After a stroke, organizing your day with a daily routine in a way that works for you will help you stay focused on your stroke rehabilitation and recovery.

The Importance of Setting Up a Post Stroke Routine

Having a daily routine helps us create habits to meet our goals. After a stroke,
there is a lot of information and recommendations that may feel overwhelming.
Organizing your day in a way that works for you will help you stay focused on
your post stroke rehabilitation and getting back to the things that matter most.

After a stroke there are several things to work into your day that have been
shown to assist in your stroke recovery and rehabilitation
[https://home.neofect.com/smart-glove].

 * Aerobic exercise
 * Strength training
 * Sleep
 * Meditation
 * Intensive Repetitions
 * Functional Goal Training

AEROBIC EXERCISE
It is common for people who have had a stroke to become deconditioned. They may
have limited movement and may struggle with depression. Aerobic exercise is
important for stroke because it improves the function of the heart and lungs,
which can reduce the risk of heart disease and future strokes.

Aerobic exercise has also been shown to boost mood and improve cognition in
people post stroke, specifically information processing and motor learning
tasks.

The American Heart Association recommends people with stroke participate in
aerobic exercise 20-60 minutes, 3-5 days a week. The recommended method is
treadmill training, if able.

If you’re unable to safely use a treadmill or walk outside, there are several
other ways to get the heart pumping and increase the rate of breathing, which
are the key ingredients in aerobic exercise. A recumbent bicycle, hand bicycle,
or rowing machine are a few options. You might also try a punching bag or chair
aerobics.

STRENGTH TRAINING


Strength training is also an important piece of exercise to incorporate into
your daily post stroke routine. Strength training focused on high repetitions
prevents muscle atrophy, and actually improves the quality of muscle fibers and
overall functional capacity.

Guidelines for strength training are 2-3 times a week. Strength training should
take about 30 minutes. Recommendations for which muscles to train should be done
in collaboration with your physician and/or your physical or occupational
therapist. Typically, you want to address major muscle groups and complete 2-3
sets of 10-20 repetitions. You want to exercise your muscles to the point of
fatigue.

SLEEP
The brain requires sleep to detoxify proteins that are built up during waking
hours. It also helps solidify working memory. For people recovering from stroke
and in the process of building new neural connections, sleep is essential for
recovery.

Sleep disorders are common after stroke and should be addressed with your
physician to ensure maximum recovery, but making sleep a priority by putting it
into your schedule is one step in the right direction.

MEDITATION


You might be tired of hearing about the benefits of meditation, but it has been
specifically studied in people with stroke and has been shown to improve
balance, fatigue, depression, and disability. 20 minutes of daily meditation is
the recommended dosage, but if you’re new to meditation, aim for 5 minutes a day
using a meditation app and increase as you feel the benefits.

INTENSIVE REPETITIONS
Intensive repetitions (moving your muscles and joints over, and over, and over
again) is the best way to create neuroplasticity
[https://home.neofect.com/blog/why-neuroplasticity-matters-to-post-stroke-rehabilitation] 
 and create new neural pathways to the muscles that were affected by the stroke.

The NEOFECT suite of rehabilitation tools
[https://www.neofect.com/en/about-us/rapael-suite/]  help make intensive
repetitions motivating and fun. It gives you both visual and auditory feedback.

FUNCTIONAL GOAL TRAINING
Intensive repetition of movement is only one piece of the picture. You also need
to practice a functional goal over and over to retrain your brain how to
complete a task.

Choose one long-term goal. Write it on a sticky note and place it on the mirror.
Add it to your daily schedule and commit to practicing it everyday. Studies have
shown that quality of life increases with improvements in function over improved
motor control. One of the best ways to work on your skills is to incorporate it
into the things you already have to do during the day.

CREATING A ROUTINE
Does it all sound overwhelming? Take a deep breath and think about it one step
at a time. Create a digital or physical calendar and schedule time to complete
the above activities. You can print out a sample calendar and place it in a
plastic sheet protector. Check off your accomplishments for the week with a dry
erase marker, and wipe it clean the next week. Prioritize what’s important to
you to start with. You’ve got this!

For more support and encouragement, join our NEOFECT support group
[https://www.facebook.com/groups/NeofectSupportGroup/]  on Facebook!



Download your blank calendar here
[https://drive.google.com/file/d/1Gqnc_x7E_UXrZVqh2TfnM-PdXUOI2slJ/view?usp=sharing]
.

To learn more about the NEOFECT [https://home.neofect.com/]  line of smart
rehabilitation tools, which include support from occupational therapists to
maximize your rehabilitation, please call (866) 534-4989 or email 
contactus@neofect.com.

REFERENCES
Boyne, P., Billinger, S., MacKay-Lyons, M., Barney, B., Khoury, J., & Dunning,
K. (2017). Aerobic Exercise Prescription in Stroke Rehabilitation: A Web-Based
Survey of US Physical Therapists
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357184/]. Journal of neurologic
physical therapy : JNPT, 41(2), 119–128. doi:10.1097/NPT.0000000000000177

Billinger, S. A., Coughenour, E., Mackay-Lyons, M. J., & Ivey, F. M. (2012). 
Reduced cardiorespiratory fitness after stroke: biological consequences and
exercise-induced adaptations
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3159380/]. Stroke research and
treatment, 2012, 959120. doi:10.1155/2012/959120

Bruno Bavaresco Gambassi, Hélio José Coelho-Junior, Paulo Adriano Schwingel, et
al., “Resistance Training and Stroke: A Critical Analysis of Different Training
Programs [https://www.hindawi.com/journals/srt/2017/4830265/],” Stroke Research
and Treatment, vol. 2017, Article ID 4830265, 11 pages, 2017.

Khot, S., Morgenstern (2019) Sleep and Stroke
[https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.023553]. Stroke: 2019;
50:1612–1617 https://doi.org/10.1161/STROKEAHA.118.023553

Underwood, E (2013) Sleep: The Brain’s Housekeeper?
[https://science.sciencemag.org/content/342/6156/301]  Science 18 Oct 2013: Vol.
342, Issue 6156, pp. 301. DOI: 10.1126/science.342.6156.301

Vennu, Vishal & Kachanathu, Shaji & , PriyankaBhatia & Nuhmani, Shibili. (2013).
 Efficacy of meditation with conventional physiotherapy management on sub-acute
stroke patients
[https://www.researchgate.net/publication/264554102_Efficacy_of_meditation_with_conventional_physiotherapy_management_on_sub-acute_stroke_patients]
. Scholarly Journal of Medicine. 3. 48-52.

Kelly, Kristina M; Borstad, Alexandra L; Kline, David; Gauthier, Lynne V;
National Library of Medicine.Improved quality of life following
constraint-induced movement therapy is associated with gains in arm use, but
not
motor improvement [https://www.ncbi.nlm.nih.gov/pubmed/30246613]. Topics in
stroke rehabilitation Vol. 25, Iss. 7, (October 2018): 467-474.
DOI:10.1080/10749357.2018.1481605

Additional information on Post Stroke Routines:
National Institute of Neurological Disorders and Stroke - Post Stroke
Rehabilitation Fact Sheet
[https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Post-Stroke-Rehabilitation-Fact-Sheet]
American Stroke Association - Life After Stroke
[https://www.stroke.org/en/life-after-stroke]
Healthtalk.org - Stroke Recovery
[http://www.healthtalk.org/peoples-experiences/nerves-brain/stroke/stroke-recovery-daily-activities-and-personal-care]

All content provided on this blog is for informational purposes only and is not
intended to be a substitute for professional medical advice, diagnosis, or
treatment. Always seek the advice of your physician or other qualified health
provider with any questions you may have regarding a medical condition. If you
think you may have a medical emergency, call your doctor or 911 immediately.
Reliance on any information provided by the NEOFECT website is solely at your
own risk.

stroke recovery and rehabilitation

In the United States alone, more than 6.5 million people have experienced and lived through a stroke. More than 795,000 people in the United States have a stroke every year, and our objective is to help those survivors and their families through providing resources, information, tools, and support throughout their journey and through all stages of rehabilitation and recovery. 

Stroke Management

In the United States alone, more than 6.5 million people have experienced and
lived through a stroke. More than 795,000 people in the United States have a
stroke every year, and our objective is to help those survivors and their
families through providing resources, information, tools, and support throughout
their journey and through all stages of rehabilitation and recovery.

I had a stroke. Now what? [http://home.neofect.com/blog/i-had-a-stroke-now-what]
Strokes are often unexpected and can be frightening, disorienting events.
Fortunately, there is a lot of research and information available about the
disease. Learn more about the causes, preventative measures, and different
treatment options for rehabilitation following a stroke.

 * What causes a stroke? [https://home.neofect.com/blog/what-causes-a-stroke]
   
 * Stroke Treatment [https://home.neofect.com/blog/stroke-treatment]
   
 * Rehabilitation Following a Stroke
   [http://home.neofect.com/blog/rehabilitation-following-a-stroke]
   

Recovering from a Stroke [http://home.neofect.com/blog/recovering-from-a-stroke]


Stroke recovery is different for every individual, but learning to return to
your day-to-day life is possible. Recovery post-stroke is all about adjustments.
Setting goals and making modifications to some of the emotional, physical, and
social aspects of your life are all steps in the recovery process.

 * Jumpstart Recovery [https://home.neofect.com/blog/jumpstart-recovery]
   
 * Post-Stroke Challenges [https://home.neofect.com/blog/post-stroke-challenges]
   
 * Daily Life Post-Stroke [https://home.neofect.com/blog/daily-life-post-stroke]

Spasticity

A stroke is caused by either a blockage of a blood vessel or bleeding in or around the brain, which results in a lack of oxygen to the brain and the death of brain cells.

Spasticity and Stroke

Stroke and Brain Function
A stroke is caused by either a blockage of a blood vessel or bleeding in or
around the brain, which results in a lack of oxygen to the brain and the death
of brain cells.

In the simplest terms the brain receives messages, process messages, and sends
messages. Each area of the brain is responsible for different things. Depending
on the area of the brain that was damaged will determine which messages are
interrupted.

If the area of the brain that was damaged was the signal to send a message to
your bicep and/or tricep muscles (the muscles that bend and straighten your
elbow), you might experience tightness of those muscles due to spasticity.

What is Spasticity?


Spasticity is essentially a reflex. Reflexes are our bodies way of protecting
ourselves. When we touch a hot stove with our hand, our muscles immediately
contract to move our hand out of harms way. This message is not actually coming
from the brain. It would take too long for the signal to go from the skin to the
brain, process it, and send a signal back to the muscle to move away from the
hot object. The pain message from the skin goes to the spinal cord and sends a
signal right away to the muscle to contract. Once the hand is moved away from
the harmful surface the brain has had enough time to process if it is safe for
the muscle to relax, and is able to send a signal to relax the muscle.

In it's truest definition, spasticity occurs in response to quick movement: if
your elbow is quickly extended, it will pull into flexion. This reaction is a
symptom that the brain to muscle messaging system is impaired. But spasticity
and increased tone are also used as general terms to describe any tightness of
muscles that result from damage to the brain or spinal cord. Meaning when the
tightness of a muscle occurs without the quick stretch, such as posturing the
arm in flexion or a muscle tightening during an activity, this is often referred
to as spasticity as well.

What happens after a stroke is that the brain has difficulty sending a signal to
the muscle to relax. Sometimes the message is absent and there is no active
signal and sometimes the message to relax is weak. This is why some people might
tighten when they are running or during an activity. Their brain is working hard
on sending signals to the rest of the body, it doesn't have the time to work on
sending a signal to relax the muscle.

Managing Spasticity
It’s important to note that not all spasticity is bad. Many people with stroke
use their spasticity to assist with standing, transfers, and daily activities.
It’s important to discuss options for managing spasticity and functional
implications with your physician and your occupational or physical therapist.

There are two general approaches that address spasticity: medical management and
physical management. Medical management is decided in collaboration with the
patient and physician. It addresses the neural component that is causing the
muscle tightness. Medical management of spasticity includes oral medications,
neurotoxin or phenol injections, and surgical interventions.

The physical management is typically addressed by a physical or occupational
therapist and addresses the biomechanics of the joint to prevent muscle
shortening, joint deformities, and decreased function. Physical management
includes stretching, muscle strengthening, and intensive repetitions. Physical
and occupational therapists also use electrical stimulation
[https://home.neofect.com/blog/can-e-stim-help-jumpstart-outpatient-stroke-rehabilitation] 
 and ice as modalities to limit spasticity during exercise or functional
activity.

STRETCHING

Spasticity tightens our muscles and over time the muscle begins to shorten. This
limits our ability to move our joints even further. Stretching has the potential
to quiet the hyper exaggerated reflex for several hours, as well as the benefit
of maintaining range of motion. Stretches should be held for 30 seconds or more
and you may feel a release of the muscle tone.

Splinting and orthotics are used for an even longer stretch. They position a
joint optimally to maintain length of a muscle and prevent contractures.
Depending on the purpose, splints and orthotics are worn during the day or at
night to allow for hours of stretch time.

Weight-bearing is a form of prolonged stretching with the added benefits of
strengthening and increasing bone density. After a stroke the motor function of
the leg tends to return before the arm, and one of the reasons may be the
motivation to walk and the intensive weight bearing of the leg. When we weight
bear or put pressure on our muscles and joints, we are sending signals to the
brain. The brain is getting a lot of feedback from that extremity. Any weight
bearing of the upper extremity either at the wall, table, or floor helps sends
signals to the brain that reminds it the arm is still there.

STRENGTHENING

Strengthening can improve spasticity in two ways. By strengthening the
antagonist (opposing) muscle, it can help inhibit the reaction of the spastic
muscle. When the spastic muscle activates and tries to pull a joint into
flexion, the extensor muscle has the capacity to limit the flexion just by being
stronger.

We must also strengthen the spastic muscle. It might seem that with all that
contracting a spastic muscle would be a strong muscle, but without the brain to
muscle connection a spastic muscle is actually a weak muscle. Utilizing
electrical stimulation or ice prior to strengthening a spastic muscle may be a
way to optimize your strengthening session.

Strengthening can happen any time a muscle is contracted, but depends on the
capability of the person doing the contracting. It has to be somewhat difficult.
The muscle has to fatigue. The person who does not have full active range of
motion, but is able to visibly contract a muscle is strengthening with each
repetition of movement.

Repetition of movement is a rehabilitation strategy not only for strengthening,
but plasticity. Intensive repetitive training or massed practice is the key to
neuroplasticity and improving the way the brain sends signals to the muscles.

INTENSIVE REPETITIVE TRAINING

Voluntary movement has the potential to maintain joint range of motion,
strengthen, and increase plasticity
[https://www.brainhq.com/brain-resources/brain-plasticity/what-is-brain-plasticity/]
. But it’s all about repetition. In a typical therapy session, you might expect
to do 20-30 repetitions of movement. You would be responsible for completing the
movements for each joint on a daily basis. This can become boring and the habit
slowly slips away.



The NEOFECT Smart Glove [https://home.neofect.com/smart-glove]  and Smart Board
[https://home.neofect.com/smart-board]  fit right into the gap of what we know
therapeutically and what is actually happening on a day to day basis. The 
NEOFECT [https://home.neofect.com/]  Smart Glove and Smart Board turn your home
program into a fun and motivating way to maintain range of motion, strengthen,
and optimize your functional outcomes.

Every person is unique and has a different rehabilitation journey. Neofect has
experienced occupational therapists to consult with to see what might work for
you.

If you've had a stroke and are looking for an effective solution for your
rehabilitation needs, please look into NEOFECT's line of Smart Rehabilitation
Solutions [https://www.neofect.com/en/pt-solution/].

To learn more, please call (866) 534-4989 or email contactus@neofect.com.

For more information on stasticity and stroke:
American Association of Neurosugical Surgeons - Spasticity
[https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Spasticity]
National Institute of Neurological Disorders and Stroke - Spasticity
Information
Page
[https://www.ninds.nih.gov/Disorders/All-Disorders/Spasticity-Information-Page]
Cleveland Clinic - Spasticity
[https://my.clevelandclinic.org/health/diseases/14346-spasticity]

National Stroke Association - What is Stroke
[https://www.stroke.org/understand-stroke/what-is-stroke/]
Mayo Clinic - Stroke Symptoms and Causes
[https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113]
Stroke Association - About Stroke
[https://www.strokeassociation.org/en/about-stroke]

All content provided on this blog is for informational purposes only and is not
intended to be a substitute for professional medical advice, diagnosis, or
treatment. Always seek the advice of your physician or other qualified health
provider with any questions you may have regarding a medical condition. If you
think you may have a medical emergency, call your doctor or 911 immediately.
Reliance on any information provided by the NEOFECT website is solely at your
own risk.

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