If you haven’t guessed from my previous blogs on Multiple Sclerosis and Parkinson’s Disease, I’m very passionate about the importance of incorporating Pilates into daily routines for people with neurological conditions. This time, I want to turn the spotlight on one of the leading causes of disability – cerebrovascular accident, more commonly known as stroke.
A stroke occurs when there is an obstruction of blood flow to the brain, or a blood vessel actually bursts causing damage to surrounding area. The effects of this have a wide range depending on the area of the brain that is damaged, how quickly treatment was received, and a number of other factors. Typically, one side of the body is affected after someone has a stroke, leading to weakness, sensation changes, speech impairment, difficulty with sensing joint position, muscle tone changes, impaired coordination, visual changes, and balance impairments on the affected side. While not all of these things are evident following a stroke, these are some of the most common changes that can occur following damage to one hemisphere of the brain.
So how can Pilates help? The good news is that the brain is an INCREDIBLE structure and has the ability to change itself over time. Neuroplasticity refers to the brain’s ability to lay down new neural pathways following tissue damage. However, another important phrase to keep in mind in the world of neurorecovery is “if you don’t use it, you lose it.” That is to say, if you don’t engage the affected side of your body in repetitive daily use, you will not make functional gains and will likely see even more weakness over time. Enter: The Reformer. I love all Pilates equipment, but the Reformer is my favorite for using with someone following a stroke. The use of spring-loaded equipment helps provide assistance into certain movement patterns that are difficult to attain while at the same time providing resistance for the weak muscles. Additionally, the freedom of changing one’s foot position on the foot bar allows for increased weight bearing through both legs and provides better information to the body of where the the limbs are in space (often difficult for someone to feel when there leg is swinging in the air during walking). Using the feet-in-straps exercise is also a great tool to help the client visualize how they have one side moving smoother than the other and you can focus in on symmetrical movement in an effort to get the affected limb to move more in sync with the unaffected side.
A word we use often in the neurophysical therapy world is “salience,” which signifies that a task must be meaningful to a client. Research has found that someone will have better neurorecovery if salience is incorporated throughout their treatment. I have found that this is so much easier for me to make happen with pilates equipment than with traditional gym equipment. Do you want to get back to golfing? Great – I can help you mimic a golf swing in at least 1,356 different ways. Want to be able to play on the ground with your grandchildren? Awesome – I have plenty of ways to help you practice sitting to standing from a low surface and in a safe environment. Want to get back to running? I have a jump board that can help with that. Really, I find that the possibilities are endless and the versatility of the equipment helps me fine-tune my session with someone exactly to what their desires and goals are.
In summary, if you or someone you know has suffered from a stroke and is looking for an alternative way to help address your deficits, Pilates may be a great option for you! If pilates isn’t in the cards for you just yet, the most important thing you can do is to KEEP MOVING. According to the CDC, 1 in 4 people that have already had a stroke will have another one in their lifetime, and 80% of strokes are preventable. Exercise is one of the top ways to help prevent these strokes. So get out there and get your health back!
Kelsey Garcia DPT, PMA-CPT
Board-Certified Neurologic Clinical Specialist