Friday, July 29th, 2016
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.
Saturday, July 23rd, 2016
Friday, July 15th, 2016
The National Institute of Neurological Disorders defines foot drop, also known as dropped foot or drop foot, as “the inability to raise the front part of the foot due to weakness or paralysis of the muscles that lift the foot.” Consequentially, people who have foot drop scuff their toes along the ground; they may also bend their knees to lift their foot higher than usual to avoid the scuffing, which causes what is called a “steppage” gait.
Tuesday, July 5th, 2016
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 upper limb electrode positioning by Axelgaard. Click on the thumbnail below to visit the video link.
Friday, June 24th, 2016
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?
Thursday, June 9th, 2016
A stroke is a “brain attack”. It occurs when blood flow to an area of brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die. When brain cells die during a stroke, abilities controlled by that area of the brain such as memory and muscle control are lost.
Stroke can be caused either by a clot obstructing the flow of blood to the brain (called an ischemic stroke) or by a blood vessel rupturing and preventing blood flow to the brain (called a hemorrhagic stroke). A TIA(transient ischemic attack), or “mini stroke”, is caused by a temporary clot.
Wednesday, June 8th, 2016
By Ira Rashbaum, MD, Special to Everyday Health
Strokes occur in more than 795,000 in the United States each year, killing about 130,000. Survivors have an increased risk for long-term disability and face challenges completing daily activities.
Rehabilitation is a crucial component of care following a stroke. At top stroke centers some form of rehabilitation begins virtually immediately after a patient is admitted to the hospital — to get them on the right path to the best possible outcomes.
However, there are several things patients can do to ensure they are maximizing their recovery starting the second they suspect a stroke.
Friday, June 3rd, 2016
Evaluating the impact of stroke rehabilitation requires the use of reliable, valid, and objective outcome measures. Despite consensus among nationally published guidelines recommending the use of valid and reliable assessment tools, the scientific community lacks direction regarding what outcome measures should be selected for particular evaluative needs. One measure that appears to have general acceptance and embraced by many neurorehabilitation specialists is the Action Research Arm Test (ARAT).
Tuesday, May 24th, 2016
Stroke is one of the main causes of disability throughout the world. Due to hemorrhagic or ischemic damage to brain, many clients will suffer from impaired strength leading to poor gross motor movements and motor planning. In order to perform every day tasks such as grooming, eating, typing on a computer, or writing, adequate proximal strength (shoulder/elbow) is required to allow for normal distal control (hand/wrist).
Tuesday, April 26th, 2016
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.
Thursday, April 21st, 2016
Mirror therapy, a treatment technique first described by V.S. Ramachandran for phantom limb pain following amputation, is a form of motor imagery in which a mirror is used to process visual feedback about motor performance of the unaffected body part as it performs various movements. It is primarily used to speed up and improve motor function after stroke and other neurological disorders.
Friday, April 15th, 2016
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.
Thursday, April 7th, 2016
Stroke is a major cause of disability in the world. Significant impairment in the affected arm can be seen roughly between 30 and 70% of individuals suffering from stroke (Kwakkel et al., Lancet, 1999). One of the most common areas often affected by a neurological injury is the glenohumeral joint (i.e., shoulder). The shoulder complex is a very sophisticated and complicated joint in the body. It consists of 20 muscles, 3 bones, 3 joints, and 1 articulation. It has the greatest ROM of any joint in the body but at the expense of stability.
Monday, March 28th, 2016
As if learning to adjust to a new life following a stroke or neurological injury is not difficult enough, finding a home exercise program and appropriate stroke/neuro therapy equipment can be equally daunting. Assuming a therapist is up-to-date with current stroke research and latest technology available (could be a big assumption), there is a good chance that he or she will recommend exercises and products that will be meaningful to the client.
Tuesday, March 22nd, 2016
Shoulder pain is a common complication after stroke. Up to 72% of stroke patients develop hemiplegic shoulder pain. It may occur in up to 80% of stroke patients who have little or no voluntary movement of the affected upper limb. Painful stroke shoulder can negatively affect rehab outcomes as adequate shoulder function is a prerequisite for hand function, ADL’s, and functional mobility.
Thursday, March 17th, 2016
Approximately 30% of all stroke patients suffer from post-stroke visual impairment (Sand KM. Acta Neurol Scand Suppl. 2013). Following a stroke or other neurological injuries, various types of vision deficits can occur including the inability to recognize objects, color vision deficits and difficulty with perceiving various types of motion. Approximately 20% 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.
Monday, March 7th, 2016
Driving is often a major concern following a neurological injury. Movements, sensations, alertness, judgement, coordination, and vision can be adversely affected which may impair the ability to drive a car. Due to these impairments, there is cause for concern regarding increased risk of crashes post stroke and other neurological injuries (Perrier et al., 2010).
Wednesday, March 2nd, 2016
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).
Friday, February 26th, 2016
The latest research shows that the brain is capable of rewiring and adapting after stroke. Therefore, arm and hand recovery is more possible than previously thought. However, in order to improve function in the upper limb, the client must be willing to incorporate the affected side purposefully, functionally, and repeatedly. In addition to functional training, other beneficial strategies include strength training, mental imagery, robotics, and gravity compensation.
Below are the key takeaway’s that highlight the current thinking from the scientific community.
Thursday, February 25th, 2016
What is a Stroke?
A stroke, or cerebrovascular accident (CVA), is the rapid loss of brain function(s) due to disturbance in the blood supply to the brain. When you have an ischemic stroke, there is an interruption, or reduction, of the blood supply. Eighty percent of all strokes occur due to ischemia. With a hemorrhagic stroke, there is bleeding in the brain. After about 4 minutes without blood and oxygen, brain cells become damaged and may die. When brain cells are damaged or die, the body parts controlled by those cells cannot function. The loss of function may be mild or severe and temporary or permanent. This depends on where and how much of the brain is damaged and how fast the blood supply can be returned to the affected cells.