term.
Physiotherapy Stroke Rehabilitation
Physiotherapy helps people retrain the body to be able to perform everyday tasks by regaining use in stroke-impaired limbs and teaching strategies to maximise function while deficits remain. This may include coordinating leg movements for walking or regaining control of muscles in the arm and hand to hold a cup for example.
Physiotherapy rehabilitation following stroke can help with movement control and weakness, coordination of movement and loss of fitness. There is clear evidence that physiotherapy in the form of strength training, electrical stimulation and mental practice can improve movement control; task specific practice clearly improves performance of coordinated movements; and being generally more active, moving towards fitness training is beneficial to recovery following stroke (Scrivener, 2016).
Neurological physiotherapy can also provide sensory retraining, fatigue management, balance training, pain management, treatment for ataxia along with other treatments to meet the needs of individuals.
Home-based physiotherapy for stroke allows people to tailor their rehabilitation to fit their schedule and provides an environment for meaningful practice in their home and community.