Traumstrand auf den Malediven

At any time in our lives, much more on vacation days, we want to enjoy the outdoors with the family and friends, so many of us choose to go to the beach or to a pool.

However, can we go to the beach or to a pool and get in the water after suffering a stroke or a CVA (Cerebrovascular Accident)?

The physiotherapist, Valerio Sarmati, explained some topics on this issue addressing the recovery and the rehabilitation matter after a CVA, strictly respecting the medical contraindications focus.

Considering that a stroke is the result of a vascular accident, a prolonged exposition to the sun and heat is not the most appropriate.

Consulting you family doctor who is conscious of the specific conditions of each case will be the most appropriate, Sarmati said.


Choosing the beach should be rational and the patient’s difficulties must be taken into consideration.

Not all beaches are equipped or prepared to have wheelchairs access or walking with the help of a cane.

“We have to consider that walking on the sand can change the skill that we achieved when we walk on the pavement or flat surfaces”.

“Particularly we have to pay attention to the ankle, that it is often the site of a problem known as supination, that is to say the exaggerated rotation of the foot during the support on the floor determining the contact of the lateral side of the foot with the usual risk of distortions”, explained the neurocognitive rehabilitation specialist.

The second aspect that he mentioned was referred to the load, which could make walking on the sand more difficult.

“ Another consideration to take into account when walking on beach sand is the load , in fact the load represents one of the step aspects that recover more slowly and the load of the body over a terrain more variable like the sand makes the walking experience more difficult”.

Taking these advices into consideration, it is recommended to choose an adequate beach fit to each requirement.


Sarmati a rehabilitation post stroke specialist teaches the relatives how to take care of the recovery of their patient themselves from their house; considers that the rehabilitation in the water is not the most correct decision for the recovery after a stroke, “but here we are talking about the possibility of having a nice day at the beach” he explained.

This said, he mentioned that the majority of the experiences reported to date by his hemiplegic patients who ventured to have a day at the beach were positive.

“The men have a deep relation with the water, especially with the sea. We have all had experiences with the water and personally I consider it nice for a patient to face again the beach atmosphere”.

Without a doubt, there he will have the possibility of experimenting innate movements, he could make movements  that only in the water could be done thus, submerging again in a rich context of past experiences, which should be taken advantages of, I find it stimulating from the cognitive point of view and then the  motor.

Like we have pointed out before, an aspect more or less difficult to recover is the load during stepping, thus if the sea is calmed and there are not particular currents, the patient can experiment a greater stability during stepping precisely due to the fact of handling less weight thanks to the help of the water.

The only inconvenience to consider during the beach bath is the temperature, often perceived as very cold and annoying.

This aspect is easily foreseeable, since they have had experiences of this type in the shower.

The perception alterations in fact perform the contact with several water temperatures, are not always pleasant. Las alteraciones de la percepción, de hecho, rinden el contacto con varias temperaturas del agua, que no son siempre agradables.

In addition as we know, the cold momentarily increases the hypertonus (exaggerated muscular tension when a muscle is at rest), noted the Italian teacher.


“In the case of a pool it is different, says Sarmati President of the Group “Ictus Emiplegia Onlus”.

He assures that it is one of the most frequent questions made in the web site.

“Regarding the information that they ask is not like the case of the beach, which is an isolated event like a simple vacation day, but they inform about the possibility of making the rehabilitation after a stroke or a CVA, and I realize that they get better results with the neurocognitive rehabilitation.

With the neurocognitive rehabilitation the patient is gradually taken to come back to touch the environment, through the recovery of the main functions of the road and the grip.


Like we said before, the water is an interesting atmosphere, where you can experiment, and live different experiences than the daily ones, but it is not our natural environment, thus it is not possible to adjust to the environment in a fruitful manner and close to our requirements.

“Still the rehabilitation in the water in general is not badly tolerated by the patients, so we can say that if we cannot do the neurocognitive rehabilitation and are obliged to depend on a traditional rehabilitation, the physiotherapy in the water is among the bad ones the least, if it is not very muscular and then harmful with respect to the hypertonus and the recovery in general”.

Valerio Sarmati is an Italian physiotherapist who allowed the development of the telerehabilitation in the neurological field and more specifically in the post cerebrovascular accident rehabilitation.

The creation of his model of telerehabilitation is based on the participation of the family in the care of the hemiplegic patient.

He founded the Gruppo Ictus Emiplegia Onlus, a nonprofit organization in Italy for the protection of the families affected by cerebrovascular accidents, and also to diffuse in the national territory the neurocognitive rehabilitation.

Its mission is to allow the entire world to get the benefits of the neurocognitive rehabilitation understanding that a CVA does not affect the muscles but the brain.