Most strokes damage one side of the brain, injuring the opposite side of the body. When one side of the body is weakened or paralysed by stroke, the motor movements associated with walking are often affected. Balance can be off and sensation in the legs and feet diminished. Reduced muscle tone is another symptom many stroke victims experience. The sooner physiotherapy begins following a stroke the better. However, depending on the severity of the stroke and the extent of the damage, rehabilitation to help a patient learn how to walk again may begin within a few days or perhaps not for several weeks.
It is not uncommon for stroke patients to develop an abnormal gait pattern as they learn to walk again. Even following an extended period of physiotherapy and rehabilitation, many stroke patients are unable to walk correctly. Whether a stroke leaves a person partially paralysed or with weakened legs, walking impairments increase an individual's risk for falling, as well as affect the quality of the person's life. Recovery time frequently depends on the extent of the neurological damage and the amount of hands-on assistance provided by a physical therapist. A study published in Stroke: Journal of the American Heart Association suggests that stroke patients who are able to walk some on their own may do better when physical therapists help them to walk during rehab. Patients in the therapist-assisted group of the study made more improvement in walking speed than those assisted with robotic devices. They also reported having fewer physical limitations after completing physiotherapy.
A good deal of work goes into taking a single step, as walking involves the movement of many different muscle groups. Sometimes stroke patients must learn the various movements required for walking separately before combining them into a coordinated movement. Although walking normally is a product of the brain sending messages to the muscles in the body telling them how to move, for individuals who have suffered a stroke, the process actually works in reverse. During the initial phases of rehabilitation, the physical therapist manually moves the patient's muscles, which then sends messages to the brain. This is how a patient relearns the movements that will enable her to walk. Another important aspect of a physiotherapy program for relearning how to walk is building the individual's strength and endurance.
Improvement Over Time
How long it takes to walk again following a stroke varies from person to person. For some, it may take only a few months, but for others it may take years. In certain cases, an individual might never regain the total use of a leg. Many stroke patients must continue to use a walker or cane long after recovering from other symptoms related to the stroke. Then again, some individuals who are told that they may never walk again following a stroke make continuous progress.