Easy Hand Exercises to Boost Recovery from a Stroke

NeuroRehab Team
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.

Loss of hand function is common after a stroke. Every stroke survivor is different. Stroke survivors can experience a wide range and combination of problems based on the size and location of the injury to the brain.

 

Problems can include:

  • Loss of movement in an arm or leg
  • Difficulty with speech or swallowing
  • Changes in vision or thinking

 

Some people might notice a loss of a specific skill of the hand such as coordination or strength.  A recent study found the area of the brain that controls coordination of the hand was different than the area that controlled larger movements of the hand.

The good news is that new connections in the brain can form. While many people don’t regain every ability, many people make significant improvements after a stroke. The ability of  the brain to learn and form new connections is called neuroplasticity. Exercises are a great way to use neuroplasticity to help the brain form new connections.


 

Our Hands are Amazing and Complex

Our hands do so many amazing things. You may not realize all the daily tasks your hands complete. Or, you might not notice how much you use your non-dominant hand until you experience a stroke or an injury.

The systems of the hand include sensation, coordination and strength. Any of these systems can be impacted after a stroke and make it more difficult to perform daily activities. Addressing the area of skill loss can help improve your ability to use your hand.

 

Sensory Deficits after a Stroke

Some people may have altered sensation after a stroke. This might be numbness, pain or tingling. This makes it difficult to know where the hand is or what objects it is touching.

 

Decreased Fine Motor Coordination after a Stroke

Fine motor coordination is the name for the small motions of your hand. This allows you to write, pick-up small items, and move each finger individually.

 

Some examples of fine motor movements:

  • Repeated finger tapping — like when you are waiting impatiently.
  • Moving items from fingertips to palm — like when you pick up marbles one at a time.
  • Moving items from palm to fingertip. Think of bringing a coin from the palm to be able to put the coin into a vending machine.
  • Moving the index finger side to side. Like your mother wagging her finger saying,  “no, no, no.”
  • Rotating objects — like turning the dial on a watch
  • Bringing the tip of the thumb to the tip of the index finger.

 

Loss of Hand Strength

Both grip and pinch strength are important for daily tasks. Grip strength gives you the ability to grasp objects with weight or force. For example, holding a bag of groceries or opening a jar. Pinch strength gives you the ability to turn a key or close a ziplock bag.  Research has shown that grip strength improves the most in the first 6 months after a stroke but slow improvement continues for up to a year.



Benefits of Hand Exercises for Improving Your Ability to Use Your Hand

 

Top Benefits of Hand Exercises after a Stroke

  • Use muscle contractions to reduce swelling.
  • Decrease pain and stiffness by moving muscles and improving blood circulation.
  • Activate the areas of the brain that control the hand.
  • Increase hand strength.
  • Improve fine motor coordination.
  • Maximize the motion in the fingers and hand.

 

Diving Deeper into Making a Hand Exercise Program that Works

Because of the brain’s ability to learn and make new connections, exercises can help improve skills after a stroke. One study showed that repetition encouraged the brain to form new connections. Repeating your exercises helps your brain to learn. Also, research suggests daily hand function is improved with exercises that include tasks or activities. In summary, research suggests exercise programs should include repetition and performing tasks or activities with your hand.

Physical or occupational therapy can be beneficial following a stroke to improve strength and learn new skills. If your therapist has provided a custom exercise program for you, it is a good idea to continue that program.

However, some people look for new ideas as their needs or abilities change. Or maybe, your program got lost or you never received one. Whatever the case, remember that these exercises aren’t for everyone and are not a substitute for advice from qualified health professionals.

 

 

 

Get Your Hand Back With the 2-Day Stroke Boot Camp – Now Registering.

 

 

Where to Start: 4 Basic Hand Exercises

 

It is good to have a starting place. These four exercises activate different muscles of the hand and get the circulation going. If you are just beginning to regain hand motion, your entire program could focus on these exercises. If you are ready for some more advanced hand exercises, this list makes an excellent warm-up.

 

These exercises work best for stroke survivors who don’t have:

  •  a lot of spasticity (hand too tight to move).
  •  flaccidity (limited ability to move the hand, very floppy hand).

 

A different program might be more helpful if you have a lot of tightness or limited active motion in your hand.

 

1. Make a Full Fist

 

  • Instructions: Open your fingers all the way and then work on closing your fingers into your palm.
  • Helps improve finger range of motion and decrease swelling

            

 

 

2. Spread Your Fingers

  • Instructions: Spread your fingers as far apart as you can and then bring them back together again
  • Great for helping to move out swelling.

 

 

 

3. Bring the Thumb to Each Finger Tip

 

  • Bring the tip of your thumb to the tip of your index finger. Try to make this the shape of a circle. Next, try to bring your thumb to the middle finger. Continue until your thumb goes to each finger. If you can’t touch each finger, just work on reaching in the direction of the finger and visualize them touching. If you can touch each finger easily, work on increasing speed. 
  • This exercise helps with finger range of motion and coordination. 

 

 

 

4. Round Your Hand for a Functional “C”

 

  • Make a “C” with the thumb and fingers of your hand and then flatten the hand again. 
  • To help with this motion, imagine you are getting ready to pick up a glass of water
  • Great for activating the small muscles in the hand. 

 

 

More Hand Exercise Ideas Based on Stage of Stroke Recovery

The following section describes different ability levels of the hand following a stroke.  Each level provides suggestions for exercises that may work well. Since every person is different, some exercises in different categories may or may not apply to your particular situation. Read through the exercises and try some new ideas. You may surprise yourself with what you can or can’t do.

 

Exercises for When Your Hand is Beginning to Regain Control

This stage can be both frustrating and exciting. It is exciting to see a finger wiggle for the first time. But it is also frustrating because there are still so many things that are difficult. Be patient and begin exercises slowly because the muscles (and brain) can get fatigued easily.

Stroke survivors with hand function in this stage are typically working on regaining the ability to perform motions of the hand and wrist. For instance, they may have difficulty opening and closing the fingers or bringing the thumb to the fingertips.

 

Here are some ideas to get you started if your hand just has a little muscle control:

  • Review the basic list above, that is a great place to start. Try to perform each exercise with your affected hand, even if it isn’t able to match the motion perfectly.
  • Work on picking up a variety of objects. Medium-sized objects without much weight are a great place to start.
    • Practice picking up a foam cube or stress ball.
    • Wrap fingers around a plastic cup. Then work on releasing the cup by putting it down gently.
  • Fold a washcloth using both hands.
  • Roll playdough or putty into a ball or a snake on a tabletop.
  • Find a tennis ball and roll it in different directions on a tabletop.
  • Clap hands together.

 


 

Hand Exercises for Moderate Hand Function

 

Stroke survivors in this category have basic motions of the hand. This means they can pick-up objects (maybe clumsily) and can replicate most hand motions with extra time. Daily activities can still be a challenge because of limited coordination and strength.  For instance, they might be able to put on clothes but it might take extra time. Or, they might be able to pick up an empty glass but don’t feel confident lifting a full glass.

 

Some exercise suggestions for this stage include:

  • Use the sign language alphabet to practice making a variety of shapes with your hand.
  • Putty exercises are great for working on strength and hand motion. There are limitless options because putty can be used in so many different ways. Plus, the resistance can be adjusted for your strength level.

Some putty exercise ideas:

      • Squeeze putty in hand.
      • Roll putty in snake and pinch along the top.
      • Spread out putty by pushing with fingers.
      • Hide marbles in putty. Then work on finding the marbles and pulling them out.
  • Lay a piece of paper flat on a table and use fingers to scrunch it up into a ball.
  • Pick a ball you can hold easily in your hand. Pass the ball back and forth between your two hands. Increase difficulty by going from passing to tossing from hand to hand.
  • Stack small to medium-sized objects blocks, small cans or legos.

Advanced Hand Exercises for Fine-Tuning and Strengthening After a Stroke

 

 

Depending on the size and location of the stroke, some people might start at this stage. Other stroke survivors might not see this level of skill return. These exercises are recommended for stroke survivors who have good control over the motion of their hands and fingers. The exercises for this stage focus on challenging strength and coordination to fine-tune the muscles and the brain.

 

If your hand is mainly lacking strength and coordination, here are some exercise ideas:

  • Practice moving items in and out of the palm of the hand.
    • Pick up 5 coins, one at a time. Then put the coins into a slot like a piggy bank, one at a time while holding the remaining coins in your hand.
    • Pick up cotton balls one at a time and see how many you can fit in your hand.
  • Work on picking up and using smaller objects.
    • String beads, starting with larger beads and working down to small beads.
    • Pick up toothpicks and push each one into a piece of foam.
    • Turn nuts and bolts.
  • Use tweezers to pick-up items such as beads, fluff balls or toothpicks.
  • Work on strengthening.
    • Pinch chip clips and place on a piece of cardboard or notebook.
    • Squeeze stress balls.
    • Advance putty hand exercises by buying stiffer putty.
    • Hide beads in putty and remove.
  • Find or return to hobbies where you use your hands.
    • Knitting or crocheting.
    • Pound in nails or tighten screws using hand tools.
    • Tasks related to fishing such as sorting or tying tackle.
    • Painting, drawing or writing.
    • Shuffle or turn playing cards.
    • Play board games with small pieces.

Celebrate Your Progress and Keep Moving Forward in Your Stroke Recovery!

 

Stroke recovery is a journey. It takes time and patience to regain skills and learn a new normal. But, you can do it! Start with a few exercises and activities that match the abilities of your hand right now. Remember, our brains are amazing and continue to heal, learn, and grow. It takes time and consistent practice to maximize the return of hand function.  The key is to pick exercises that are challenging and interesting to get the most of your hand exercise program.

 

 

References

 

Birchenall J, Térémetz M, Roca P, Lamy JC, Oppenheim C, Maier MA, Mas JL, Lamy C, Baron JC, Lindberg PG(2019). Individual recovery profiles of manual dexterity, and relation to corticospinal lesion load and excitability after stroke -a longitudinal pilot study. Neurophysiol Clin, 49(2), 149-164. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30391148?log$=activity.

 

Dobkin, B. (2005). Rehabilitation after Stroke. New England Journal of Medicine, 352(16), 1677-1684. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106469/

 

Israely S, Leisman G, Carmeli E. (2017). Improvement in arm and hand function after a stroke with task-oriented training. BMJ Case Report, March 17, 2017. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28314812

 

Mawase, F., Uehara, S., Bastian, A.J., Celnik, P. (2017). Motor Learning Enhances Use-Dependent Plasticity. Journal of Neuroscience,  37(10), 2673-2685 https://www.ncbi.nlm.nih.gov/pubmed/28143961.

 

Stock R, Thrane, G, Askim T, Anke, A. Mork PJ. (2019). Development of Grip Strength One Year after Stroke. Journal of Rehabilitation Medicine 51(4), 249-256. Retrieved from  https://www.ncbi.nlm.nih.gov/pubmed/30848829

 



2 responses to “Easy Hand Exercises to Boost Recovery from a Stroke”

  1. Mable Scott says:

    My husband had an ablation of an avm in the left motor strip. At the end of the procedure the surgeon nicked an artery and basically gave him a stroke. He’s doing well but had to drop occupational therapy due to corona virus and we have been working at home. printed your exercises to add the his activities.

  2. NeuroRehab Team says:

    Thank you for your comments and we wish you and your husband all the best. Hopefully you can get back into OT soon. Take care!

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