As far as I can see her strategies appear to be useful and work well.
At the moment I am interested in getting more use out of my upper right limb. I am hopeful, confident even, that the exercises she demonstrates will be a help.
She has quite a range of instruction presented in a very accessible form.
Thanks @Bobbi
Looks like you’ve ferreted out a a useful niche YouTuber.
The ARNI institute founded by Tom balchin is based on the notion that a stroke survivor with actual experience of lived condition knows much better than the book reading degree awarded physiotherapist how to advise a fellow stroke warrior
I haven’t found physiotherapists very useful mainly because: they don’t communicate using the language that I’m familiar with that would make a visceral connection, and they give me exercises to do that are out with my normal daily life, disconnected and disassociated from anything, they’re disruptive of living, and the frequency of interaction at an hour a month or less never achieves critical mass, and they don’t match the actual complexity or sophistication of using the hand for example to pick a cup up or carry the kettle from the sink to the work surface.
I swept the floor and trimmed a hedge yesterday. the amount of right hand exercise for grip, opening fingers, using arm at the shoulder and elbow and wrist that I got as a result was hours and hours. Because sweeping a floor takes a long time and trimming hedge takes even longer.
Standing on a step ladder and trying to get my right hand into position maybe took 30 seconds and then I’d get 15 seconds of trimming and then I’d have to resume the 30 seconds of hand positioning but after an hour I had trimmed a noticeable amount. after 3 hours I done 3/4 of it. The clearing up took a long time to and really requires that wrist flex with open fingers which is beyond my limits at the moment each attempt added the best part of a minute and boy was I knackered when I finally sat down around 6:30. the workout I’d had meant when I woke up this morning and did my before_I_get_up exercises with my hand I think I can open it more.
(There’s something about the first half hour after I wake up where I get more hand movement than any other time of day so I use that time to try and build range and stamina opening my hand and flexing my fingers back with just the muscles in my right arm I can only do in the first half hour after I wake up - any other time of day I have to use my left to stretch it to the same degree)
I think the rate of progress follows an S curve graph: it’s been slow for a long time but as capability develops I can use it more so it develops more capability more rapidly. I noticed my arm movement capability isn’t growing at the same rate now as a few months ago because I’ve got probably 80% of my range and strength back. With the hand I’m still in the 0 to 10% for somethings and the 10 to 30% for others. The wrist is also in the 0 to 30% range. Where I started and the one constant that is still the basis for my hand and arm exercises is with showering & drying and that’s got my hand to not being liftable above my navel to now being able to get pretty much to my ear on the opposite side of my head but it’s taken almost 2 years
Thanks for sharing this through resource and In your own words “keep on keeping on” with the exercises and you’ll (we will) get there
Interesting topic guys. I’m certainly looking for anything to help with hand functionality but my main issue is almost zero sensation in my hand. I can use it, it has fairly good grip but I have to concentrate so much by looking at this alien being on the end of my arm that it is so fatiguing.
I find the best way forward is when I need to do a task such as gardening and I just go and try. Is is frustrating but I eventually manage although there is real danger of cutting myself on ‘that’ hand (Thing from the Adams family).
I love my job but it does mean I have very little time or energy to do these kind of tasks that would help my recovery physically.
I guess there aren’t so many of us SS that have my specific lack of feeling issue so not sure if anyone has any relevant advice for that? I shouldn’t moan as many are less able than me but it certainly is a frustrating issue to lose the sense of touch in your dominant hand.
I subscribe to the use it or lose it theory but do find it annoying that it is just my brain not remembering what it should feel like (even though my right hand can teach it).
if you lay out your progress, methods and time scale just here on these forums, you are doing a great service to others who share this predicament and you set down a path that can be trod by those who can find it.
@Ingo66
I think you are in the best place to ask questions.
I’ve been quite a while trying to deal with my ‘difficulties’.
I’m sure there are answers, don’t give up on it.
I have sensation all over, though when I use my problem side the feelings are not the same as the, for want of a better word, ‘good’ side.
I find it very easy to not bother struggling with a problem, very easy to simply find a non-therapeutic simpler way.
I have to make myself
Keep on keepin’ on
This is connected loosely with this thread, if you fancy something else to read,
Simon, Bobbi
Have you ever tried restricting your good arm/hand and then seeing if the weak side kicks in to take its place ? Like getting to a dripping tap or similar ? Something annoying/something urgent where your natural instincts kick in ?
It has been some time since my stroke and the arm/hand were pretty unresponsive.
The latest thing was the installation of an additional banister rail so that I could begin using the stairs.
This involved quite a lot of awkward gripping and pulling each time I ascended and descended.
The result has been quite a degree of improvement in the mobility of the arm. I can lift and direct it better than up until then. I used the staircase daily and I think this vigorous activity has woken things up somewhat.
My wrist is pretty much locked up, but with some regular manipulation seems to be slightly freer.
I’ve been looking at the videos produced by Tracey and they have given me ways to work with my body that feel as if they will work.
I have a long way to go but there is enough slight improvement to encourage me to continue.
I would like to improve my walk too, but first I want a hand and arm that can be useful, not just ornament.
I am doing most work stretching and loosening the wrist bones.
@Nigelglos
I have only very slight actual ability to raise my wrist, I feel that continued manipulation, combined with sending out the ‘move’ message will bring improvement. Thanks for your helpful suggestions.
I find it is essential to keep up exercises, one trick I have is a short length of twig. In fact I have a bunch of them in the garden and pick up the favourite every time I go out for an exercise walk. I keep this twig working around my hand, just twisting it or trying to get it to run through my fingers, even trying to snap it!. I’m not good at picking stuff up from the floor so if I drop it I can leave it there Since it is only a twig and will rot away so I cant be considered littering!
The advantage is that it is helping to keep my right hand flexible.
Deigh
@Deigh
That sounds like a good idea. I like it.
I’ve not been getting outside but I could pick up a biscuit in the kitchen and use it as a twig substitute.
If I accidentally break it, eat it and leave no crumbs, then no-one will be any the wiser, they might start noticing that the biscuit tin is slowly emptying, though.
Forgive me, please, for not being serious, sometimes it is a straight choice and I would rather laugh than cry.
. . . though a good cry can sometimes lighten the burden.
Hi @Nigelglos
If you look up constraint induced movement therapy you’ll see there’s a whole cannon of work on the subject.
I did have a therapist that I’d paid to run a CIMT course / exercise program. For lots of reasons my wife and I found it more frustrating than rewarding. Before I took it I was inspired by the basis upon which it was framed and I still use that concept on a daily basis, in fact multiple times per day.
The research which was done on monkeys who first had their neuro-capabilities surgically removed and then their good arm constrained.
They showed better progress than a control group. That’s been turned in the CIMT ‘copyrighted’ method, a combination of an amended GRASP based exercise program and the mitten and a lot of metrics. I don’t think using grasp exercises with a hand mit to create a constraint honours the mechanism that the original research found to be efficacious.
I think if you have the gym rat mentality of picking up tennis balls and walnuts in three lots of 15 repetitions against the clock and filling in a spreadsheet and doing that for 3 hours a day and spending 7 hours a day with a mitten on so you can’t use your good hand then cimt has something to offer. However that 7 hours encompasses a whole bunch of things that I just truly impossible with only one hand and a severely impaired hand even with one hand that was a good hand that still be impossible
so the 3 hours of exercises and 7 hours of a meeting is not ‘where we are’ . The therapist I had was a different personality to my wife and I. She was very: Let’s make a plan, let’s write it all down, let’s count everything let’s, use a timer, let’s make it all procedurally disciplined as possible. At the end of 3 weeks both my wife and I were exhausted and very very very glad to stop. I think with a more empathetic therapist who responded more insightfully to the feedback in modifying the program it could actually have been a lot more beneficial than it was.
I think the concept in cimt of "if you are using your good hand when you should be attempting to use your bad hand you’re between slowing or stopping entirely the prospect of improvement” is an absolutely accurate observation.
So in a way I practise it all day everyday but my constraint is my discipline which I relax based on the frustration level that will accompany what I’m doing. for example I’ve just this afternoon built myself a compost bin out of old fence posts and plastic windproofing that I strung together with cable ties which is very definitely a two-handed job! Each cable tie took in the order of minutes to get lined up pulled through the ziplock, but I did the pulling right handed on almost all of them. there were one or two that gave in and did left-handed because after 10 attempts I was getting frustrated that the cable tie wasn’t a inch longer making it easier to get the tongue through the ziplock, grab the tongue and pull. It kept slipping and everything came unravelled and I’d have to start again and in the end I just said oh to hell with it I’ll do it with the other hand - then it only took four attempts.
Eating is the one exception I hate spilling food down myself so I’m going to become more dexterous make a concerted effort to use cutlery two-handed. I try periodically to benchmark my progress but I’m not yet sufficiently competent to not get food everywhere so it’s the one daily living opportunity that I pass up and I try it and capitalise on 80% of the rest
Caio S.
That has its merits but the only biscuit I can think as suitable would be the ones issued to the crew in the old days of sailing ships, I believe that you had to soak them for ten minutes before being able to bite them! Apparently weavels were the only ones that could penetrate them!
Deigh
In recent days I have reclaimed some use of my wrist.
I achieved this by frequently tugging apart the wrist joint, manipulating the bones in the hand and firm pressure pushing the hand back on itself.
I think this will take quite some time, but there are signs of activity, the wrist no longer hanging closed, becoming more open.
This is giving me a tiny improvement in the mobility of my hand, so I will persevere.
That is actually fantastic new Bobbli
Osteopaths do something very similar and its what we all need and would benefit from on our stroke affected limbs.
Sometimes that’s all it is with this, joints seize and lock up after a stroke. They need to pulled, manipulate, twisted and clicked back into life basically. Well done, so pleased for you
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