Tom says 'Life will never be the same for anyone who has survived a stroke, but successful survivors are those who can accept the reality of their new situations with a positive attitude. As such they are able to try to live each day productively, with as much creativity and fulfilment as possible within the new boundaries imposed by stroke. If you’ve hired a therapist or trainer to get you started (advised), you must have maximal input towards your own rehabilitation and the way you want to go, and feel able to ask for it if you’re not getting it. Activity is the watchword!'
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Remember goals are just goals. They are important but not inflexible and carved in stone. Rather they are targets, which are appropriate for your new lifestyle of relative limitations, which you must strive hard to achieve. But you must be open to possibilities of change according to the individual nature of your limitations and, of course, your growing capabilities as you rehabilitate.
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Try this if you are unsure of your ability to get down onto the floor from standing. The idea is that you are building up your confidence to attempt to move to the floor smoothly, safely and in control.
You need to be standing balanced on two feet for this fundamental exercise. This is a starter exercise to get you to feel confident about going down onto the floor. Reach down with your good hand to the front side of your good foot and try to touch the floor with your fingertip, and straighten up again. You can lower your hips and bend at the knees as much as you like. Don’t worry. You may not be able to get even half-way there! Depending on your age, time from injury, degree of rehabilitation so far and many other factors, This can be easy or may require considerable courage to contemplate doing. However, please persist. Try to get close to touching the floor. Do this technique over and again until you have it worked out really well.
If you like this post then please share it with others. Each time that you share a post, you can directly help other people – as who knows which people in the world might find us and gain, either directly from the charity or simply by being able to copy an ‘innovative and useful’ move/trick of the trade that might help them manage after stroke.
Every time you share, you could directly help someone – as knowledge is power ;)
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Hi all - have you ever wondered if you can do FES rehab on your weak arm and hand at home, online with your ARNI instructor or therapist? And is it worth it? Well actually, I would say yes it is, especially if your hand is more weak and floppy (flaccidity) than clenched tight (spasticity). The actual difference it makes is this:
FES sends a small current to the nerve that fires a muscle in your weak arm, so when you try to move, your hand or wrist actually completes the movement. So, if your hand barely moves, a rep without FES obvs isn’t really a rep - you try, and not much happens visually - neurologically it's GREAT, but with FES, the hand can actually open when you try, so you get a whole movement to practise completing instead of a 'failed' one. So in VERY basic terms your brain gets the feedback of a full movement paired with you meaning to make it, which is what drives the rewiring.
Again, no one’s yet run a research study/trial of telerehab with FES against telerehab without it, so I really can’t tell you for sure that it beats 'ordinary' upper limb online rehab with a physio or ARNI trainer. BUT the logic, and the older FES evidence both suggest that if your hand is currently too weak to complete the movement on its own, including FES (if you can set it up and adjust it optimally with the help of someone online who will then set you tasks to do etc and monitor you/challenge you while you do them) could well be better than the same without FES, if you see what I mean?
I would say also that there's one big thing - whether you have a presentation of flaccidity and/or spasticity (or often, a mix of both), if you do this AND try every single rep yourself rather than letting the current do the 'opening', then it's much less effective, yes? You trying ultra hard and the current helping/finishing off the movement is optimal.
So is it worth asking your ARNI instructor? Yes.. IF your hand is weak enough that you can’t complete the movements without it, ok?
Were you ever offered FES, at home or in clinic? Did it help? Do you still use it? Ever done TeleFES?! Is that even a thing/word?! Please let me know your experiences in the comments!
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Retraining the ability to turn: If you walk in one line, at some point you’ve probably got to turn round. This turning point can be an area where a stroke survivor is unsure on their feet, meaning this can also can be a point where a fall could happen. Very simply, the more you walk, the better you should get at coping with unexpected problems faced when walking. But you are still vulnerable when changing direction. Instead of either leaning on something to help yourself turn, or shuffling around, and perhaps taking about 3 or 4 steps with each foot (the two most common strategies I see being used), you should learn how to pivot. Pivoting is the practice of sweeping one foot round and taking it off the floor while keeping the other on the ground as the centre of rotation.
Taken from The Successful Stroke Survivor book by Tom Balchin
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CIMT (constraint induced movement therapy) is a beneficial treatment option to use in conjunction with other rehabilitation. It is useful in that it can be performed at any stage of stroke recovery and it can be performed in any setting after being assessed and the principals of treatment outlined by a therapist. CIMT can be goal directed and patient specific so it focuses on individual patient’s objectives, which can mean that stroke survivors are kept motivated and enthusiastic as they have set their own goals which they want to achieve. However for CIMT to be effective, stroke survivors need to adhere to the duration and frequency of the treatment, to ensure the best chance of neuroplasticity to take place. For neuroplasticity to happen stroke survivors need to be dedicated and positive to the concept and getting family and friends involved seems to be a good way to keep motivation and support ongoing. Regularly recording outcome measures will also show any progress that has been made and can allow the stroke survivor to review their goals and treatment options.
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