Although improving your walk after a stroke will significantly help with mobility, walking helps overall recovery as well. The therapeutic benefits of improved walking after a stroke are well researched. However, which techniques will work for any particular patient is still unclear.
The months following a stroke are vitally important to recovery, so it is important to take a systematic approach to therapy. Each technique requires close monitoring to gauge improvement, allowing for adjustments or change in technique where appropriate.
Gait and Speed
One aspect of recovery which most therapists agree on is that gait and speed play a large part in successful recovery. Conventional ankle foot orthoses (AFOs), which deal with the proper mechanics of the foot and ankle when walking, can be essential to a normal gait. The use of digital gait analysis can be very effective in monitoring progress.
Many of the therapies you will receive after your stroke will concentrate on improving the mechanics of foot-ankle and knee-ankle movement. The desired result is moving towards a walking speed of around 1.36 m/s (meters per second), in combination with other techniques and support devices.
Orthotic devices may be used to aid walking techniques, depending on the patient’s needs. The rocker shoe is a common artificial device used in stroke recovery. The purpose of the device is to improve gait, when the patient lacks sufficient strength of cognitive control in the early stages of recovery.
Another option is locking the ankle through the use of a brace to aid stability. This technique is usually combined with a rocker sole, with a degree calculated on the individual patient’s ability to remain stable on their feet. Rocker shoes and soles are not suitable for everyone, so it is important to communicate your level of comfort and mobility with your therapist.
Nerve and Brain Stimulation
Electrical stimulation has shown increasing promise in improving gait and speed. Known as functional electrical stimulation (FES), this technique targets the peroneal nerve. Targeting the peroneal nerve has resulted in marked improvement in foot drop for many patients recovering from a stroke. Additionally, the physical effects of FES continue even after the therapy has ended, which allows the patient to indefinitely benefit from improved gait and speed.
In order to re-establish neural connections, repetitive movement is important in post-stroke therapies. In the upper limbs, the working limb is constrained in order to force the use of the affected limb. The same effect is achieved in the lower limbs through the use of targeted exercise. One form of exercise which has shown positive results is split-belt treadmill training.
Perhaps the most important factor in recovery, overall, is tracking improvements in your walk. Stability and gait speed are the two greatest indicators that therapy techniques are having the desired results. The process of measuring improvement is neither complicated nor expensive.
By creating a straight line, measuring 20 metres, you can record the improvement in your gait speed throughout your recovery. While walking at a comfortable pace and speed, you will use a stopwatch to time a 10 metre walk. The time taken to walk 10 metres acts as a marker for improvement, allowing you to record incremental increase or decrease in gait speed.
Your therapist will keep a record of improvements. However, it may also help you to keep your own record for any techniques you follow at home. A pedometer is a device that records distance walked, which you can attach to your clothes. Wearing a pedometer will allow you to record how far you can walk before you start getting tired and need to rest.
Step By Step can help you improve your walk after a stroke through the use of various therapies and devices custom-fit to your specific needs. If you or a loved one have had a stroke recently, contact Step By Step so we can help you regain your independence and get back on your feet.