REHABILITATION & RECOVERY
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Increase Your Endurance
Train Like a Triathlete with Discipline and Persistence
By Lori Ann Bravi
As an Ironman
triathlete and occupational therapist, I often tell my clients that their
rehabilitation after stroke is similar to my training for a triathlon. It takes
persistence, discipline and desire to make progress as an athlete, just as it
does to meet the short- and long-term goals in rehab.
There are many days
when I wake up tired and do not feel like going to swim practice before work.
But I go because I know the importance of steadily and slowly building
strength. There are also times when I do not feel up for the 3-hour bike rides.
It crosses my mind that skipping a workout will not matter in the long run. But
once I get going, I always feel better and stronger. By mid-season, I find that
climbing hills on my bike for long stretches is actually easier and more
enjoyable because I did the prep work for my endurance in the off-season.
Endurance is a key
factor in rehab after stroke. It is actually a very complex part of rehab
because it must be built slowly, yet steadily, in order to positively impact
the daily routine. There is a rule of thumb that states, “for every day spent in bed or in the
hospital, one week of physical activity is required to regain the strength that
was lost.” Stroke survivors must start
slowly and accept that building endurance again will and should take time if approached
correctly. Keeping this in mind, a survivor should work together with a
therapist to create measurable and reasonable goals with slow increases in
important when building endurance. We do not always see the small gains we
make, often mistaking this for not making any progress at all. A survivor may
feel ready to stand in the shower again rather than sit on a tub bench. But in
reality the body is building the endurance needed to tolerate such a complex activity.
If someone is able to handle two minutes of standing at the start, consistency
in rehab will steadily increase those minutes to three, four, five and even
more over time. The greatest successes happen over time, not overnight.
Discipline is also
very important when building endurance. It takes the guesswork out of deciding
whether or not to do the exercises or go to therapy every day. Following a
basic routine in order to stay active will most likely directly increase endurance.
Committing to a program is committing to oneself. Survivors owe it to
themselves to do those additional repetitions of each exercise every day, or
add one new exercise to the routine weekly to increase strength and endurance.
Caregivers can help this process by giving the person encouragement and support
during the rehab process.
Desire is one of the
most important components of building endurance. I can encourage clients to
perform activities or exercises during a therapy session. However, I cannot make
them do the programs at home. In order to see long-term changes that will move
them ahead, the survivor has to want to improve. That is how they will notice
six months later that they are now able to stand in the shower again. With
persistence, discipline and desire survivors can slowly, yet steadily, build
endurance and positively impact their daily routines. Again, caregivers can
help give motivation and feed a survivor’s desire to make progress.
Lori Ann Bravi,
MS, OTR/L is a Level IV Occupational Therapist at the Rehabilitation
Institute of Chicago where she specializes in Neurorehabilitation and serves as
a faculty member with the RIC Academy. She was awarded the Baskin
Award in Research for her publication in Topics In Stroke and is a two-time recipient of the
Buchanan Fellowship for her research in stroke rehabilitation.
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