Reading back through the most recent blogs I feel as if I am becoming obsessed with both stroke research and the effects of strengthening and balance training! This article will only add further to that feeling of obsession as we will look at an interesting bit of research about the effects of strength and balance training in patients who had a stroke a while ago. I try to keep the blogs varied but recently there have been a load of interesting bits of research and reviews on this topic.

There has always been a general understanding that the majority of recovery after having a stroke occurs in the first 6 months and certainly I think it would be reasonable to say that this is my (and all of our physiotherapists’) clinical experience. After that the research has been inconclusive as to whether patients could make further progress and what might be the best interventions. A recent review on this topic has highlighted the potential to make improvements in balance a significant time post- stroke (specifically in the chronic phase which is after 6mths).

This systematic review looked at a series of trials that examined the effects of exercise therapy (supervised by a physio) on balance in patients who had a stroke over 6 months ago. It found that patients made significant improvements in their balance when doing exercises even though their stroke was a significant time in the past. This is great news for patients and physiotherapists alike as it shows that even if you have had a stroke a long time in the past it is still possible to improve your balance by doing exercises. Now this doesn’t mean that if you have not been able to use your left hand for 3 years that exercises are likely to change that but it does mean that by doing exercises you can improve your balance and reduce risk of falls.

This review certainly matches my own experience with stroke patients who had their stroke several years ago which is that often they have poor balance and general fitness which can be improved with exercises and strengthening and I am happy to say that it supports the general approach to rehab that our physiotherapists take here at ThreeSpires Physiotherapy.

Further details of the review are available either here on the CSP site ( http://www.csp.org.uk/frontline/article/nihr-signal-exercise-therapy-may-still-improve-balance-when-started-long-time-afte )or here on the NIHR site (https://discover.dc.nihr.ac.uk/content/signal-000330/exercise-therapy-may-still-improve-balance-when-started-a-long-time-after-a-stroke )

One final point that is raised by a commentator on the original review on the NIHR site is that this presents a significant challenge to the NHS. Physiotherapy post stroke will continue until patients have stopped making progress but usually this will stop after about 6 months (in some services this is longer but mostly it is around 6 months). Certainly there is no physiotherapy available for patients who had a stroke several years ago and need ongoing physiotherapy to help maintain their balance and strength. I think that this is where our service can really help patients – we are able to see patients a long time after their initial stroke and help them make improvements in both balance and function.

Okay, I hope that you have found this article helpful. If you or anyone you know has had a stroke and would like physiotherapy then please feel free to get in touch. We are a home visit physiotherapy service serving Lichfield, Sutton Coldfield, Tamworth, Cannock, Rugeley and Walsall.