According to the National Stroke Association, about 730,000 people suffer strokes each year. About 80 percent of stroke survivors experience mobility problems such as muscle weakness and gait issues due to a condition called hemiparesis, which is weakness on one side of the body. With early rehabilitation and physical therapy exercises, persons suffering with a hemiparetic knee can eventually regain movement.
Water Exercise
Stephen J. Page, Ph.D., Stroke Smart Magazine contributing writer, lists swimming or water exercise as one of the best exercises for stroke survivors. The water is a safe and supportive environment for people who are suffering with a hemiparetic knee and have trouble walking. Exercising in the water is gentle on your joints, helps you improve your balance and also increases your cardiovascular fitness. Aqua-exercises may include walking movements to mimic and restore normal movement patterns. Repetitive motions, such as knee lifts and extensions might be used to specifically target the knee joint. Other "real-world" movements, such as getting up and down out of a chair and lifting the arms to open a door or take a plate out of cabinet, can be done in the water as part of the therapeutic rehabilitation process.
Knee Extensions
Strengthening exercises, such as knee extensions can be done using a knee extension machine or with resistance from an assistant or physical therapist. For example, when using the extension machine, you may use little to no weight at the beginning of the exercise and only extend one leg at a time for several repetitions, focusing on regaining range of motion. With a therapist, you can do passive or assisted range-of-motion knee flexion exercises. An example of this type of exercise is supported knee flexion. The therapist has the patient lie on his back, while the therapist supports the patient's leg and gently bends the knee towards the patient's chest and then returns the leg to full extension. After a stroke, it is important that you follow the exercise guidelines from your physician. The extent of muscle and motor skill loss will dictate your particular exercise prescription.
Hamstring Isolations
In addition to strengthening the knee through flexion, extension exercises may also be helpful. Lying hamstring curls may be recommended using both equipment and assisted or passive resistance depending on your case. With a hamstring machine, you will lie on your stomach with your heels placed underneath roller pads. As you exhale, slowly bring your heels towards your buttocks by squeezing your thigh muscles as well as your calves and buttocks. Slowly return your legs to the starting position to complete one repetition. In the case of assisted range-of-motion, lay on your stomach on a table. Your therapist will bring your heel towards your hip and slowly return your leg to the starting position.
Stretching
Strengthening exercises may be accompanied by specific stretching exercises. The muscles targeted will be the quadriceps and the hamstrings, the main muscles that support the knee joint. Stretches may initially be done in the water. For example, to stretch your quadriceps, you may hold on to the side of the pool or ladder, while you grasp your ankle or foot with your hand and gently pull it towards your hip. For your hamstrings, or the back of your thighs, you can place one heel on a bottom stair or rung of a ladder as you gently bend forward from your waist and reach for your toes. On land, MayoClinic.com health experts recommend that you stretch your quadriceps by standing near a wall or something sturdy to support yourself. Grasp your ankle and gently pull your heel up and back towards your buttocks until you feel a gentle stretch in the thigh muscle. A physical therapist can help you with the best stretches you can do at home to assist you in your recovery process.
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