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Walking After Stroke: How to Maximize Your Chances of Recovery
- Published on January 23, 2020
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
Every stroke is different, so every recovery will be different. The chances of walking after stroke vary greatly among patients.
Although it’s difficult to know if or when you will be able to walk again, there are a couple phenomena worth pointing out.
First, the fastest motor recovery occurs within the first 3 months after stroke. After that initial phase, most patients experience a stroke recovery plateau where progress slows down.
This is when most patients are discharged from inpatient rehab, and recovery is in the survivor’s hands. If rehab continues at home, the prognosis is more positive.
With continued rehabilitation, patients can continue to improve their gait for years.
One study analyzed the impact of long-term rehabilitation by analyzing 51 stroke patients that could not walk 3 months post-stroke. Researchers tracked their progress for 2 years.
At the end of the study, 74% of the patients regained their capacity to walk without assistance. That means no walkers or canes.
This shows that the chances of walking after stroke are good, especially if you continue with rehabilitation well after the initial plateau hits.
The process for improving your gait and walking abilities is complex, and we will dig into it next.
Quick Summary
When patients continue with rehabilitation well-after discharge from inpatient rehab, the chances of walking again are high.
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.
Quick Summary
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.
Quick Summary
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.
Quick Summary
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
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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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