Stroke occurs more than 100,000 times per year in the UK, once every five minutes (https://www.stroke.org.uk/). A stroke happens when the blood supply to the brain is cut off, which can lead to the death of brain cells and connections between cells, damaging the brain. This can be caused by a blockage which cuts off the blood supply to the brain or a blood vessel in the brain bursting.
The effects of the stroke depend on which part of the brain was damaged and the extent of the damage. The most common types of disability after stroke are changes to speech, learning and understanding, and weakness or paralysis on one side of the body (https://www.ninds.nih.gov/health-information/disorders/stroke). A stroke that affects the left side of the brain for example may affect speech and language and the person’s ability to reason and organise.
One of the incredible things about our brain is that it has the ability to change its structure, form new connections and pathways, rewiring itself – a process known as neuroplasticity (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525913/). Neuroplasticity allows the brain to adapt to injury like a stroke by restructuring itself.
Every time anyone experiences something or learns something new, they are forming new neural connections (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912552/). If a connection or pathway in the brain is used regularly when a skill is practised, then the neural pathway is strengthened and becomes more effortless. “Neurons that Fire Together, Wire Together”. This is why things that take a lot of conscious effort and attention when you are first learning, become automatic and effortless with repeated practice over time. Think of learning to drive a car for example. Initially, there are multiple things to think about and you have to get used to doing numerous things at once, but with time and repetitive efforts, it becomes automatic and requires minimal mental effort. A new pathway has been developed in the brain and a new skill learned.
This means that after a stroke, a person can relearn and improve lost skills and movements, like walking and talking that may have been affected by the stroke. The brain will simply form a new pathway in the brain.
After someone has a stroke, the brain will work around the dead cells and attempt to construct other neural pathways to compensate for what has been damaged (https://pubmed.ncbi.nlm.nih.gov/18180655/).
Rehabilitation activities help the brain in making new neural connections in the healthy parts of your brain. Every time you take an extra step, say a new word or do an exercise, it helps the brain make new connections.
1. Repetition is key
The more you stimulate your brain by practising these tasks, the easier these will become as new connections are formed (French et al., 2016). This is just like learning any new habit, skill or behaviour.
2. The earlier you start the better
Immediately following a stroke or brain injury your brain automatically increases the generation of new cells and the reorganisation response. You can maximise progress by taking advantage of the brain’s process (Marshall et al.2009).
3. Focus specifically on improving the functions that you want to improve
Specific exercises can be done to improve specific functions. For example, increasing social activities will help to develop the frontal cortex, which is responsible for cognitive functions like decision-making and planning. If you want to improve movement and balance, don’t focus on speech exercises (Lotze et al.2006).
4. Intensity matters
The more challenging the better (Ward et al 2017).
5. Focus on the purpose and meaning behind your recovery.
Why is regaining your balance and strength important to you? (Maia et al. 2019) Someone who plays golf may focus on getting back to playing golf with their friends for example.
Exercise has been shown to boost the production of a protein - brain-derived neurotrophic factor (BDNF), that promotes cell growth and connectivity between cells in areas of the brain responsible for learning and motor control (Konopka et al. 2015).
So exercise can help with stroke recovery, as well as improve strength and balance, relieve stress, improve mood and boost your brain health.
Get Plenty of Rest
Research shows that sleep helps to strengthen connections between cells, potentially encouraging greater brain plasticity (Gorgoni et al. 2013).
Research shows that by practising mindfulness, and paying attention to sights, sounds, and feelings (internal and external), you can increase the number of cells in the area of the brain responsible for learning and memory (Lardone et al, 2019).