Traditionally, after a stroke, patients do physical therapy that recruits the legs, including gait exercises and balance training. But a new study published in the Journal of Neurophysiology found that regularly exercising your arms can also help recover walking ability.
Researchers from the University of Victoria in Canada found that stroke patients who did moderate-intensity rhythmic arm cycling for 30 minutes, three times a week, performed significantly better on walking tests after five weeks of training. The participants ranged in age from 57 to 87 years old, and all had suffered a stroke between seven months and 17 years earlier.
To measure walking improvements, the researchers had participants do three tests before and after arm cycling training. Test 1 measured how far they walked in six minutes; Test 2 recorded how fast they walked 10 meters; and Test 3 (officially named Timed Up and Go) determined how long it took them to stand from sitting, walk 10 feet, then return to sit in their starting place. The participants improved on all of these tests, especially the Timed Up and Go.
The advancements in walking, balance, and muscle activity seen in this study echo those reported in previous ones that combined both arm and leg cycling to rehabilitate stroke patients. But how can exercising the arms alone lead to better leg function?
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The answer is neuroplasticity, or your brain’s ability to adapt, says Ira Rashbaum, MD, a clinical professor at NYU School of Medicine who was not involved with the study, and past medical director of stroke rehabilitation at NYU Langone’s Rusk Rehabilitation. “The brain is a very dynamic organ and has the ability to a certain degree to restructure itself throughout your life,” he explains. For instance, “in 2006 there was an article that showed with certain types of rehabilitative interventions, parts of the brain that had dealt with sensation (somatosensory cortex) could actually be remodeled to motor cortex [the part that deals with voluntary movement]. And so some of these cells can essentially flip from doing sensory functions to doing strength functions.”
In the case of this recent study, arm cycling likely created a similar effect of neuroplasticity, Rashbaum says. So when nerves in the patients’ arms fired up, they may have stimulated function elsewhere in the body to make up for areas damaged by stroke, thus helping with walking ability.
The results are promising, and yet another reminder that what we know about stroke rehabilitation—from recovery timeline to treatment—is ever-changing. “Most of the recovery we see after a stroke occurs within three months’ time, but particularly with things like speech, language, cognition, and thinking, those kinds of recovery can occur for even years after,” says Rashbaum. “And with some newer techniques … we’re also seeing some improvement in walking well after a year after the stroke.” (This is what it’s like to have a stroke at 44.)
One such technique is called body weight supported treadmill training (BWSTT), where a harness offloads some of a stroke patient’s body weight and prevents them from falling as they ease back into walking with the help of a rehabilitation therapist.
Of course, the best way to minimize the impact of a stroke is to recognize the signs of one early and seek medical attention immediately. (Here’s how to spot a stroke before it’s too late.) Rashbaum suggests using the BE FAST (Balance, Eyes, Face, Arm, Speech, Time to call 9-1-1) method to check for scary symptoms affecting these areas, such as face drooping or garbled speech. “If you have any concern that things are not neurologically fine, you should seek emergent care.”