After a stroke, one side of the body often becomes weak, heavy or hard to control. This is called hemiplegia (paralysis of one side) or hemiparesis (weakness of one side). Regular, repeated practice is what helps the brain relearn movement, and much of that practice can happen at home between physiotherapy sessions.
The exercises below are commonly used in stroke rehab, arranged from easier to harder. They are general examples. Your physiotherapist should check which ones are right for the patient, because doing exercises that are too hard can lead to falls, shoulder injury or frustration.
Safety first
- Check that blood pressure is under control as advised by the doctor before starting exercise.
- Never pull or lift the patient by the weak arm. This can injure the shoulder.
- For any standing exercise, a caregiver should stand on the weak side, and a sturdy chair or counter must be in reach.
- Exercise in a cool, ventilated room and keep water nearby, especially in the Jaipur summer.
- Short sessions spread through the day are better than one long, exhausting session.
Stop if the patient has chest pain, breathlessness, dizziness, sudden headache, new confusion, or new weakness or speech difficulty. New neurological symptoms need emergency care immediately.
Level 1: Exercises in bed
Assisted shoulder movement
Lying on the back, the patient clasps both hands together, fingers interlocked, and uses the strong arm to help lift both arms slowly up towards the ceiling, only as far as is comfortable, then lowers them. Do 10 repetitions, 2 times a day. Stop before any shoulder pain.
Heel slides
Lying on the back, slide the heel of the weak leg up towards the bottom, bending the knee, then slide it back down. A caregiver may assist. Do 10 repetitions, 2 sets.
Bridging
With both knees bent and feet flat, press through both feet and lift the hips off the bed for 3 to 5 seconds, then lower. Do 8 to 10 repetitions. The caregiver can hold the weak knee steady. Bridging builds hip strength needed for standing and also helps with using a bedpan and moving up the bed.
Rolling practice
Bend the knees, clasp the hands, and turn the knees and arms together to roll onto the side. Practise rolling to both sides 5 times each. Rolling towards the weak side is often easier at first.
Level 2: Exercises in sitting
Sitting balance and weight shift
Sit on the edge of the bed or a firm chair, feet flat on the floor and hands resting on the thighs. Shift weight slowly towards the weak side and back to the middle, then forward and back. Do 10 shifts in each direction. A caregiver should sit or stand close by.
Reaching
Place objects at different distances on a table. Reach forward and to the sides with the weak hand if possible, or with both hands clasped. Do 10 reaches, 2 sets. Reaching across the body also trains trunk control.
Knee straightening and marching
Sitting tall, straighten the weak knee and hold 3 seconds, then lower. Then lift the knee up a little as if marching. Do 10 of each, 2 sets.
Ankle movements
With the heel on the floor, lift the toes and front of the foot up, then lower. If the foot cannot lift yet, a caregiver can help. Do 10 to 15 repetitions. This is important for foot drop.
Level 3: Standing exercises
Only start these once the patient can sit steadily and the physiotherapist has cleared standing practice.
Sit-to-stand
Sit near the front of a firm chair with both feet back and the weak foot slightly behind if possible, so it takes weight. Lean forward "nose over toes" and stand up, with help if needed. Sit back down slowly. Do 5 to 10 repetitions, 2 sets. This is one of the most valuable exercises after stroke.
Standing weight shift
Standing at the counter, shift weight onto the weak leg and hold for 5 seconds, then back to the middle. Do 10 repetitions. Watch that the weak knee does not snap backwards or buckle.
Stepping practice
Holding the counter, step the strong foot forward and back while the weak leg takes the weight. Then try stepping the weak foot forward and back. Do 10 steps each, 2 sets.
Mini squats
Holding the counter, bend both knees slightly and straighten. Do 8 to 10 repetitions. Keep weight evenly on both feet.
Arm and hand practice
Hand recovery is often slower than leg recovery, but regular practice helps.
- Weight-bearing through the arm: sitting, place the weak hand flat on the bed beside you with the elbow straight (support it if needed) and lean gently onto it for 10 to 20 seconds. Repeat 5 times.
- Grasp and release: squeeze a soft ball or rolled cloth and let go, 10 to 15 times.
- Wrist lifts: with the forearm resting on a table, lift the back of the hand up, 10 times.
- Functional tasks: moving cups, stacking small boxes, turning pages or picking up large beads, 5 to 10 minutes a day.
If some movement is present in the hand, your physiotherapist may encourage using the weak hand in daily tasks as much as possible, while the stronger hand rests. This idea, used in constraint-induced therapy, should be planned by a professional.
How much practice is enough?
Repetition drives recovery. Aim for exercise sessions two to three times a day, even if each is only 15 to 20 minutes. Use daily activities as practice too: standing to brush teeth, reaching for a glass with the weak hand, or walking a few extra steps to the dining table.
When to see a doctor urgently
- New or worsening weakness, face drooping or speech difficulty: call for emergency help
- Severe headache or a seizure
- A painful, swollen calf, which can be a blood clot
- A fall with head injury, or severe pain after a fall
- A swollen, hot or very painful shoulder or hand
Physiotherapy at home in Jaipur
Home exercises work best when they are chosen for the patient's level and checked regularly. At LifeWell Physio, Dr. Rohit Kumar teaches these exercises at home in Jaipur, corrects technique, trains the caregiver and progresses the programme as recovery continues. Learn more about our stroke and paralysis rehabilitation at home, or see stroke rehabilitation in Mansarovar, Jaipur.
For a personalised home exercise plan after stroke, send a WhatsApp enquiry to LifeWell Physio.
This article is general health information from a physiotherapist and is not a substitute for a personal assessment or medical advice. If symptoms are severe, sudden or getting worse, please see a doctor.
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- #Stroke exercises
- #Home exercises
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