More than 700,000 people suffer strokes each year in the United States, according to the National Institute of Neurological Disorders and Stroke. Rehabilitation exercises help stroke patients relearn patterns of motion helping them to stand, walk, climb stairs and increase range of motion. These exercises can begin 24 to 48 hours after the stroke. Patients are encouraged to practice passive range of motion exercises while lying in bed as the first step in rehabilitation.
Three types of range of motion exercises are used in rehabilitation active, active-assisted and passive exercise. Passive ranges of motion exercises are started as soon after the stroke as possible. These can be done in a hospital bed without any effort from the stroke patient. A nurse or physical therapist moves all the stroke victim’s limbs. Each limb is put through the full range of motion using gentle circular motion. The patient is encouraged to change positions frequently while the therapist moves the limb through the full range of motion repeatedly, according to the National Institute of Neurological Disorders and Stroke.
For example, with a patient lying on his/her back, the therapist supports the back of the head with one hand and the chin with the other hand. Slowly raising the head, the therapist then gently moves the head towards the patient’s chest and back to the starting position. Head turns are done by holding the patients head with both hands, one on each cheek and slowly rotating the head from side to side.
Active-assisted exercise is used with stroke patients who have some mobility, but still need assistance with motion exercise. A therapist who may use bands or other exercise equipment aids helps stroke patients who can move their joints or muscles, but have pain. The therapist will help guide the limb through the full range of motion, helping to move the limb when the patient cannot move or has too much pain. Range of motion exercise should be done both on the weak side and the unaffected side of the body.
An example of active-assisted exercise is when the stroke patient is assisted by the therapist to rotate the forearm up towards the body. The therapist only helps get the motion started until the patient can move the joint through the rest of the rotation on his or her own.
When the stroke patient starts to recover and has voluntary muscle control, active range of motion exercise is done with out physical aid by the patient. The physical therapist may instruct the patient or these exercises may be done at home. Range of motion exercise keeps joints flexible and the muscles strong. Each exercise should be done slowly, being careful not to force the movement, according to Ohio State University Medical Center. Exercises are done within your tolerance of pain. The pain will go away when the joint is returned to rest.
A shoulder range of motion exercise can be done standing, sitting or lying down. Begin by interlocking the fingers with your arms flat against the body. Slowly raise the arms bringing them out in front of the body and then directly overhead. Slowly lower the arms through the range of motion to the starting position.
- National Institute of Neurological Disorders and Stroke: Post Stroke Rehabilitation Fact Sheet
- Merck Manuals: Physical Therapy (PT)
- Ohio State University Medical Center: Self Range of Motion Exercises for Shoulders, Arms, Wrists, Fingers
- Brookside Press: Nursing Fundamentals: Active-Assited Exercise
- The Henry Samueli School of Engineering: A Pneumatic Robot for Re-Traingin Arm Movement After Stroke