Walking after stroke is the most common goal in physical therapy because it offers independence, which greatly contributes to our quality of life.
The ability to walk makes it possible to use the kitchen, run errands, and move about the day without relying on a caregiver or rehab equipment (although there is no shame in that).
When walking becomes difficult or impossible after stroke, it’s usually a sign that the stroke was moderate or severe. This often means that the road to recovery is longer, but there is hope.
Improving your gait (manner of walking) takes hard work and rigorous physical therapy, and we’ll show you what the process entails.
Chances of Walking After a Stroke
First it’s important to understand that every stroke is different so every recovery will be different. It’s impossible to know if or when a patient will walk again because it varies from person to person.
However, by looking at the size and location of the stroke, you can make some inferences about recovery. Talk to your neurologist to get this information.
Generally speaking, stroke patients recovering from a mild or moderate stroke have higher chances of walking after a stroke. Patients that sustained a massive stroke often have more obstacles to overcome.
The size and location of the stroke impact recovery. If the stroke was large and created considerable side effects, like post-stroke paralysis, the stroke patient must work very hard to relearn complex motor skills like walking.
Fortunately, the brain knows how to reorganize and adapt itself through neuroplasticity. This means that, even if a stroke left behind considerable damage, the brain can utilize new brain tissue to learn new skills.
Although walking isn’t technically a new skill for stroke survivors, it’s essentially new for the brain. Learning how to walk again after stroke is just like learning how to walk for the first time when you were a child.
The size of the stroke and the resulting stroke side effects impact your chances of walking after stroke.
Physical Therapy Process for Walking After Stroke
Physical and occupational therapists work hard to help patients improve their gait because walking is critical for the activities of daily living.
Here is what the gait rehabilitation process may look like:
Inpatient Rehab with State-of-the-Art Equipment
After stroke, patients often spend time at an inpatient rehab facility where they participate in rigorous therapy.
One advantage of inpatient rehab is access to a dedicated team of therapists and expensive rehab equipment, like assistive treadmills and parallel bars. This equipment makes task-specific training (i.e. walking) possible, even with severe impairments.
In the video below, you can see how intensive gait rehabilitation can be. During this rehab session, 3 therapists are working with 1 patient on an assistive treadmill:
By working with advanced equipment and a team of therapists, patients can make considerable gains with gait improvement.
After intensive inpatient rehab, some patients might be able to transition to a walker or 4-prong cane by the end – or even no assistive equipment at all – but it’s impossible to know for sure.
The best way to ensure your chances of walking after stroke is to do what your therapist asks you to do, and keep pushing.
Inpatient rehab provides access to special equipment and therapists, which can accelerate gait rehabilitation.
Outpatient Rehab with Neurodevelopmental Sequencing
After inpatient rehab, you will continue to work with a therapist during outpatient therapy visits. If your stroke was mild, you might have skipped inpatient rehab altogether.
Regardless of your unique stroke recovery process, outpatient therapy offers another opportunity to keep pushing on your walking skills.
Physical therapists often help stroke patients improve their walking skills through neurodevelopmental sequencing. This refers to the movement progression that infants follow as they grow and develop the ability to crawl, stand, and walk.
Relearning how to walk after neurological injury like stroke means learning the skill all over again, like in childhood. While it can be frustrating and challenging, a good physical therapist can help you make strides in progress.
Here’s a video showing a young stroke survivor going through the process of walking after stroke:
After your time in inpatient and outpatient therapy, recovery at home is in your hands.
Below, you’ll discover different methods to keep improving.
Rehabilitation Methods for Walking After Stroke
By understanding different gait rehabilitation methods, you can continue to improve your walking abilities at home between outpatient therapy visits.
Here are some of the best gait rehabilitation methods for walking after stroke:
1. Rehabilitate Your Legs and Feet
Your feet and leg muscles are the foundation of walking. To walk, you need to put one foot in front of the other.
Many stroke survivors have difficulty moving one of their legs, however, and some survivors have a condition called foot drop, which involves difficulty with dorsiflexion (lifting the front part of your foot).
In order to regain the ability to use these muscles, you need to perform leg and foot drop exercises to retrain your brain.
2. Work on Your Balance and Core
Balance is also crucial for walking.
Aside from your foot and leg exercises, it’s a good idea to practice balance exercises because balance is also crucial for walking and preventing falls.
Balance exercises for stroke patients could involve standing on one leg for a couple minutes a day, or heel-to-toe walking.
Also, don’t forget about your core. Having a strong core is essential for staying balanced while walking.
Be sure to add some core exercises for stroke patients to your daily regimen too.
3. Prioritize Massed Practice
When you practice your stroke rehab exercises, be sure to do them consistently and with high repetition. This repetitive stimulation helps spark neuroplasticity, the mechanism that brain uses to rewire itself and strengthen new skills.
Neuroplasticity occurs based on experience, so whatever you repeatedly experience – or repeatedly practice – determines how your brain will reshape itself. More repetitions means more recovery.
High repetition of rehab exercises for your legs, core, and balance help improve walking skills after stroke.
4. Try Rehab Exercise Devices
Many stroke patients struggle to achieve the high repetition of rehab exercise necessary for recovery, and some devices can help. For example, Flint Rehab’s FitMi home therapy device brings the element of gaming to rehab exercise.
It challenges you to beat your own high scores and accomplish about 23 times more repetition than traditional therapy. FitMi is highly recommended by therapists and patients alike because it helps you get your rehab done.
5. Do Any Necessary Vision and Spatial Awareness Training
Good vision and spatial awareness are important for walking too. You need to be able to see where you’re going and spot any bumps or obstacles in your path.
If you have vision problems after stroke, then you might need vision therapy to improve your vision before you can safely walk.
You should also be aware of a condition known as hemineglect, which can cause stroke patients to be completely unaware of their affected side – and also unaware that they’re unaware.
This can be dangerous when you’re walking as you can bump into things and hurt yourself. Typically, your doctor or therapist will diagnose one-sided neglect, and a caregiver may also be able to pick up on it too.
Walking isn’t just about mobility. You need to check your vision and spatial awareness too.
6. Enjoy Task-Specific Training
Finally, another great method for relearning how to walk after stroke is task-specific training. This means directly practicing the task you want to improve. In this case, that’s walking.
If you want to get better at walking, it helps to just walk. This therapy is only accessible once you regain enough mobility to get on your feet. Even if you need adaptive equipment like a walker, assisted walking is still great therapy.
With all the hard work required to improve your gait, walking is often a fun and rewarding therapy for stroke patients. Just be sure to stay safe by using any equipment your therapist recommends.
Hope for Walking After Stroke
The road to recovery looks different for everyone, and it might be longer for some, like massive stroke survivors.
However, recovery is always possible when you put in the work. By training alongside good therapists, you can improve your gait and relearn how to walk again after a stroke.
By placing emphasis on massed practice and rehab exercise, you can give yourself the best chances of walking again after stroke. Good luck!
Featured image: ©iStock.com/Wavebreakmedia