Audience: Those recovering from a stroke, Families of a stroke survivor
Time to Read: 8 min read + 3 min video
Traditional Stroke Rehab
Over the past 5 years we have worked on a variety of stroke clients (here are two testimonials of recent client – Stroke and Stroke2) and have noted many similarities between their experiences and what I would call the “Traditional Stroke Rehab Approach”. This approach is quite different from the strategies we use at Move Therapies and this post discusses the differences between what we do and the traditional approach.
Here is one article I found from the Mayo clinic that outlines some of these Traditional Stroke Rehab strategies.
Our understanding in regards to the “exercise rehab” portion of the traditional approach is to focus on the “affected” areas of the body, in hopes it will improve those parts. In some cases they may even restrict the areas of the body that are “unaffected” in hopes that the individual will move the affected parts more often and hence they will start working better.
For example, traditional stroke rehab may take someone who has a left arm that is affected by the stroke and focus on that by exercising it, “re-training”, and strengthening it. They may even restrict the right arm of the stroke survivor to encourage use of the left arm.
Common complaints about Traditional Stroke Rehab
In talking with our stroke survivors we have heard some common complaints about this traditional rehab process. Here are some of their main concerns:
- The rehab usually starts in a hospital setting, which is where it should start in case there are further complications, but the problem with this situation is two-fold in that 1) in this setting rarely are patients given unlimited time to sleep and rest and 2) this setting is not the most familiar setting for clients that may already be confused and scared from what has just happened.
- The rehab exercises appear to be scheduled throughout the day and are dependent on the instructor’s schedule, not on the client – and this can interrupt the client’s sleep and rest.
- How the traditional exercises make the clients feel has also been a cause of complaint, namely in that the exercises are too hard, or outside of the clients capabilities, and make the client feel “bad” or that they are “failing” in some way.
- From what we have heard the clients typically don’t look forward to doing the traditional rehab exercises or going to the sessions. I think a lot of us have experienced a similar situation where we were taken to some sort of music/riding/tutoring lessons, as kids, but we totally didn’t want to go. How we feel about what we are doing can play a big part in what we take away from the sessions.
- The client is not given a lot of hope that things will improve after the rehab is over. Usually once they have left the hospital (in 5-6 weeks) the clients expectation of continued improvement is not very high. In some cases, it seems the doctor or person giving the “news” is trying to be realistic with the clients, but when a person of authority gives “bad news”, that can have unintended consequences.
The “Fix It” not “Feel It” approach of Traditional Stroke Rehab
The current overall strategy of traditional stroke rehab is to focus on the things that are not working and try to make them better. Namely, if an arm has been affected, or leg is affected or speech is slurred, we should do something specifically with those things.
That “fix it” strategy (or “focus on the symptom” strategy) sounds like it’s the right approach and is similar to how we would fix a car. If the battery isn’t working in your car you might replace it, or if the tire is blown, you would replace the tire. Although this strategy can work for a car it doesn’t take into consideration the complexity of a human being.
And from personal experience with cars, not always does focusing on fixing the thing that is broken fix the underlying problem.
That is the battery may just be a symptom that the alternator or power system of the car is not working properly. And the cars of today are becoming more complex, in that we may need to fix the car computer first, before the engine or some other part starts working again.
The last missed consideration in this approach is that most people’s energy, will power, and motivation are low when recovering from a stroke so it would be in the best interests of the stroke survivor to get the MOST outcome with the LEAST amount of effort.
Doing things that DON’T require a lot of “physical” effort, that make you feel GOOD (literally moving in a way that feels good), and you are excited to do because you like them – typically leads to an outcome where you FEEL better.
How we feel and what our experiences are, MATTER. Think about your favourite teacher (if you had one) and how they made you feel, how you felt about the subject they were teaching and why you felt that way. And then think of your least favourite teacher and what were your take-aways from that experience? Some people hate math or writing for the rest of their lives all because of one teacher. Our EXPERIENCE of how something makes us feel is very important.
What can work better than just “exercise”?
We are Information Systems, not just physical systems. Research has shown that exercise in itself, like running on a treadmill or going for a walk, can improve the brain, but movement that is fun, easy, dynamic, involves LEARNING, and revolves around what the client can already do, and improving upon that – can have a bigger impact on recovery from a stroke.
Move Therapies rehab in regards to Strokes (and many other neurological problems) uses that Strategy. We focus on what is currently working and improve those things a bit better. The idea of neuroplasticity shows us that the brain can learn, change, and adapt at any point in life. The strategy of improving on what the client is already doing leads to more changes and quicker improvement in other areas.
And if you consider that the brain is the epicentre of the injury in a stroke, it makes the most sense to focus on that. Doing movements that are easier, slowing things down, and with less intensity is a large MENTAL activity that gets the persons brain more organized, and in essence it begins to function better.
Try this experiment (or watch the video below)- wiggle the toes of your left foot a couple times. Notice how they all can move and maybe how your overall foot moves. Now focus on trying to move just your middle toe on that foot.
Don’t do a big movement – just try and move that one middle toe a little up and down. If other toes move along with it, that’s ok. Try moving the toe a couple times, SLOWLY and VERY SMALL, and with as LITTLE effort as you can. Be curious about it and have fun – like really – you are just moving your toe here! Think how you may have done this if you were a kid and do it that way.
Stop and rest for 10 secs. Then try it again a couple more times. Rest for 10 secs again.
Try it one more time and notice if you are doing it differently. Watch how your toe moves. See if it may even feel different. Get up and walk around. Is there a difference between your left foot and right foot in how you are walking? This is a small example of what we mean by “mental” exercise.
In our one-on-one sessions at Move Therapies we do this type of easy, slow, curious, movement with the whole body – with us moving the client. You can watch a video of that HERE. We do offer group classes as well where the client move themselves like in the video of Dale above.
We use slow and subtle movements with the goal of moving EASIER and with more QUALITY, which we realize can have a huge POSITIVE impact on the brain. The outcome of this strategy typically leads to happier, better moving clients, and ones with TOOLS on how to get back into LIFE.
Where to next?
Although there is no one best approach to dealing with a life altering situation like a stroke, some methods seem to lead to a speedier, better, and a fuller recovery. At MOVE Therapies we focus on the power of brain plasticity as the hub of recovery – and that is the key to the effectiveness of the therapy to do.
If you want more information for what we do at Move Therapies please contact us or please look at our testimonials to see what others have had to say about us!
Stroke Testimonial 1 – Claire Marty, Osoyoos, BC
“But I think one of the biggest changes has been with my hand. Since my stroke my right hand has always been freezing cold! I’ve ended up wearing a glove 24 hours a day. It also kept me awake or woke me from my sleep many times throughout the night – because it was always just freezing!
And then on the way to my last lesson of my six session intensive, I was on my scooter halfway between my home and MOVE Therapies… And I noticed I didn’t have my glove on! I haven’t done that in years! In fact, generally after my shower – it is the first thing I put back on!”
Stroke Testimonial 2 (with video testimonial) – Rhonda Gerrard – Osoyoos, BC (daughter)
“She (Myrna, Rhonda’s Mom) has regained so much more independence and confidence in her daily life. Simple things like the everyday movements of pouring a cup of coffee and walking with it in hand and not spilling are now completely within her grasp.
I have watched every session with amazement in how much easier it is for her to move, but most of all I noticed her balance has vastly improved! (Myrna herself today said – “It’s so wonderful not having to worry if I am going to fall all the time!”)”