Lynette Diaz, COTA/L
Tuesday, June 9th, 2020
How many repetitions does it take to create changes in the brain? How many repetitions must one complete before movement is strong, volitional and functional? Research indicates the number is high and the answer is more complex than we may think. Factors to be considered are, quality of repetitions, attention during repetitions, number of joints involved in movement, area of injury in the brain to name a few. It would stand to reason the more complex a movement is the more repetitions would be required.
Lynette Diaz, COTA/L
Monday, June 8th, 2020
Attitude of Gratitude.
After experiencing a traumatic injury such as a stroke, it may be hard for many people to perceive daily things in a positive light. After all, life is not what it was before. Many stroke survivors go from an independent lifestyle to depending on a loved one. It is evident to see how there is not much room for positive thought.
Wednesday, February 19th, 2020
You are eager to return to your normal life, so you are ready to learn more about the typical timeline for recovery after a stroke. Keep reading to get some answers to common questions:
Saturday, January 25th, 2020
A stroke can impact any number of life skills. But the ability to walk can be one of the most significant. Many people identify walking as an important goal after they experience a stroke. This makes sense because walking is related to so many daily routines. Every stroke survivor is different. Some stroke survivors might need help to walk a few feet. Other individuals might recover significantly and be able to walk long distances. This article will provide post-stroke walking education for a range of skill levels.
Tuesday, January 14th, 2020
Launching a hand exercise program begins with understanding how a stroke that happens in your brain can cause problems with your hand. A stroke is basically an injury to the brain due to limited blood flow. The symptoms in the body reflect the area of injury in the brain. So a stroke survivor with hand issues, experienced an injury to the area of the brain that controls the hand.
Thursday, December 26th, 2019
Sleep Apnea is a known risk factor for stroke and new research suggests that curbing the condition might also aid the recovery of people who’ve suffered a stroke or mini-stroke. New research shows that, among stroke patients, “treatment of sleep apnea with CPAP therapy provides significant benefits, even greater than the benefits of tPA, the FDA-approved drug treatment for stroke,” said study lead researcher Dr. Dawn Bravata.
Wednesday, December 25th, 2019
When suffering from a brain injury such as stroke, a sense of hopelessness, frustration and vulnerability can occur. Don’t be alone on your journey to recovery! Below are excellent books that provide immense insight into stroke recovery. Click on any of the links for more information.
Monday, December 23rd, 2019
Getting oneself dressed is a critical part of being a fully independent person. For a person who has had a stroke, getting dressed can help feel more normal again. This can really help to boost both mood and self esteem.
The tips below will help both the stroke patient and the caregiver make dressing an easier part of the daily routine:
Lynette Diaz, COTA/L
Monday, December 23rd, 2019
Stretching can be a very important part of recovery especially following a stroke, when feeling, sensation and movement are returning to a previously flaccid limb. However, is it possible to stretch too much or too hard? Yes it is.
Clinicians frequently see patients handle their affected limbs rather aggressively in an effort to “make it move” or “get it loose”, often stretching their fingers, wrist, elbows and shoulders too far too fast. This may partly be due to lack of sensation or awareness.
Saturday, December 21st, 2019
Stroke survivors often struggle to regain full use of their affected side. Below are a just a few of the available products on Amazon that can help with improving more recovery at home. Whether you are hoping to improve your arm and hand strength or looking for better results with your walking and endurance, the good news is that you can find excellent products for very low prices. Just take a look below and click for more information.
Thursday, December 19th, 2019
Adaptive equipment helps stroke patients experience greater independence with everyday life skills or activities of daily living. There is a plethora of assistive devices for all areas of self care including dressing, bathing, grooming, cooking, feeding, toileting, and mobility aids.
Tuesday, December 10th, 2019
Decreased balance is a common area affected by stroke. Many patients are prone to falling which could lead to serious injuries. Studies have shown that stroke survivors are twice as likely to fall following a stroke and more than three times as likely as the general population to fall multiple times. About 40 percent of stroke survivors have serious falls within a year of their stroke.
Tuesday, December 3rd, 2019
Da Silva Ribeiro NM, Ferraz DD, Pedreira E, et.al. Topics in Stroke Rehabilitation 2015; 22: 299-305.
This study compared the use of the Wii Nintendo to a conventional physical therapy program to improve both sensorimotor activity (measured by the total Fugl-Meyer assessment score) and quality of life (measured using the SF-36). Thirty stroke survivors were randomly assigned to either group and all participants received two hourly sessions for each of two months.
Dorothee Zuleger, MOT, OTR/L, DRS
Thursday, November 21st, 2019
Following a stroke, abnormal muscle tone is a common complication. A single muscle or a muscle group may become completely paralyzed. This is known as hypotonic or flaccid or a muscle may increase in muscle tone. This is known as hypertonic or spastic. This abnormal tone usually occurs in the side of the body opposite to the side of the brain lesion.
Saturday, November 2nd, 2019
When a stroke patient returns home, the home environment can impact a person’s recovery. The home includes the social and cultural environment such as the people who live there, as well as the physical aspects of the home such as steps and layout. It is important that the home environment be one that supports continuing recovery and safety for the patient. This article is intended to provide basic information to stroke survivors and their families about potential problems with the physical aspects of the kitchen.
Friday, October 25th, 2019
Stroke can cause muscle weakness and tightness along one side of the body. Muscle weakness affects how well you move your body. Without continuous movement daily, your muscles, joints and ligaments will become gradually stiff eventually leading to a contracture.
The ankle and foot is one of the common areas affected by stroke. Often times, foot drop occurs which causes the foot not to clear and lift when walking, which could lead to a risk of falls. When suffering from foot drop, you may experience ankle stiffness over time.
Thursday, October 17th, 2019
Yuzer GFN, Dönmez, Özgirgin N. J Stroke Cerebrovasc Dis 2017 (in press).
This randomized trial investigated the effects of functional electrical stimulation of the wrist and finger extensor muscles of patients with chronic stroke who had spasticity of their wrist flexors. The electrical stimulation intervention was applied for 30 minutes a day for 5 days a week for a total of 20 sessions to fully extend the wrist and finger flexors.
Friday, October 11th, 2019
Winstein CJ, Wolf SL, Dromerick AW, et al. JAMA 2016;315(6):571-581.
This clinical trial recruited 361 participants, approximately 45 days post-stroke with mild to moderate impairments, for upper extremity retraining in order to improve functional use of the impaired upper extremity. Participants received either a new problem solving approach, Accelerated Skill Acquisition Program (ASAP) for 30, 1 hour sessions, Dose Equivalent Usual Customary Care (DEUCC), or Usual and Customary Care which varied from 0-46 hours. Findings demonstrated that all three groups improved in function (Wolf Motor Function Test) and quality of life (Stroke Impact Scale).
Wednesday, October 9th, 2019
Individuals suffering from neurological injuries, such as brain injury or stroke, typically develop many side effects including, but not limited to, physical weakness, decreased sensation, cognitive and speech impairments and balance just to name a few. Over the past 2 decades, neurological rehabilitation strategies have shifted more from theory-based treatment to evidence-based (science driven) treatment.
Lynette Diaz, COTA/L
Friday, October 4th, 2019
Sleep is an extremely important component to achieve optimal brain health and function. Poor sleep has been implicated in affecting heart function, blood sugar regulation and cognitive decline. Good sleep and normal sleep-wake cycles have been linked to improved cognitive recovery following neurologic insult to the brain such as in the case of both traumatic and non-traumatic brain injury, stroke, multiple sclerosis and parkinson’s. Typically after a neurological insult the normal sleep-wake cycle is disrupted, with the brain injured patient sleeping throughout the night and day with intermittent periods of wakefulness.
Friday, September 20th, 2019
“Quahana ran that way!” is the statement my mother normally heard when she went to round up my sisters and me after Sunday worship services. The Roadrunner was not just a cartoon in my house; it was my life. Laughing, smiling, painting and running was my DNA. Fast forward many years to a warm day in July when I’d just returned from a trip to London for an art conference and I collapsed on my living room floor as I was lacing up my sneakers for you guessed it; a morning run and workout. A carotid artery in my neck; a young woman who had never had a major medical issue; spontaneously dissected (i.e. tore) and subsequently a stroke resulted (with a 10% survival rate!). What followed was weeks in a rehabilitation hospital where I was treated by some of the top specialists and therapists in the country and the world. But what they all shared in common was a clinical belief that stroke recovery typically halts after three years. However, what I know to be true is that I’ve made more recovery after year three than I ever have BUT there is more recovery to be made.
Wednesday, August 21st, 2019
Fundraising Website Makes It Easy for Patients to Identify Breakthrough Treatment Solutions and Raise Funds to Improve Their Recovery.
Salia Rehab, provider of the world’s largest neurorehabilitation product directory, www.neurorehabdirectory.com, today announced the launch of a game-changing crowdfunding platform that increases treatment access to thousands of patients worldwide.
FundMyTherapy, an innovative crowdfunding platform, helps patients suffering from neurological injuries, such as stroke and brain injury, identify and select therapeutic products that match their needs using advanced sorting features such as impairment, product category, price, body part and/or reviews. Once users find appropriate products and create their wishlists, the proprietary platform enables them to build and personalize fundraising campaign pages to share with family and friends.
Friday, August 16th, 2019
While in therapy, it is not uncommon for patients and family members to enhance their rehab vocabulary from daily conversations with the clinical team. From the early moments of their arrival, they are immediately bombarded with clinical “whatchamacallits” from physicians, nurses, and therapists. Although the learning curve can be quite challenging, for many it is achievable thanks to Google and Yahoo.
Unfortunately, once the clinical jargon is finally mastered, the patients are preparing for their discharge date that is typically around the corner. It is not until their discharge week that they begin to have serious discussions with their occupational and physical therapists about what exercises to do at home and various equipment that might be needed.
Tuesday, August 13th, 2019
Suffering a stroke is a life-changing event. The statistics show that many patients will struggle from long-term impairments well after discharge from the hospital. In addition, a majority of stroke survivors will require ongoing rehabilitation on an outpatient basis so continued progress can be made.
As if learning to adjust to a new life following an injury is not difficult enough, finding a good therapist can be challenging. Like every profession, some individuals are hard working, passionate and extremely knowledgeable about their respective industry, while others seem to live day-to-day in an alternate universe lacking basic skills, motivation and common sense. When your recovery is in the hands of a therapist, it is absolutely critical that you identify the best possible clinician that checks all of your boxes so maximum progress can be made.
Friday, August 2nd, 2019
One of the most common impairments resulting from stroke is paralysis, which can affect a portion or the entire side of the body. Problems with body posture, walking, and balance can be significant. Two thirds of the patients are unable to walk without assistance in the first week after stroke (Jorgensen HS et al. Arch Phys Med Rehabil, 1995). Approximately 35% of survivors with initial paralysis of the leg do not regain useful walking function (Hendricks HT et al. Arch Phys Med Rehabil, 2002). Although 65% to 85% of stroke survivors learn to walk independently by 6 months post stroke, gait abnormalities and poor endurance persists through the chronic stages of the condition (Wade DT et al. Scand J Rehabil Med, 1987).
Dorothee Zuleger, MOT, OTR/L, DRS
Monday, January 28th, 2019
What is Aquatic Therapy?
Aquatic therapy is a type of therapy that takes place in a pool or other aquatic environment. It is a physical and medical rehabilitation specialty that requires the supervision of a trained professional.
Dorothee Zuleger, MOT, OTR/L, DRS
Friday, August 3rd, 2018
What is dystonia?
Dystonia is a type of movement disorder in which muscles in the body contract involuntarily often causing twisting or repetitive movements. Dystonia can range from affecting one part of the body, known as focal dystonia, or can affect multiple/all parts of the body, known as general dystonia. Muscle spasms due to dystonia can be anywhere from mild to severe, impacting daily functioning. Unfortunately, there is no known cure for dystonia, but different medications can alleviate symptoms.
Dorothee Zuleger, MOT, OTR/L, DRS
Tuesday, July 3rd, 2018
Spasticity is a condition in which a muscle or group of muscles is hyperactive and unable to turn off and relax. After an injury to the brain or nervous system signals to and from a muscle are not regulated as they should be and therefore create abnormal muscle tone. This constant state of contraction can cause, pain, stiffness and shortening of soft tissue limiting normal range of the joint. The degree of spasticity can range from mild muscle stiffness to severe, painful, and uncontrollable muscle spasms.
Dorothee Zuleger, MOT, OTR/L, DRS
Monday, May 21st, 2018
Central Pain Syndrome (CPS) is a dysfunction of the pain-conducting pathways of the central nervous system (CNS). The CNS includes the brain, brain stem, and spinal cord. CPS occurs when there is damage to an area of the brain that carries lots of sensory pathways.
People often experience CPS as the result of a stroke, traumatic brain injury, multiple sclerosis, Parkinson’s disease, or spinal cord injury. CPS is commonly referred to as neuropathic pain or sometimes as thalamic pain syndrome by medical professionals.
Dorothee Zuleger, MOT, OTR/L, DRS
Thursday, April 26th, 2018
Damage to one side of the brain can cause a lack of attention to the opposite side. Most common is an inattention or neglect to the left side of the body after an injury to the right side of the brain due to stroke or traumatic brain injury. The brain attends to the right side with both hemispheres but attends to the left side with only the right hemisphere.
Saturday, April 21st, 2018
A recent randomized trial by Yuzer et al., in the Journal of Stroke and Cerebrovascular Diseases 2017, investigated the effects of functional electrical stimulation of the wrist and finger extensor muscles of patients with chronic stroke who had spasticity of their wrist flexors.
Tuesday, March 27th, 2018
Anyone who’s done physical or occupational therapy knows how hard it is not to cheat. The body wants to get back to work, and the easiest way to do that is to use the uninjured limbs to help out. The therapist is there to make sure it’s the injured limb that’s doing the work.
Wednesday, January 17th, 2018
Intensive therapy can help people who have suffered a stroke recover motor function—even if the treatment begins a year or more after the stroke occurred. After a stroke, the brain and body can start recovering immediately and can show improvement up to six months afterward.
Tuesday, December 26th, 2017
One of the most common impairments resulting from stroke is paralysis, which can affect a portion or the entire side of the body. Problems with body posture, walking, and balance can be significant. A patient’s rehabilitation should start as soon as he or she is stable. That could be anywhere from a couple of days to a few weeks or longer. Established guidelines, as well as a huge body of literature, insist that the earlier therapy is initiated the better.
Monday, November 20th, 2017
A common impairment following stroke is called hemiparesis or one-sided (“hemi”) weakness (“paresis). Hemiparesis affects about 8 out of 10 stroke survivors, causing weakness or the inability to move one side of the body. One-sided weakness can affect your arms, hands, legs and facial muscles. Individuals with hemiparesis may have trouble performing everyday activities such as eating, dressing, and using the bathroom. Rehabilitation techniques, such as strengthening exercises, can help with speeding up your recovery.
Listed below are 10 exercise products that can help improve your strength following stroke.
Thursday, October 5th, 2017
The principle of Mirror Therapy is the use of a mirror to create a reflective illusion of an affected limb in order to trick the brain into thinking movement has occurred. Mirror therapy allows the brain to be activated during the imitation movements and interact simultaneously with the motor neurons. For example, if you put your left hand behind a mirror and right hand in front, you can trick your brain into believing that the reflection of your right hand in the mirror is your left. You are now exercising your left hand in the brain!
Monday, September 4th, 2017
Activities of Daily Living (ADL) are impacted continuously for may stroke survivors that suffer from limited arm and hand function and movement. Research indicates that Biofeedback and Electrical Stimulation can result in improved mobility and functional use. Biofeedback combined with electrical stimulation (NMES or FES) can be an effective tool in reducing the symptoms of stroke, such as increasing strength and function.
Monday, July 31st, 2017
Following a stroke or other neurological injury, multiple vision disorders can occur including the inability to recognize objects, color vision deficits and difficulty with perceiving various types of motion. Approximately 20% of patients experience permanent visual deficits (Romano JG. J of Neurol Sci. 2008).
According to the National Stroke Association, homonymous hemianopia, which is the loss of one half of the visual field in each eye, is the most common visual disorder. Most people who have vision loss after a stroke do not fully recover their vision. Thankfully, some recovery is possible. Treatment and outcomes will depend on the type of vision impairment and its cause.
Listed below are 7 Visual Motor Training Devices that are currently available on the market that can assist with improving recovery.
Wednesday, July 12th, 2017
Whether you suffered a stroke, living with multiple sclerosis (MS) or experiencing another neurological disorder, experiencing Foot Drop can be quite a struggle. Finding the right support to maintain foot clearance when walking can be challenging at best. Areas of concern include size, comfort, durability and effectiveness.
Listed below are 5 comfortable “out-of-shoe” Foot Drop Braces that are currently available on the market. Although the below braces may be more comfortable to wear, it is important to realize that not everyone will qualify for these lower profile ankle supports. Individuals will need to consult with a healthcare professional to make the most appropriate choice for their needs.
Monday, July 3rd, 2017
Thursday, June 1st, 2017
It is not uncommon for individuals to experience decreased hand function and strength following a neurological injury such as stroke. Sadly, even after 6 months following stroke, over 60% of clients are still struggling to achieve full arm and hand recovery (Kwakkel et al., 2003). Moreover, the inability to actively open the hand for pre-grasp activities is a severe limitation for many stroke survivors. The impaired movements lead to decreased independence in leisure and self-care tasks (activities of daily living). Because this limited function is a difficult challenge, traditionally, clients were required to relearn new compensatory movement patterns and one-handed strategies so functional activities could be achieved.
Sunday, May 7th, 2017
The Stroke Hand and Upper Limb Clinic, offered by occupational therapists specializing in neurorehabilitation, provides an intensive (3 days, 6 hours per day) upper extremity treatment program for patients suffering from neurological impairments such as spasticity and weakness. The specialized stroke clinic, located in Charleston, SC is geared primarily towards clients that struggle with arm and hand function.
Thursday, April 27th, 2017
Listed below are various clinical product categories that you may have learned while in therapy. Feel free to click on any category to see a list of products that may be appropriate for your needs.
Monday, April 24th, 2017
Studies have shown that stroke survivors are twice as likely to fall following a stroke and more than three times as likely as the general population to fall multiple times. About 40 percent of stroke survivors have serious falls within a year of their stroke.
Monday, April 3rd, 2017
It is true that recovering from a stroke will be an uphill battle for many, however, it is also accurate that the latest research findings regarding neuro recovery are more promising than ever before. How serious are you with embracing evidence into your practice? As a clinician, are you stuck using numerous theoretical-based treatment concepts that have not scientifically been proven to be effective?
Listed below are some of the common interventions supported by research that have shown positive results. How many of the below techniques are in your current therapy toolbox? If just a few, then why?
Friday, March 24th, 2017
Electrical stimulation, also referred to as e-stim, NMES, or FES, can be an effective tool in reducing the symptoms of stroke, such as increasing strength and function. The success of one’s recovery using electrical stimulation will rely heavily on proper electrode placement.
Listed below are some key video examples of lower limb electrode positioning by Axelgaard. Click on the thumbnail below to visit the video link.
Tuesday, March 14th, 2017
Neurological conditions can cause trouble with swallowing as a result of damage to the brain, spinal cord and nerves. This type of swallowing problem is called dysphagia. The most common conditions associated with dysphagia include stroke, head trauma, multiple sclerosis, cerebral palsy and motor neuron disease, but any neurological disease can cause dysphagia.
Monday, March 6th, 2017
Edema is swelling caused by excess fluid trapped in the body’s tissues. Although edema can affect any part of your body, it’s most commonly noticed in the hands, arms, feet, ankles and legs. Edema occurs from a variety of reasons. For individuals who are inactive, a collection of fluid in the ankles and legs, fingers and hands can be seen. Individuals that are paralyzed after a neurological injury such as stroke, may have fluid collection just on the affected side.
Tuesday, January 31st, 2017
It can be quite challenging caring for someone with a stroke. When a loved one is first hospitalized immediately after a stroke, families usually assist the hospital team with key personal information as well as convey patient care preferences and serve as the connection between the hospital staff and the patient. You suddenly become the patient’s voice and chief advocate.
Monday, January 23rd, 2017
What is it?
Constraint-induced movement therapy (CI, CIT, or CIMT) is a form of rehabilitation therapy that improves upper extremity function in stroke and other neurological injuries by increasing the use of their affected upper limb. The focus of CIMT is to combine restraint of the unaffected limb and intensive use of the affected limb. Types of restraints include a sling, a splint, a sling combined with a resting hand splint, a half glove, and a mitt. Determination of the type of restraint used for therapy depends on the required level of safety vs. intensity of therapy.