Stroke Recovery Exercises: Home Rehabilitation Guide

Stroke recovery is a journey that continues long after hospital discharge. Home-based exercises are crucial for regaining movement, strength, and independence. This guide provides practical exercises and strategies for effective stroke rehabilitation at home.

Understanding stroke recovery

Stroke recovery varies greatly between individuals depending on:

• Severity and location of stroke
• Which side of body is affected
• Age and overall health
• Speed of treatment
• Commitment to rehabilitation

Recovery timeline

• First 3 months: Most rapid recovery
• 3-6 months: Continued significant improvement
• 6-12 months: Ongoing gains with effort
• Beyond 1 year: Further improvement possible

Key principles of stroke rehabilitation

Neuroplasticity

The brain can rewire itself and form new connections. This requires:

• Repetition of movements
• Consistent practice
• Challenging but achievable tasks
• Focused attention

Use it or lose it

• Use affected limbs as much as possible
• Avoid learned non-use
• Include affected side in daily activities
• Practice functional tasks

Task-specific training

• Practice actual activities you want to do
• Real-world movements
• Meaningful to you
• Transfers to daily life

Arm and hand exercises

Passive range of motion

If you cannot move arm yourself:

1. Use unaffected hand to move affected arm
2. Move through full range gently
3. Shoulder, elbow, wrist, fingers
4. 10 repetitions each movement
5. 3-4 times daily

Active-assisted exercises

If you have some movement:

• Clasp hands together
• Lift arms overhead
• Reach forward and to sides
• Unaffected arm helps affected arm
• 10 reps, 3 times daily

Strengthening exercises

As movement returns:

• Reaching for objects
• Lifting light weights
• Resistance band exercises
• Pushing and pulling activities
• Functional tasks (dressing, eating)

Hand exercises

• Opening and closing fist
• Finger spreads
• Thumb to each finger
• Picking up small objects
• Squeezing therapy putty

Leg exercises

In bed or sitting

• Ankle pumps: 20 reps, hourly
• Knee bends: Slide heel towards buttock
• Hip flexion: Lift knee towards chest
• Leg straightening: Tighten thigh, straighten knee
• Hip abduction: Move leg out to side

Standing exercises

• Weight shifting side to side
• Marching on spot
• Hip extension: Leg back behind you
• Knee bends (mini squats)
• Heel raises

Walking practice

• Practice daily, multiple times
• Use walking aid if needed
• Focus on quality of movement
• Gradually increase distance
• Practice different surfaces

Balance exercises

Sitting balance

• Sit unsupported if able
• Reach in different directions
• Weight shift side to side
• Trunk rotations

Standing balance

• Stand with support initially
• Progress to less support
• Weight shifting
• Single leg stands (supported)
• Tandem stance

Transfers and mobility

Bed mobility

• Rolling to affected side
• Rolling to unaffected side
• Moving up and down in bed
• Sitting up from lying
• Lying down from sitting

Sit-to-stand

Key technique:

1. Shuffle forward in chair
2. Feet flat on floor
3. Lean forward (nose over toes)
4. Push through legs to stand
5. Practice 10 times, 3 times daily

Stairs

Going up: Unaffected leg first

Going down: Affected leg first

Remember: "Up with the good, down with the bad"

Functional activities

Self-care tasks

• Washing and dressing
• Brushing teeth
• Combing hair
• Eating and drinking
• Using toilet

Household tasks

• Making tea or coffee
• Preparing simple meals
• Light cleaning
• Folding laundry
• Watering plants

Managing spasticity

What is spasticity?

Muscle stiffness and tightness common after stroke. Can affect movement and cause discomfort.

Management strategies

• Regular stretching
• Positioning affected limbs correctly
• Gentle range of motion exercises
• Heat therapy
• Medication if prescribed
• Avoid triggers (pain, cold, infection)

Preventing complications

Shoulder pain

• Support arm when sitting
• Do not pull on affected arm
• Regular shoulder exercises
• Correct positioning
• Seek help if pain develops

Contractures

• Daily stretching
• Full range of motion exercises
• Correct positioning
• Splints if recommended

Falls

• Use walking aid if needed
• Remove home hazards
• Good lighting
• Non-slip footwear
• Balance exercises

Daily exercise routine

Overcoming challenges

Fatigue

• Very common after stroke
• Exercise when energy highest
• Short frequent sessions
• Rest between activities
• Gradually build stamina

Motivation

• Set meaningful goals
• Track progress
• Celebrate small wins
• Exercise with family
• Join stroke support group

Frustration

• Recovery takes time
• Progress is not linear
• Focus on what you can do
• Be patient with yourself
• Seek emotional support

The role of professional support

Elderly Rehabilitation & Exercise provides:

• Assessment of specific deficits
• Personalized exercise programme
• Hands-on treatment
• Progression guidance
• Problem-solving
• Motivation and support

Family involvement

How families can help

• Encourage daily exercises
• Assist with exercises if needed
• Provide emotional support
• Help with functional practice
• Be patient and positive
• Celebrate progress

Important principles

• Encourage use of affected side
• Allow extra time for tasks
• Provide appropriate assistance
• Avoid doing everything for them
• Focus on abilities

Long-term recovery

Continuing improvement

• Recovery continues beyond first year
• Requires ongoing effort
• Consistent practice essential
• Never give up

Maintaining gains

• Continue exercises indefinitely
• Stay active
• Challenge yourself
• Set new goals
• Prevent deconditioning

The bottom line

Effective stroke recovery at home requires:

• Daily exercise and practice
• Repetition of movements
• Using affected side in daily activities
• Functional task practice
• Consistent effort over time
• Professional guidance
• Family support
• Patience and persistence

Stroke recovery is challenging but most people can make significant improvements with the right approach. The key is starting early, practicing consistently, and never giving up. Every repetition helps your brain rewire and recover function.

About the author

Lizzie Thornton is a specialist community physiotherapist with over 15 years of experience in stroke rehabilitation. She is HCPC registered and a member of the Chartered Society of Physiotherapy. Lizzie provides home physiotherapy visits across Staffordshire Moorlands and Cheshire East, helping stroke survivors regain function and independence.

View Lizzie's profile