In the case of existing physical and/or mental limitations, a medical assessment is the first step before starting to practice Yoga.

No matter what the limitation is, Yoga is always possible. Yes, always. Yoga is much more than physical exercise. Even people with significant limitations can practice Yoga.

If a patient is sitting in a wheelchair, the upper body can be mobilized. Bedridden patients can work with visualizations. The brain cannot distinguish whether a movement is carried out or only thought about. The received stimuli reactivate the damaged brain areas. The yogic philosophy gives patients hope and can have a positive effect on mental health.

The term “stroke” does not refer to a specific condition; instead, is a general term summarizing different forms of damage to the brain.

A stroke (apoplexy/apoplectic insult) typically occurs suddenly. In about 80% of cases, occlusion of a blood vessel results in impaired circulation (ischemic infarction). In about 20% of cases, the cause is cerebral bleeding (hemorrhagic infarction).

Insufficient blood supply often results in nerve cell death. The health implications of a stroke depends on the location and extent of damage as well as on how quickly medical assistance occurs.

The life of a stroke patient can change from one minute to the next. A stroke can be accompanied by a range of different symptoms:

Weakness or paralysis (hemiparesis/hemiplegia) of one side of the body or individual parts of the body is one of the most common symptoms and often the main one; many times this is what the patient notices first. Suddenly, they may no longer be able to lift their arm or they may fall because their leg won’t support them anymore. These are serious warning signs!

Often, sensation is reduced in one half or individual parts of the body. Other common symptoms include a tingling or unpleasant sensation on the affected side.

The ability to speak and swallow can also be impaired resulting in adaptation to allow for feeding and nutrition. For example, a nasogastric tube could be necessary to feed the patient on a temporary basis or, if permanent assistance is required, a stomach tube may need to be surgically inserted.

Cognitive performance, retentiveness, and memory function can be reduced. The patient’s personality may change as well. Depression is common, as the patient will need time to get used to the physical impairments, limitations, and other changes they are experiencing.

The ability to act and plan might be reduced. Some patients may no longer be able to use daily objects as intended. For example, they may put their undershirt over their shirt.

Another common problem in the period immediately after a stroke is incontinence. Some patients might struggle to retain urine or cannot retain urine at all. Some may require a permanent urinary catheter, because bladder function can remain reduced. Bowel function can also be affected.

Body perception of the affected side can be reduced. Patients may no longer feel stimuli applied to the affected side. In severe cases, the patient might even “neglect” the affected side completely. Some patients even “forget” that the affected side of their body exists.

Acute phase after a stroke

At the hospital, personal items can make the stay more pleasant. Pictures of family members, flowers, their favorite music or anything else that cheers the patient up can improve the situation. Regular visits, card games or good conversations can also support the healing process.

As a family member can support the patient in this acute phase by the following:

• Address the patient from their affected side and sit on that side when you talk to the patient. This encourages the affected half of the brain to establish new neural connections.
• Speak to the medical staff about using a specific initial touch. For example, lightly touching the patient’s right shoulder before starting a conversation. It alerts the patient to the fact that someone is talking to them. Such an initial touch is commonly used as a support measure for patients with reduced awareness and on intensive care wards especially.
• Close relatives benefit from touching the affected side of the body. Briefly touching the hand can be sufficient. Massaging the hand can also stimulate sensory functions. This stimulus helps the brain to create new connections.
• Take the patient for walks outdoors if that is an option. Nature, natural light and fresh air have a positive impact on mental health.
• Offer support and let the patient know you are there to help.

Depending on the severity of physical and cognitive limitation, the conditions at home and options for support, a patient may return to his/her own home.

If the stroke patient requires more support with daily tasks, home visits by a nurse can be arranged. If extensive support is needed or safety is a concern, a 24-hour nurse might be a suitable option.

An assisted living facility may allow for a greater degree of independence due to improved accessibility. Those who need continued nursing care and rehabilitation may discharge to a skilled nursing facility (SNF). Patients with the most severe strokes may be transferred to a nursing home.

Outpatient therapy is advisable to maintain the gains made during rehabilitation, to make further progress, and to prevent any secondary damage. Depending on the deficits, physical, occupational, and/or speech therapy, as well as psychological support can be beneficial. If the patient’s mobility makes it impossible to visit a therapist, home visits may be available.

With continued therapy, suitable aids, and adaptation of the patient’s home, a high quality of life may be achieved after a stroke. The support of family and friends will be an important source of assistance and comfort for the patient.

Nevertheless, relatives themselves should also take good care of their health. Only if you are well and healthy, you can watch out for others.

Recovery after a stroke often continues long after discharge from hospital or rehabilitation. Alongside physiotherapy, occupational therapy, speech therapy, and family support, technology-assisted rehabilitation can help patients practice meaningful movements with greater intensity, repetition, and motivation.

Our robotic and sensor-based therapy solutions support evidence-based rehabilitation of the upper and lower extremities. Devices such as Amadeo, Diego, Pablo, Myro, Tymo, Lexo, and Omego Plus enable therapists to tailor therapy to each patient’s individual abilities, goals, and stage of recovery.

Through task-oriented training, motivating therapy games, biofeedback, and objective assessments, technology-supported rehabilitation can help patients regain function, improve independence in everyday life, and stay engaged throughout their recovery journey.

Progressive resistance training is a form of strength training after a stroke. The intensity of the selected exercises increases continuously. The muscles slowly adjust to the increasing strain.

circuit class training is used to train strength stamina. Different exercises are combined to address different muscle groups. This type of training brings variety and increases motivation. Each exercise is repeated 15 to 20 times. There are short breaks between exercises.
Below you will find some exercise recommendations for circuit class training of the lower extremities. The basis for every exercise is an upright position.

• Do alternating side taps with the left and the right leg.
• Do alternating steps forward with the left leg and the right leg, respectively, and always step back with each leg after making the step forward. The steps should be about the same size.
• Alternately rotate your toes outwards or inwards. In doing so, the weight is slightly shifted to the heels.
• Push up to tiptoe and lower again. The exercise can be performed with or without stopping.
• If your strength and coordination allow, try making small jumps with both legs. Be sure to land on the floor with both legs at the same time.

Discuss the exercises with your physiotherapist or occupational therapist to adapt them to your individual possibilities.