APRIL 2013 Stroke Recovery Tips www.stroke-rehab.com

Recovering Balance After Stroke

Here are the steps I take with my stroke patients to regain an elbow and back up. balance. First, one must have 4. Work on dynamic sitting sitting balance. Just like an balance without hand Examples of balance exercises infant must learn to sit before support—same as #3 standing so must an individual can be viewed at http:// but neither hand is used who has had a stroke. Here for support. www.stroke-rehab.com/ is a simple sequence to follow: balance-exercises.html 5. Work on sit to stand, 1. Work on static sitting leaning the body for- balance with hand sup- ward and coming to full port—just holding oneself stand as able. One can sitting upright without use an elevated mat to moving allowing patient make it easier to stand. to hold on as necessary. 6. Static standing with hand 2. Work on static sitting support (standing in balance without hand place with no movement). support—same as above except patient is not al- 7. Static standing without lowed to hold on with hand support. hands. 8. Dynamic standing 3. Work on dynamic sitting (shifting weight side to balance with hand sup- side, forward/back, port—this involves add- reaching, etc.) with hand ing movement as you are support. sitting such as shifting weight side to side, for- 9. Dynamic standing without ward and back, and hand support. lowering oneself down on

Inside this issue: Exercise Tip of the Month Recovering Balance After 1 When trying to improve shoul- such as shoulder blade der range of motion, many squeezes and shoulder rolls. Stroke patients may not realize that If the scapular muscles are 1 they need to make sure their tight, one can mobilize their Exercise Tip of the scapula (shoulder blade) is own scapula by rolling over Month—Scapular moving correctly. In order for the scapula. This is done by Mobilization the arm to raise above shoul- lying on one’s back with the der height properly, the scap- knees bent toward the ceiling Adaptive Clothing 2 ula has to rotate upward and & feet flat, the affected arm out away from the spine. If is lying out to the side. The the scapula does not rotate, patient then rolls toward the Caregivers Corner—Take 2 then the patient will most like- affected side and gently Care of Yourself ly feel shoulder pain when rocks back and forth over the attempting to bring the arm shoulder blade. Repeat 3-4x up. To make sure your scapu- and then proceed to shoulder lar muscles are strong, one range of motion exercises Edema in the Hand 2 can work on moving the scap- which are often less painful ula through various exercises after scapular mobilization. Page 2 STROKE RECOVERY TIPS

Adaptive Clothing for Stroke Patients

Adaptive clothing is chore to get your pants off Adapted clothing offers available for stroke patients to go to the bathroom? other conveniences such as There are several adaptive who have difficulty dressing Adaptive clothing uses solu- zipper front dresses or clothing retailers. themselves due to weakness, tions such as Velcro or snap robes, comfortable shoes immobility, or poor closures rather than buttons with Velcro, front closing coordination. Adaptive to make dressing easier, can bras, open back clothing, Check out www.silverts.com clothing is also designed to be applied from a seated wrap skirts, side opening for examples of adaptive allow caregivers ease of position, accommodates pants, and more. You can access when assisting a problems like swelling or also find accessories that clothing that can be patient in getting dressed. poor circulation, and allows help improve safety and purchased and to get for quick changes when in- cleanliness such as non-skid Do you have trouble putting continence is an issue. Even socks, arm protectors, and dressing tips for the disabled. on a bra or button down pants can be changed from protective bibs. Search shirt? Is tying your shoes too a seated position with no adaptive clothing online to difficult? Do you avoid standing. find various retailers. going out because it's a

CAREGIVER’S CORNER-TAKE CARE OF YOURSELF!

According to Schedule time away from 3. Get enough sleep. www.caregiver.org, about your loved one each week 60% of caregivers show to do something you enjoy. 4. Join an online or in signs of clinical depression. Have a friend, other family person support group so They also take more member, church member or you can vent frustrations prescription medicines, paid caregiver watch your or get informative care- including those for anxiety loved one while you enjoy giver tips that can help and depression, than others a dinner, movie, shopping you. their age who are not trip, or maybe just time caregivers. Unfortunately, alone to read a book. 5. Don’t isolate yourself many caregivers do not take from family and friends. 2. Accept help from the time to take care of 6. Seek counseling if themselves and often isolate others. When someone themselves from friends and asks if they can help, needed. family. Here are some say yes! Others can steps that caregivers can help with meals, getting take to protect their own groceries, yardwork, health and emotional well– watching your loved being: one, running errands, etc. 1. Make time for yourself.

Edema in the Hand

Edema can be a problem involves gently massaging with a hemiparetic or the arm moving upwards hemiplegic arm especially in from fingertips to elbow as the hand. This edema can if pushing the edema up and affect sensation as well as out of the fingers (never the patient’s ability to move push down toward the the hand. One solution for fingers as this can increase hand edema is a swelling). In my experience, compression glove worn at compression gloves work night along with elevating best, however, check first the hand above the heart. with your MD before using One can also try a cold gloves or retrograde volume overload, congestive pack to help reduce swelling massage as these may be heart failure, and some other or try retrograde massage. contraindicated for some conditions). Retrograde massage individuals (e.g. those with