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Muscle Atrophy After Stroke: Causes and Solutions for Recovery

Physiotherapist helps patient raise dumbbells because he has muscle atrophy after stroke

Muscle atrophy after stroke causes a decrease in muscle mass. This leads to decreased strength and increased risk of injury.

Many stroke patients experience this condition during rehabilitation, and it can be serious. Fortunately, there is hope for recovery.

In this article, you will discover the 3 major causes of muscle atrophy after stroke and how to reverse its effects.

Causes of Muscle Atrophy After Stroke

Muscle atrophy is the deterioration of muscle tissue due to extended periods of inactivity.

All muscles will waste away if you do not exercise them regularly. For example, someone who wears a cast on their arm for a few weeks will lose muscle mass on that arm. This also applies after a stroke.

There are multiple reasons why you might experience muscle atrophy after stroke. Three of the most common include:

  • Learned non-use. Stroke often causes weakness or paralysis on one side of the body. This can lead to learned non-use, a condition where your brain loses its connection to your muscles. This lack of use in turn leads to atrophy of the muscles.
  • Prolonged hospitalization. If a stroke was severe, the patient may need to remain in the hospital for several weeks. This prolonged inactivity will cause muscles to deteriorate.
  • Malnutrition. Finally, stroke can cause difficulties with chewing and swallowing food (also known as dysphagia). This can lead to malnutrition which, if combined with inactivity, can speed up muscle atrophy.

As you can see, stroke causes a number of factors that can lead to muscle loss. Therefore to reverse muscle atrophy, you will need to address these underlying causes.

Preventing and Treating Muscle Atrophy

The consequences of muscle atrophy are severe, as it creates a vicious cycle. The more your muscles deteriorate, the less strength you have to move your muscles. And the less you move your muscles, the more your muscles will atrophy.

That’s why, if possible, it’s important to take measures to prevent muscle atrophy as soon as possible. However, even if your muscle mass has already decreased, these measures can also help you reverse the atrophy and prevent it from getting worse.

The following are a few of the best ways to prevent and treat muscle atrophy after stroke:

1. Treat Hemiplegia with Passive Exercises

therapist helping stroke patient move their arm

If you struggle with hemiplegia – i.e. paralysis on one side of the body – it is crucial for you to address this immediately. The longer you do not move your affected side, the more muscle mass you will lose.

Fortunately, even though you can’t move on your own right now, there are ways to reverse the effects of stroke paralysis.

You will start with passive exercises, which are performed by a therapist who moves your affected limbs for you. As your therapist moves your limbs, this stimulates your brain and activates a process known as neuroplasticity.

Neuroplasticity refers to the brain’s ability to rewire neural pathways. This allows undamaged portions of the brain to take over functions from damaged areas. You can activate neuroplasticity through repetitive, and even passive, movement.

Therefore, the more you passively move your arms or legs, the more you will stimulate your brain and form new neural pathways between your brain and muscles. Eventually, you should regain small amounts of movement.

When this occurs, you can move on to the next step.

2. Strengthen Muscles with Active Exercises

senior man doing bicep curls to reverse his muscle atrophy after stroke

When you regain enough movement in your affected muscles, you can start practicing active stroke rehab exercises.

The more you practice, the more you will reinforce the neural pathways that help you move. Eventually, your strength and control over your muscles will improve.

You can start by simply moving your affected arm or leg without resistance. But as your abilities improve, you should progress to more challenging activities, such as weight-bearing exercises. This will stimulate muscle growth and reverse atrophy.

To fully regain muscle strength will require a high number of repetitions though. For example, animal studies have shown that it takes about 400 to 600 repetitions per day of challenging functional tasks to trigger neuroplasticity and recover movement.

This can be hard to accomplish on your own, but many stroke patients find that rehab tools, such as Flint Rehab’s FitMi home therapy, motivate them to complete more repetitions. In fact, the average patient accomplishes about 23 times more repetitions with FitMi than with traditional therapy.

The more exercises you perform, the faster you will reverse your muscle atrophy after stroke and regain function.

3. Prevent Malnutrition with Speech Therapy Exercises

speech therapist teaching patient how to do speech therapy activities after stroke

Finally, it’s important to address dysphagia after stroke to prevent malnutrition and muscle atrophy.

The best way to do this is through speech therapy exercises. Like other stroke exercises, speech therapy activities harness the power of your brain’s neuroplasticity. This helps you regain control of your swallowing and chewing muscles.

Some good speech therapy activities include:

  • Cheek puff. Take a deep breath through your nose, then puff your cheeks out. Hold the air in your cheeks for five seconds, then exhale slowly. Next, take another deep breath, but this time only hold the air in your left cheek. Repeat 10 times.
  • Tongue strengthening. Stick your tongue straight out. Press the tip of your tongue against a flat stick 2 or 3 times. Then press the stick in towards your mouth while pushing your tongue hard against the stick as if you are trying to force it away. Hold for 5 seconds. Repeat 10 times.

These are just a few examples of speech therapy exercises that can help you improve your swallowing abilities. Talk to a speech therapist for more suggestions.

If you can treat your dysphagia early on in your recovery, you can keep yourself from becoming malnourished. This in turn will prevent more muscle atrophy from occurring.

Reversing Muscle Atrophy After Stroke

In summary, muscle atrophy occurs when muscles deteriorate due to inactivity and poor nutrition.

This triggers a vicious cycle in which muscles weaken and become further neglected, leading to even further atrophy.

To break this cycle and reverse muscle atrophy after stroke, all you need to do is move. If that is not possible, you can begin with passive exercises and slowly work your way up to active weight-bearing activities.

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See how Susan is recovering from post-stroke paralysis

“I had a stroke five years ago causing paralysis on my left side which remains today.

I recently began using FitMi.

At first it was difficult for me to be successful with a few of the exercises but the more I use it, the better my scores become.

I have recently had some movement in my left arm that I did not have before.

I don’t know if I can directly relate this to the use of the FitMi but I am not having occupational therapy so I conclude that it must be benefiting me.

The therapy modality motivates me to use it daily and challenges me to compete against my earlier scores.

I heartily recommend it!-Susan, stroke survivor

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