Post-Stroke Rehabilitation

Post-Stroke Rehabilitation: How to regain Strength and Mobility

Stroke is a life-changing condition, which leads to physical disability and mental setback. After returning from the hospital, a patient suffering from a severe stroke may feel depressed and helpless as a result he might refrain from doing the prescribed exercises. Through this blog, we will provide you with exercises, which will not only improve patients function but also will boost their confidence for doing the tasks independently.

These exercises are based on Active-Passive Bilateral Therapy, a therapy in which a patient is asked to use the unaffected and the affected arms and legs together. This helps the two sides of the brain to work better together, as severe stroke is a condition that affects the balance between the two sides of the brain therefore these exercises help to restore the balance and improves hand and leg function.

 

1: ARM STRETCHING EXERCISES

Sit on a chair with a table in the front, place 2 boxes on the table, now place your hand on the box and extend your elbow and stay in this position.

Lie down and hold your wrist with your healthy hand lift your arms backward lift as far as you can and stay in this position.

Place your elbow over a towel on the table. Hold your wrist with your unaffected hand, Extend your elbow with the help of your unaffected hand stay in this position.

Hold the hemiplegic wrist with the unaffected hand extend your hemiplegic arm behind your back with the help of your unaffected hand, stay in this position.

Place your elbow on the towel over the table. Hold your wrist with your unaffected hand turn the forearm with the palm of your hand facing you extend the elbow with the palm of your hand towards the ceiling, and then stay in this position.

Place your hemiplegic hand on the table open your hand and extend your fingers with the help of your unaffected hand stay in this position keeping your hand on the table.

Place your hand on the table with the help of your other hand extend your thumb.

 

2: LEG STRETCHING EXERCISES

Sit on the bed by your side supporting yourself on your healthy hand with legs bent kneel to sit on your heels put a cushion under your buttocks, sit down on it. Straighten your back and stay in this position.

Place two chairs opposite one another and extend your hemiplegic leg on the chair, press down on your knee with your unaffected hand lean forward without bending your knee and maintain this position.

Stand on the stairs holding onto the handrail let your heel hang off the edge of the step while moving your heel downwards then extend your knee. Maintain in this position.

·   Place your hemiplegic foot on a low height stool against the wall with your heel hanging off the edge move your heel downwards while extending your knee move your pelvis forward without lifting your heel. Maintain in this position.

 

 3: ARM MUSCULAR STRENGTHENING

 

·    Lifting an object

Sit on a chair and hold a bottle full of water with both hands lift the bottle as high as you can put the bottle back on the table

·    Extending the elbow

Place your elbow over a towel on the table hold bottle full of water in the hand lift the elbow as much as possible and bring down, take the help of the healthy hand.

·    Extending the wrist

Place your forearm on the pillow or a box with your hand hanging then extend your hand as high as you can try to take the help of your unaffected hand.

·    Hand-Opening

Place your forearm on a box with your hand hanging then  open your hand as much as you can with your wrist extended  try to take the help of your unaffected hand

 

4: LEG MUSCULAR STRENGTHENING

 

·    Extending your leg outwards

Stand opposite to the wall and hold the wall with both your hands, extend your hemiplegic leg outwards without extending the pelvis without putting your foot on the floor and start again.

·     Extending your leg outwards

Stand opposite to the wall and hold the wall with both your hands, move your hemiplegic leg backward without putting your foot on the floor and start again.

·     Extending  your knee

Sit comfortably on a chair with your back straight then extend your knee as much as you can.

·     Extending your knee

Sit on a chair with your back straight then extend your knee and lift your foot as high as you can.

·     Bending your knee

Lie down in bed on your stomach, bend your knee, bring your foot towards your buttock, gently bend it back.

·     Standing on tiptoe

Stand opposite to the wall with both your hands on the wall and your feet apart stand on tip-toe and move back down again.

·     Extending your toes

Sit in a chair place a towel under your knee with your foot hanging loose extend your toes as much as you can.

 

5: GETTING UP FROM A FALL

 

Hemiplegic patients have a greater risk of fall, therefore if a stroke patient had a fall he should follow the following steps to stand or get up:

Assume a side-sitting position with the unaffected side close to a heavy chair or other objects that will not move.

·   Place the affected forearm on the seat of the chair and lean on the elbow or hand. Shift weight forward onto your knees and lift your hips until you are in a kneeling position.

·    Supporting yourself with your affected arm, bring your unaffected foot forward and place it flat on the floor. Keep the affected limb in the kneeling position while placing the unaffected one in the kneeling position.

·    Lift yourself by pushing with your unaffected arm and leg. Twist your hips toward the chair and sit on the seat.

 The forces needed to move the disabled arm or leg with the help of your healthy arm or leg while doing stretching and strengthening exercises reduces spasticity, helps to prevent muscle shortening and joint stiffness. Repeatedly using the hemiplegic arm and leg arm to do tasks is effective for recovery after a stroke. And this repetitive practice is now considered key to stroke rehab.

World Down Syndrome Day

World Down Syndrome Day: Managing Gross Motor Skills via Physical Therapy

Since the year 2012, March 21 has been officially observed by the United Nations as a global awareness day for Down syndrome. Down Syndrome (DS) is a genetic disorder that causes a global delay in development, including motor function, language, and cognition. It is a medical condition that makes the immune system weak and patients have about a 12-fold increased risk of infectious diseases. For COIVD-19 also, Down syndrome patients are considered to be at higher risk. An early intervention presents the most benefits, as neural plasticity is at its peak in the first months of life. One of the interventions used is Physiotherapy. Physiotherapy is offered from birth to stimulate the acquisition of motor skills. It helps to strengthen the muscles, enabling the children with Down syndrome to keep their body in proper alignment and therefore prevents future health problems. 

The physiotherapist uses the following techniques for giving treatment to the Down syndrome patient:

 Relaxation:

Relaxation decreases muscular tension, improves body control, and co-ordinated movements. The treatment may include breathing control, which focuses on relaxing your upper body and breathing from your tummy. This can be used in conjunction with deep breathing which helps the muscles relax when pain is restricting breathing. Progressive muscle relaxation is another technique, which involves slowly tensing and then releasing each muscle group individually, starting with the muscles in the toes and finishing with those in the head.

 Improve Co-ordination:

Coordination is the ability to execute smooth, accurate, controlled motor responses (optimal interaction of muscle function). It is the ability to select the right muscle at the right time with proper intensity to achieve proper action (which involves the co-ordinated action of various segments, as in cases of hand-eye coordination) and general co-ordination (which involves the entire body). The physiotherapist uses the activities like hitting a balloon, rolling balls, popping bubbles, throwing into a container, throw and catch, juggling, egg and spoon race etc, to improve the coordination of the patient.

 Improve Balance:

It is well known that persons with DS are often considered floppy, clumsy, uncoordinated, and have awkward movement patterns due to balance issues. These balance challenges often follow the child into the teen years and sometimes into adulthood. The physiotherapist may use equipment such as an exercise ball or bobath ball, to improve your child's ability to hold the head erect or to maintain a sitting position. Other skills such as jumping, skipping, and dribbling a ball may be incorporated into a fun physical therapy regimen. The development of balance happens progressively, starting from various postures (control of the head from prone positions, of the trunk in the seated position, etc.), and moving on to the more refined postures found in dynamic and in in-motion balance. 

 Improve Motor function:

The Down syndrome patient has hypotonic or low muscle tone. The physiotherapist teaches the patient to move the body in appropriate ways and improves muscle tone. The therapist works on the muscles and movements which help to reach some of the milestones and prevents the child from developing problems of bad posture. Physiotherapy can play a major role in the management of children with Down syndrome, through exercises, manual therapy, and education, physiotherapists can empower people to take charge of their health and participate in their treatment.

 Improving Strength:

If the muscles are not strengthened the child can end up having a postural, gait, and greater risk of joint problems later in life from using their muscles incorrectly. The physiotherapist can teach exercises to improve and increase muscle strength, this can include crawling, climbing, wheelbarrow, pushing up through their arms in tummy line, bridging, crab walking, roll-ups, planks, games, and fun tasks that are adjusted as the child grows. Also identifies new fitness activities to reduce the risk of obesity and improve and maintain heart health.

 Improve Developmental Skills:

Physical therapists can help your child to learn motor skills such as crawling, sitting to standing, standing to sitting, pulling, and walking. They can also give training for positioning, movement, feeding, and play, and suggest changes at home to encourage movement and communication development.

 The importance of early intervention should be emphasized. Physiotherapy treatment aims to assist people to live as independently as possible.

 

Physiotherapy for moderate stroke patient

Top 10 Rehabilitation Exercises for Moderate Stroke Patient 

Are you or any of your loved ones suffering from a stroke? Do you feel depressed or frustrated, due to lack of independence? Do you miss doing the activities and hobbies you used to love? If yes, then Physical therapy has a solution for you. It can help you regain your strength and mobility. This Blog is to provide an exercise program for a moderate stroke patient in order to promote flexibility, range of motion, balance and coordination, and also decrease pain and stiffness in your body. These exercises can be done by the patient without the assistance of a physiotherapist or an assistant.

1: To enhance shoulder motion and possibly prevent shoulder pain

Lie on your back on a firm bed. Interlace your fingers with your hands resting on your stomach

Slowly raise your arms to shoulder level, keeping your elbows straight. Return your hands to the resting position on your stomach.

2: To maintain shoulder motion

Lie on your back on a firm bed. Interlace your fingers, with your hands resting on your stomach. Slowly raise your hands directly over your chest, straightening your elbows. Slowly move your hands to one side and then the other. Then bend your elbows and return your hands to a resting position on your stomach.

3: To promote motion in the pelvis, hip and knee

Lie on your back on a firm bed. Keep your interlaced fingers resting on your stomach. Bend your knees tightly together; slowly move them as far to the right as possible. Return to center. Slowly move your knees as far as possible to the left, still keeping them together. Return to center.

4: To improve motion at the hip and knee, stimulating the movements needed for walking.

Lie on your unaffected side, with your legs together. Bend and move your affected knee as far as possible towards the chest. You may need your helper’s assistance to support the leg you’re exercising. Return to starting position

5: To strengthen the muscles that straighten the elbow.

Sitting on a firm mattress or sofa, put your affected forearm flat on the surface with your palm facing down if possible. You may want to place a firm pillow under your elbow. Slowly lean your weight onto your bent elbow. Push your hand down against the support surface, straightening your elbow and sitting more upright. Slowly allow your elbow to bend, returning your forearm to the support surface. Work back and forth between the two extremities.

6: To strengthen the muscles of the wrist.

Place your forearm on a table facing upwards. Hold a lightweight water bottle or a can in your hand. Flex your wrist by bringing your palm towards your forearm. You can also do wrist extension by turning your forearm face down and bringing the back of your hand towards the forearm.

7: To reduce stiffness in the trunk and promote the body rotation needed for walking.

Sit on a firm straight chair with both feet on the floor. If necessary, a firm mattress, sofa, or wheelchair may be used. Interlace your fingers. Bend forward and reach with your hands towards the outside of your foot, rotating your trunk. Move your hands upward in a diagonal direction toward your left shoulder, keeping your elbow as straight as possible. Repeat the motions, moving your hands from your left foot to your right shoulder.

8: Movements needed to rise from a sitting position

Sit on a firm chair that has been placed against the wall to prevent slipping. Interlace your fingers. Reach forward with your hands. With your feet slightly apart and your hips at the edge of the seat, lean forward, lifting your hips slightly from the seat. Slowly return to sitting.

9: Supine bridge

Lie on your back with feet flat on the ground and arms relaxed by the side. Straighten your legs and place a bolster under your knees, then lift your hips by pressing against the bolster. Then lift and lower one foot, then the other, while holding the top of the bridge.

10: To maintain the ankle motion needed for walking

Stand at arm’s length from the wall, Knees straight. Feet planted slightly apart and flat on the floor with equal weight on both feet. With your unaffected hand, hold your affected hand in place against the wall at the chest level. Slowly bend your elbows, leaning into the wall. This places a stretch on the back of your lower legs. Keep your heels on the floor. Straighten your elbows, pushing your body away from the wall.

Rehabilitation is a slow process. It can take months or years for the condition to improve.