Strokes affect survivors differently, depending on the location of the blockage or rupture in their brains, the severity of the injury, and the time it takes to receive treatment. That means each survivor faces unique challenges when it comes to balance, mobility, speech and cognition.
But having a stroke doesn’t mean your active life is behind you. It just means you have a challenging road ahead, and having the right guide can make all the difference.
We spoke with three OhioHealth stroke rehabilitation specialists who explained the personalized stroke rehabilitation programs available at OhioHealth, shared their tips on how to get back to activity after stroke, and reflected on their personal connection to their work.
Hurdles to healthy living
Jumping back into exercise after stroke can be challenging both physically and psychologically.
“It’s easy to become less active after a stroke because of the physical limitations a person may be experiencing. Sometimes doing anything is just harder,” says physical therapist assistant Tina Koziatek. “Being active after a stroke is so important for continued recovery. Exercise can increase muscle strength, help maintain and improve bone and heart health, and positively affect mood.”
“Depression can play a role, too,” says Nicholas Smith, an exercise physiologist and administrator of OhioHealth’s stroke and brain injury fitness programs. “With neurologic deficits, it can take a long time to make progress and see results, and that can be frustrating to people.”
Having access to suitable exercise equipment can also be an obstacle, says Koziatek. “Unfortunately, the options in regular fitness centers for stroke survivors can be very limited. Patients may not be able to use the equipment properly, set the pins to adjust the weight or resistance, or even get on and off the machines safely.”
“And many medical fitness centers like McConnell have outpatient cardiac rehab programs, but it doesn’t seem as popular to have a post-stroke rehab program or classes,” says OhioHealth clinical exercise physiologist Tony Hansen.
Creating opportunities for activity
To help fill this need for continuing stroke rehabilitation, OhioHealth has developed two programs — the Transitional Neuro Fitness Program, a six-week program that involves one-on-one coaching for people with fewer physical limitations, and Staying Fit Following Stroke and Brain Injury, a 12-week group exercise program for people who may have more significant physical limitations or difficulty walking.
“Most of the clients who go through our program are acquired brain injury clients who have completed inpatient or outpatient rehabilitation with their care team,” says Koziatek, who works with patients in the 12-week program. “We assess each patient to make sure they meet the criteria to safely participate in the program. Some folks might meet the criteria but may still require assistance from a family member or aide.”
“Our six-week program is more of an advanced, one-on-one, well-rounded aerobic and conditioning program,” says Smith. “We cover what’s safe, what’s appropriate, what’s good, what’s not. And participants in our program don’t really need someone to help them or assistance devices.”
“We want to help people transition safely from a clinical setting to an independent setting, and make sure they are able to stay as active as possible for the rest of their lives,” says Hansen. “We talk through the basic components of an exercise routine, encourage people to get cardiovascular activity three or more days a week, and teach them to train with resistance bands or their own body weight to improve balance and strength.”
Being around people who understand you
All three say the benefits of their programs and others like them for people with brain injuries are that you are working out with people who understand your condition and share your experience.
“People can have physical, emotional or psychological changes resulting from their stroke, and it’s helpful to be among people who understand that and are supportive,” says Hansen.
“Research shows group exercise is beneficial and motivational, especially in settings like this. People are sharing an experience with others who understand what you’re going through. The group experience can motivate a person to keep going,” says Koziatek. “As trainers, we also know each person well and what their needs are. A personal trainer at a neighborhood gym might not know what is and isn’t appropriate for a person with physical limitations to attempt.”
“We can adapt our equipment with straps and other modifications to keep patients moving and make it easy to get on and off the equipment,” says Hansen. “Because we have a clinical background, we know how to work with people who have physical limitations, to keep them from trying too hard and doing too much.”
“When some people start the program, they can be skeptical or hesitant, but it helps to have people around them with a positive attitude who keep them optimistic,” says Smith. “In our work, even a slight thing like the flexion of an ankle or a change in the range of movement of the shoulder is a big step that can be challenging to achieve, and it’s good to share that with people who appreciate the effort.”
Connected to the work
“I had a stroke myself when I was 15. I have a hereditary blood clotting disorder that causes my body to naturally create too many thrombocytes or red blood cells. I had a full-blown stroke and thankfully recovered,” says Smith. “It was a wake-up call for me and led me to a career in neuro recovery. It hits close to home, and I really enjoy working with people in recovery.”
“This work has kept me here for 15 years,” says Hansen. “I enjoy seeing people progress, feeling better than when they came. It’s very rewarding.”
“I’m a true believer in the idea the everyone can have wellness,” says Koziatek. “Our hope is that once people complete our programs, they’ll be empowered to continue on their own. The people who come to us genuinely want to exercise and recover as much as possible, and it gives them hope to know that they’re not on the journey alone.”
To learn more about OhioHealth’s stroke and brain injury fitness programs, call (614) 788.9261.