The word exercise makes different sense to different experts like OrthopaedicTherapist, Physical trainer, sports trainer, yoga teacher and Masseur, Taichi trainer, Chiropractors,Traditional neuro therapist etc
What does an exercise mean for a patient with brain stroke?
For a stroke patient exercise means that his brain must be made to exercise to restore the lost sensory motor control. It is important to remember that paralysis and the weakness in the muscle is because of brain lesion and muscle is simply a victim and not the root cause of the symptom therefore victimizing the muscle further by acting on the muscle alone not only does not help return of lost control but may abuse the muscle resulting into abnormal movements, spasticity, rigidity, paraesthesia, abnormal sensation, neglect which may become difficult to reverse with passage of time unless brain is helped to re-reorganise.
For a stroke patient what exercises must not be done is as important as what must be done.
Wrong exercises repeatedly done leads to long term memory of abnormal movement with passage of time which is difficult to erase.
Use of external support may turn affected leg into a prop making restoration of the lost control of the affected side a difficult task because paretic leg influences the paretic arm to go into spastic abnormal flexion posture as everything is connected to everything else in the brain.
Use of good upper limb to sit down and stand up has dire consequences on retriving the affected limbs to get back to its earlier automatic function. Stroke patient may remain stroke for the rest of his life if, this is permitted for so called functional independance.
Use of bicycle for cardio vascular benefitsÂ makes good leg to move the affected leg passively. This is definitely not so good for the Brain, rather it makes the brain learn to compensate.
Passive movements of arm and leg done by others on the patient is forbidden by VASA CONCEPT because passivity makes the patient psychologically dependant on others and this dependancy has grave consequences for the brain from becoming self reliant.
Many a times passive movement could trigger painful shoulder hand syndrome if, flaccid subluxated shoulder is mal handled in ignorance.
Stroke patient's goal of exercise is to re integrate the paralyzed side with good side and prevent the good side from becoming an engine towing the affected side all the time.
Exercises designed with VASA CONCEPT triggers the brain to respond "here & now" that brings positive changes on day-to-day bases to make restoration of lost control possible and victory over brain stroke a reality.
This is a daunting task and needs skilled therapist to transfer VASA CONCEPT into an action plan for the brain stroke subject who implements the action plan rigorously for long hours of the day with total commitment and responsibility on the self under the supervision of an expert to achieve results to his or her expectations.
How does the time factor affect the return of lost motor control?
Time factor is very important factor in terms of returning of the lost motor control in minimum period of time before any type of abnormal movements sets in as part of natural recovery.
Abnormal movements sets in with passage of time. Motor recovery can be made possible in stroke patient even after more than 10 years have passed, the only difficulty is the need to take a "long and wide u turn" from the memory of the abnormal movement that got fixed in the brain with time lost. In such a case patient needs to be strongly motivated to be prepared to work hard to undo the abnormal and replace it with near normal movements.