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How to Improve Memory After Stroke with Cognitive Rehabilitation

senior man doing cognitive rehabilitation exercises on tablet to improve memory after stroke

Poor memory after stroke is a cognitive effect that many survivors struggle with. Fortunately, memory recovery is often possible by healing the brain through cognitive rehabilitation.

This article will teach you how to improve memory after stroke and suggest exercises to try. Use the links below to jump straight to any section:

Why Memory Difficulties Occur After Stroke

Working memory is a skill that allows us to hang onto important information until we need it, sort of like a temporary sticky note in the brain. Our working memory helps us remember to get milk at the store, for instance.

When a stroke impacts the areas of the brain that contribute to memory, these temporary sticky notes may lose their effect. A survivor may forget to grab milk at the store because the impact of the stroke has impaired the brain’s ability to hold onto information.

Fortunately, research shows that cognitive rehabilitation can increase working memory capacity after a stroke. Cognitive rehabilitation involves retraining cognitive functions such as memory and, when necessary, teaching compensation strategies to cope with impaired skills.

A specialist called a Speech-Language Pathologist can help with cognitive rehabilitation after stroke. SLPs are experts in communication. While a large part of their work revolves around restoring language skills, they also help with cognitive-communication skills including memory.

Furthermore, difficulties with language tend to overlap with memory difficulties, making SLPs a great resource for stroke patients that struggle with cognitive tasks.

When cognitive challenges are affecting day-to-day activities, occupational therapists are also able to collaborate with the survivor to adapt or modify the activities and provide compensatory strategies.

How to Improve Memory After Stroke

The brain has an incredible ability to heal after injury and rewire itself. This process is called neuroplasticity, and it’s how all skills are learned or re-learned after a neurological injury like stroke.

Neuroplasticity is activated through massed practice, which involves practicing a skill with high frequency and high repetition. The brain likes to be efficient and adapts to the activities that you practice on a regular basis. It attempts to get better at those skills by strengthening the neural pathways involved in those activities.

For example, when you first learn how a ride a bike, it’s unlikely to be a smooth experience at first. But as you continue to practice, you get better. This is neuroplasticity at work, and the same concept applies to cognitive functions like memory.

Therefore, recovering memory after stroke involves massed practice of memory-specific tasks and exercises. The more you exercise your memory, the better your memory will get.

There are several types of memory exercises for stroke patients that you can try. Before we dig into them, it’s worth emphasizing that a Speech-Language Pathologist is crucial for getting started.

SLPs can help identify any other cognitive impairments you may have (such as aphasia or post-stroke dementia) and create a custom rehabilitation regimen tailored to your unique needs.

Memory Exercises for Stroke Patients to Try at Home

There are two types of memory exercises for stroke patients: rehabilitation exercise and compensation strategies.

Rehabilitation exercise helps encourage neuroplasticity and improve your skills. Compensation strategies offer “shortcuts” around poor memory to help you remember important activities. Below you will find examples of each.

Here are some good rehabilitative memory exercises for stroke patients:

  • Concentration. This card game is a great memory-intensive exercise. You start by placing several pairs of playing cards face down, and then flip them over two at a time. Only when you find two matching cards can you keep them face up. Limiting or increasing the pairs of cards used reduces or intensifies the exercise respectively. (Learn the rules here.)
  • Simon. Simon is an interactive game that involves memorizing sequences. It uses colors to illuminate the sequence, which requires visual memory skills. (Learn the rules here.)
  • CT Speech & Cognitive Therapy App. This app was designed by two SLPs to help individuals access cognitive rehabilitation exercises straight from a phone or tablet. Many of the exercises involve visual working memory and auditory working memory. The app provides an initial assessment to target your problem areas and adjusts exercises to your ability level. (Learn how it works here.)
  • Physical rehabilitation. It turns out that physical rehabilitation exercise not only helps improve mobility but also helps improve memory, a 2019 study found. This provides extra incentive to be consistent with your physical rehabilitation regimen, as it has a carry-over effect onto cognitive rehabilitation too. (See illustrated stroke exercises here.)

As you practice these memory exercises with high repetition, you should notice your memory improving. In the meantime, it’s helpful to have some compensation strategies to help you remember important activities.

Here are some helpful compensation strategies for memory:

  • Reminder apps. Try using a reminder app on your smartphone for important events such as feeding a pet or going to therapy appointments. Try to keep your phone in the same place — ideally a central location that you can hear from most rooms.
  • Routine. It’s also helpful to get into a routine with important activities, such as taking prescribed medication. When possible, you can try pairing it with something else you do daily, such as eating breakfast. By taking your medication with your breakfast every day, you are less likely to forget to take it. Because medication is important, you can double-up on reminders by also programming an alert into your phone.
  • Simplification. Simplifying common activities, such as cooking, can help compensate for memory deficits. For example, rather than making meals with longs lists of ingredients and steps, consider making less complicated foods or using precut fruits and vegetables.
  • Lists. Finally, it’s crucial to keep lists for things you need to remember, such as items you need from the grocery store.

Hopefully these exercises help you get started on your own, and your SLP can add to your regimen as needed.

Now let’s move onto a common question:         

Can Memory Improve on Its Own After a Stroke?

There is some good news when it comes to memory recovery after stroke: Sometimes memory difficulties improve on their own. This phenomenon is known as spontaneous recovery.

Spontaneous recovery usually occurs during the acute (early) stages of recovery. There are a few possible reasons for this: 1) brain swelling is reduced during this time; 2) neuroplasticity is thought to be heightened during the acute stage; and 3) the intensity of rehabilitation is usually highest while individuals participate in inpatient rehabilitation, which requires several hours of therapy per day, during the first few months of recovery.

While the idea of spontaneous recovery provides hope, it should not be relied upon. Instead, a proactive approach is best. By practicing cognitive rehabilitation exercises on a daily basis, you can encourage the brain to continue improving well beyond the acute stages of recovery.

This is why outpatient therapy and home therapy are critical for long-term improvements. Furthermore, convenient therapy apps, like the CT Speech & Cognitive Therapy app, are great for keeping recovery going well after insurance stops covering rehabilitation services.

Improving Memory After Stroke

Impaired memory is a cognitive effect that can be improved through rehabilitation. Speech-Language Pathologists are experts on this issue, and they can create a rehabilitation plan tailored just for you.

The best way to improve memory is to practice memory-intensive cognitive rehabilitation exercises. You will see the best results by working alongside an SLP and also keeping up with cognitive rehabilitation on your own at home.

While spontaneous recovery may occur and provide a boost in memory function, rehabilitation is the best way to maximize outcomes. We hope this post has inspired you to start taking action towards recovery.

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My husband is getting better and better!

“My name is Monica Davis but the person who is using the FitMi is my husband, Jerry. I first came across FitMi on Facebook. I pondered it for nearly a year. In that time, he had PT, OT and Speech therapy, as well as vision therapy.

I got a little more serious about ordering the FitMi when that all ended 7 months after his stroke. I wish I hadn’t waited to order it. He enjoys it and it is quite a workout!

He loves it when he levels up and gets WOO HOOs! It is a wonderful product! His stroke has affected his left side. Quick medical attention, therapy and FitMi have helped him tremendously!”

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FitMi is like your own personal therapist encouraging you to accomplish the high repetition of exercise needed to improve.

When you beat your high score or unlock a new exercise, FitMi provides a little “woo hoo!” as auditory feedback. It’s oddly satisfying and helps motivate you to keep up the great work.

In Jerry’s photo below, you can see him with the FitMi pucks below his feet for one of the leg exercises:

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Many therapists recommend using FitMi at home between outpatient therapy visits and they are amazed by how much faster patients improve when using it.

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