Understanding Exercise

There are many ways to be active, and exercise looks different for everyone. The most important thing is finding an activity that you enjoy and feel comfortable doing, as this makes it easier to keep going over time.

Exercise can include gentle movement, strengthening activities, or activities that benefit your heart and breathing. This might be walking, stretching, seated exercises, using light weights, or other activities adapted to your needs and abilities.

Strengthening exercises help make your muscles stronger. They involve your muscles working against resistance. Resistance is anything that makes your muscles work harder, such as:

• lifting weights
• using exercise bands
• pushing or pulling against something solid

Being stronger can make everyday activities easier. It can also help many parts of your body, including your joints, heart, mental health, and immune system.

When doing strengthening exercises, you may repeat a movement several times. Each movement is called a repetition (or “rep”). A group of repetitions is called a set.

Your therapist may ask you to do a certain number of repetitions and sets. The aim is to work your muscles until they feel tired, as this helps them get stronger over time.

Always exercise at a level that feels safe for you, and follow the advice given by your healthcare professional.

Here are some examples of strengthening exercises: 

• Shoulder flexion
• Shoulder abduction
• Elbow flexion
• Calf raises
• Hamstring curl
• Hip abduction
• Hip flexion
• Small squats

Balance exercises can help to improve your ability to stay steady and control your movements. Improving your balance can make everyday activities safer and easier. It can reduce your risk of falls and help you to feel more confident when moving.

Balance exercises involve activities that gently challenge your ability to maintain control while sitting, standing, or moving. For example:

• weight-shifting while sitting or standing
• standing with less support
• stepping in different directions
• controlled changes of position

Your therapist might ask you to hold positions for a short time or repeat movements several times. Exercises can be adapted or progressed gradually as your balance improves.

Always exercise at a level that feels safe for you, and follow the advice given by your healthcare professional. 

Here are some examples of balance exercises: 

• Reach out of base support (BOS)
• Calf raises
• Sideways walk
• Tandem stand
• Single leg stand
• Feet together
• ½ tandem stand
• Weight shift

Stretching exercises help keep your joints and muscles flexible. If a joint is not moved regularly, it can become stiff and harder to move. This is known as a contracture.

Some neurological conditions can cause muscles to become tight or stiff. This is known as spasticity. If spasticity is not well managed, muscles can stay tight for long periods of time. Over time, this can make joints stiff and increase the risk of developing a contracture.

Contractures can make movement more difficult, affect everyday activities, and sometimes cause discomfort. Regular movement and stretching, and managing spasticity where needed, can help keep joints moving and reduce the risk of contractures.
Stretching exercises may be:

• Active – completing the movement yourself
• Active assisted – using another object to help with the movement
• Passive - another person completing the movement for you

If one side of your body is affected, you may be able to use your stronger arm to help support stretches of the affected arm.

Stretches are generally best completed little and often each day.

Remember - always stretch within a comfortable range and follow the advice given by your healthcare professional.

Stretches should be completed as demonstrated by your therapist.

Ensure that you are aware of your own posture when completing the stretches.

Avoid overstretching, twisting or bending.

Advice for carers when completing assisted or passive stretches with a patient:

Always ensure the patient is comfortable prior to starting stretches.

It is important that the patient understands what you are about to do and why.

Stretches should be made until you feel an end-point resistance, pain is indicated, or the patient informs you to stop.

Remind the patient to inform you if any pain is felt at any time. Keep observing their face for feedback; this is especially important when someone is unable to verbalise pain.

Here are some examples of stretching exercises:

• Calf Stretches
• Hamstring Stretches

Cardiovascular exercise helps improve the health of your heart and lungs. It involves activities that increase your breathing and heart rate, such as walking, cycling, or seated exercise.

It is important to pace yourself and build up activity gradually. Your therapist may advise how often and how long to exercise, based on your individual needs and abilities.

Always exercise at a level that feels safe for you, and follow the advice given by your healthcare professional.