Stroke is a significant cause of long-term disability conditions in affected patients. Also, it has been identified as a general predictor of the prevalence of falls in older adults who have survived a stroke.
These falls can lead to long periods of inactivity and may result in further associated psychological constraints. For example, depression or fear of falling can be the result of an individual’s previous history of falls. Moreover, it can increase the risk and lead to more serious medical complications such as hip and femur fractures.
Other essential factors that increase the risk for falls in stroke survivors include the severity of a stroke, female gender, and age over 70 years. Thus, it is critical to identify those individuals that are at higher risk for falls.
The effect of stroke on an individual can cause various degrees of disabilities or may cause permanent loss of function. First, stroke survivors may exhibit multiple body system impairments: sensory, motor, and cognitive. Later, a stroke could have a restricted effect on patients’ ability to perform activities of daily living (ADL).
This inability to perform ADL strongly affects patients’ independence and sense of well-being. Rehabilitation training uses motor intervention strategies that aim to reduce the disability resulting from a stroke and targets the relevant goals and needs of patients. Furthermore, the context within the rehabilitation program seeks to imitate real situations in the environment, for example teaching stair climbing techniques for patients with hemiplegia conditions.
Out of the various significant sensory-motor skills required for ADL, postural control and gait characteristics were shown to have a substantial impact on independence and overall functional control.
For example, conventional approaches to stroke recovery include gait asymmetry corrective exercises.
Restoration of balance ability in post-stroke survivors involves a variety of motor training techniques. Balance intervention programs include strength training, motor learning methods, visual feedback activities, perturbation programs, postural control, and balance control task-oriented training.
The integration of daily task activities and rehabilitative exercises were shown to be effective in improving balance abilities, gait, and postural control.
The importance of postural control skills goes beyond its direct role in promoting general health. It is also an ability that is essential for one’s independence and social participation. Normal daily activities require the simultaneous performance of more than one task at a time. Thus, real-life situations demand individuals to perform multiple motor and cognitive tasks to maintain an adequate postural function.
Example of ADL exercises to improve postural and overall fitness in post-stroke survivors:
- Sitting to standing
- Transfers – from sitting to walking to sitting again.
- Parallel bar walking
- Sideways walking with Theraband (position the band just below the knee cap)
- Using a step stool – One leg step up
- Standing unsupported with feet together
- Standing unsupported with feet together (eyes closed)
- Standing unsupported one foot in front – tandem step
- Tandem step walking within parallel bars
- Standing on one leg
- Starting in a standing position picking up an object from the floor
*** these type of exercises can be modified according to patients’ abilities – For example:
exercises can be performed on a vestibular balance disc