If you want to regain the ability to walk after stroke, one of the first things you will need to do is strengthen your legs. Fortunately, lower limb stroke rehab techniques can help you accomplish this.
To promote proper gait recovery, no single strategy will suffice. Rather, the most effective treatment uses a combination of approaches.
In this article, you will learn the best ways to promote lower limb rehabilitation after stroke. Some of the exercises we will cover are ones you can do at home. Others will require the help of a therapist.
Best Lower Limb Stroke Rehab Methods
Therapists will often use several types of physical therapy interventions to help you regain proper gait (manner of walking).
The most common lower limb stroke rehab techniques can be grouped into two main categories:
- Passive neurophysiological techniques
- Motor learning
Below we will explain both of these techniques in more detail.
Passive Neurophysiological Techniques
With passive neurophysiological techniques, therapists help patients improve their leg strength by supporting correct movement patterns.
In other words, the therapist moves your legs for you to help your brain re-establish its connection to your muscles. They do this by engaging the brain’s natural neuroplasticity, which you can activate through massed practice exercises.
Unfortunately, after a massive stroke, flaccidity often sets in. This makes it difficult to perform active movement exercises needed to regain movement in your legs, until you have improved your strength a bit.
But the good news is, having someone else do the movement for you still activates neuroplasticity.
That is why, during lower limb stroke rehab, therapists might have you use specialized equipment like an assistive treadmill. This treadmill comes with a harness that holds you up in a standing position. A team of therapists then helps you move your affected leg and foot in a walking motion as the treadmill runs, putting emphasis on re-training the appropriate muscles to activate during each portion of gait.
This type of treadmill can even be used as you regain some strength/movement in your leg – in this case, the therapists will have you try to activate what muscular movements you can during each step you take, and they will assist you with completing the full range of the step.
In the video below, you can see an example of an assistive treadmill in action:
Even though the patient is not moving her legs on her own, the passive movement itself will help rewire her brain until she regains control of her lower limbs.
Motor Learning Techniques
Once the patient regains enough strength in their legs, they can begin using motor learning techniques.
These approaches promote active patient involvement, which means you will be doing most of the movements on your own.
One popular example of motor learning techniques is task-specific training. The basic philosophy behind task specificity is that stroke rehab should target goals that are relevant to the patient. And the best way to do this is to practice those goals directly.
In other words, the best way to learn a skill like walking is to practice the movements needed to walk. If you can’t do it all at once yet, then you can break it down into smaller skills and practice those.
In the next section, we’ll take a look at some specific exercises you can do to accomplish this.
Exercises for Lower Limb Stroke Rehab
Now that you know a little more about the basic types of lower limb stroke rehab, we can show you some exercises that will help you regain control of your legs.
To get the most out of these exercises, make sure to practice them every day. The more you can stimulate your muscles, the stronger the neural pathways your brain creates will become. This will, in turn, give you more control over your leg muscles.
Below are some of the best exercises to use for lower limb stroke rehabilitation:
1. Leg Exercises
Strengthening your leg muscles is crucial for improving your walking and balance skills.
The following are a few exercises you can try at home:
- Hip flexion. Start in a seated position. Try to lift your affected leg up towards your chest, using your hand to assist as necessary when you can’t lift it anymore. Hold for three seconds, then slowly let it down. Repeat on the other leg.
- Knee extension. Sit on a stool or chair. Next, extend (straighten) your knee as far out as you can. Then slowly bring your foot to the floor. Repeat on the other leg. This exercise is a little more advanced so don’t get discouraged if you can’t do it yet.
- Seated marching. Perform the Hip Flexion movement with your affected leg, and lower if back to the ground. Then do the same movement on your non-affected leg. Repeat back and forth between both legs for this “marching” exercise.
2. Foot Drop Exercises
Foot drop is a common result of stroke that impairs dorsiflexion, i.e. your ability to lift the front part of your foot (bringing your toes towards your shin). This can make activities like walking difficult and dangerous.
Therefore, a large part of lower limb stroke rehab will involve retraining the brain to control dorsiflexion. You can do this through foot drop exercises.
Some of the best foot drop exercises include:
- Passive ankle dorsiflexion. Sit in a comfortable position and cross one leg over your other. Then, use your hand to move your toes up towards your shin and back down. Repeat ten times, then switch to your other foot. This exercise is great for patients who have weak or paralyzed ankle muscles.
- Assisted toe raises. If you can only move one foot, this exercise can help you strengthen your other ankle. First, place your strong foot underneath your affected one. Then, use your good foot to lift up your weak foot. Make sure you keep your heel on the ground at all times. Finally, lower the foot back down. Repeat ten times.
- Ankle eversion. Place your affected foot on the ground. Next, lift the outer edge of your foot up, so that the inner portion of your foot is bending inwards. Focus on initiating the movement from your ankle only, do not move your leg. Repeat ten times.
For more examples of foot drop exercises, check out this video:
3. Home Therapy Devices
Finally, to promote a good recovery from stroke and regain lower limb function, you will need to perform a high number of repetitions. For example, animal studies have shown that it takes about 400 to 600 repetitions per day of challenging functional tasks to cause changes in the brain.
This can be hard to do on your own, however, and many stroke patients struggle to reach the number of repetitions necessary to make progress. Most people only perform about 40 repetitions of a task during a traditional PT session. That is only 10% of the required amount.
Rehab devices such as Flint Rehab’s FitMi home therapy can help you overcome this problem. FitMi brings an element of gaming to rehab and challenges you to beat your high score. In fact, the average patient accomplishes about 23 times more repetitions with FitMi than with traditional therapy.
The more exercises you can get done, the faster you can recover leg function. That’s why exercise devices like FitMi are so crucial for lower limb stroke rehab.
Lower Limb Rehabilitation After Stroke
Leg rehabilitation is one of the keys to recovering full independence after stroke.
Because every stroke is different, some of you may need to start with passive techniques such as assistive treadmills, while others might jump straight to active training.
Whatever you start with, the only way to fully regain lower limb function is to persevere. Even if you can only move your foot a little, keep activating your muscles.
With time and practice, the link between your brain and muscles will strengthen, and you’ll find it easier to use your leg again. Good luck!