Sleep And Rest
During sleep, there’s little or no conscious thought, sensation or movement. Most people need
seven to eight hours of sleep each night. Sleep provides important rest for the mind and body.
Lack of sleep can cause people to be irritable and have trouble concentrating. After the stroke,
you may sleep a lot or have trouble falling or staying asleep. The hospital routine also may affect
your sleep. As you adjust, it will become easier to develop a regular sleep cycle. Your diet,
exercise level and emotional status will affect how well you sleep. Rest is an important part of
health. Rest can be defi ned as a relief from anything distressing or disturbing, allowing peace of
mind and mental and emotional calm. Besides sleep, rest can include leisure and meditation time.
Exercise can help improve your overall energy to perform daily self-care, decrease the number of
medical complications such as pressure sores, limit muscle loss and joint problems, control weight
and improve how you feel about yourself. Exercise includes stretching for fl exibility, aerobic
activity for cardio-respiratory exercise and muscle strengthening. All of these are key to a good
fi tness program and will help you stay healthy.
Flexibility is important for keeping your joints and muscles in good condition. This is done through
stretching exercises. Your therapists refer to these exercises as range or passive range of motion
(ROM). Stretching of each joint should be done through the full movement of the joint. The stretch
is held for several seconds at the end of the range. This type of exercise improves circulation and
prevents tightening of the joint and the muscles surrounding the joint. Stretching of the shoulders,
elbows, wrists, fi ngers, hips, knees, ankles and toes should be done before and after you work
out or at least once a day.
Aerobic or cardio-respiratory exercise involves doing activities that will increase and maintain
your heart rate at a moderate level over a period of several minutes. The benefits of aerobic
exercise include strengthening the heart and lungs, helping to make good cholesterol and
increasing bone strength. In general, this type of exercise should be done for 20-30 minutes, three
to five days per week. Some examples of aerobic exercise that you may be able to participate
in are: walking, jogging and stationary cycling. Regular aerobic exercise will help increase your
energy to participate in daily work, school or homemaking activities. Check with your doctor to
make sure it’s OK for you to start. You will need to know what kind of exercise is safe for you.
More safety tips are listed at the end of this section.
It’s important to strengthen your muscles. Strong muscles will make it easier to perform the
physical activities you do. Exercises that increase muscle strength are activities such as
calisthenics, which use your own body weight, lifting free weights or using equipment that
promotes muscle strengthening. By placing a demand on the muscles, as with weight, over a
certain amount of time, muscles get stronger. Again, as with other forms of exercise, check with
your doctor before starting your program, especially if you have other medical conditions such
as hypertension (high blood pressure) and heart disease. You also need to know specifi cally
what muscles can be exercised. You should receive instruction from a qualifi ed professional
experienced in working with persons with stroke on the correct way to perform the exercise
initially and for supervision initially and as needed. Performing the exercises in the correct way is
important to prevent injury. If muscles are weak, it’s important to start slowly and strengthen them
gradually. Don’t overtax your muscles.
Tips for Developing a Well-Designed Strength Training Program:
- Your program should be well balanced and include exercises when appropriate for all major
muscle groups of the upper body, lower body and trunk.
- All exercises should be done in a slow and controlled manner. Form and technique should be the focus, not how much weight is being lifted.
- Proper breathing can be just as important as proper lifting technique. Exhale when exerting the
most effort in the lift. Never hold your breath.
- To develop muscular strength and endurance, perform a higher number of repetitions of each
exercise with a moderate weight load. For example, an appropriate beginning program may
include performing two sets of 15 repetitions of each exercise.
- Start your exercise program slowly. Building endurance, strength and fl exibility is a gradual
- If using equipment, make sure it’s in good working condition.
- Make sure you wear the proper clothing and protective gear when needed.
- If you feel dizzy or lightheaded, stop exercising.
- Drink water while you’re exercising so that you don’t become dehydrated.
- Perform a warm-up at the beginning and a cool-down at the end of the exercise.
- When learning new exercises, get instruction from someone who is qualifi ed and has worked
with people with stroke. Your physical therapist can be a good resource.
Keeping physically fit after a stroke can be a challenge. Starting and keeping with an excellent
program takes initiative, planning, time management and follow through. You’ll need to use the
cognitive and physical compensatory techniques learned during your rehabilitation. You’ll also
need to consider if help or supervision is necessary for your safety.
Use the following suggestions to help you choose an exercise plan or activity that you can
Do I want to exercise alone (if safe to do so) or with others?
Do I want to do something where I’ll meet new people?
Do I prefer to be indoors or outdoors? What will I do as the weather changes?
Do I need help or supervision during activity?
Will I be able to or want to do this activity as I grow older?
Emotions and Health
Another part of health and wellness includes your mind, emotions and spiritual self. Emotions
or feelings that we hold back can be bad for our health, even causing us to become sick.
Everyone who has had a stroke goes through a variety of feelings that may be confusing or even
frightening. How you handle these emotions will be important to your physical health. Troubling
emotions that are not resolved can make you tired, give you headaches and stomach trouble
or just make you feel “under the weather” all the time. It can be helpful to think about how you
dealt with your feelings before the stroke, whether it was through meditation, talking with a
psychologist, or talking with a family member, spouse or friend and try the same thing now.
Environment and Health
The environment you live and work in will affect your goal for a healthy lifestyle. Your environment
includes your neighborhood and home. Issues that affect your health in your environment include
accessibility as well as support, involvement and stability from friends and family.
Transportation options, work access, being able to get to the grocery store, pharmacy, restaurants, doctor’s
office, therapy office and closeness to friends are important to think about in relationship to your
own personal, physical and emotional goals.
Your ability to get around in your home, including in and out of the bathroom, bedroom, kitchen and the amount of independence you have, will affect
your feelings about yourself. How people interact with you and each other at home and at work will affect your health.
Think about these things before your discharge from the hospital to make your living environment as accessible as possible. Your level of independence (physical and cognitive), work goals and your financial status will influence decisions about your living environment.