Thrombolysis, also known as thrombolytic therapy, is a treatment to dissolve dangerous clots in blood vessels, improve blood flow, and prevent damage to tissues and organs. Thrombolysis may involve the injection of clot-busting drugs through an intravenous (IV) line or through a long catheter that delivers drugs directly to the site of the blockage. It also may involve the use of a long catheter with a mechanical device attached to the tip that either removes the clot or physically breaks it up.
Recovering use of your arm does bring special challenges, though -- different than those experienced with the leg, says Susan Ryerson PT, ScD, owner of Making Progress, a physical therapy business. Ryerson has specialized in post-stroke recovery for more than 40 years with a special interest in rehab for arms.
"But you don’t have to do anything with the arm because you have the other one to use," Ryerson says. "In the beginning, it's easier to do things with your 'good' arm. So you develop a behavioral pattern of nonuse." But because early muscle activation is critical to good recovery, you should be devoting as much time as possible to getting your arm to work, she says.
What to Expect During Stroke Rehab for Your Arm
Your stroke rehabilitation program involves working with a team to guide you. This usually includes physical and occupational therapists. The rehab team will likely recommend combining a variety of exercises and other techniques to help your arm recover. Two big goals of stroke rehab are to enhance muscle control and reduce spasticity. This is a constant contraction of muscles that can lead to pain and other problems.
Stroke rehabilitation for your hand and arm includes passive movements or exercises that are movements done with the help of a therapist and more active exercises you do with little or no assistance.
Stroke rehabilitation can be tiring. It may also help to be active during times of the day when you have more energy. Set realistic goals.
Stretching Arm Exercises After a Stroke
Stretching is especially important for reducing spasticity. "Stretching should be used not as an alternative to medications, but as a foundation," says Joel Stein, MD, director of the rehabilitation medicine service and physiatrist-in-chief at NewYork-Presbyterian Hospital. "Patients that are very meticulous about it can often manage with substantial spasticity."
Your therapist will teach you range-of-motion stretches. Some of these involve using your other arm to produce the forces needed to move the disabled arm. Called passive exercises, these can help prevent muscle shortening and joint stiffness.
"Taking the arm and stretching it with the other arm is the bedrock of spasticity self-management," Stein says. You can also use the unaffected hand to stretch the thumb and all the fingers on the affected hand.
Your therapist will instruct you on how to do stretches, but these are some general guidelines:
Move the arm through its full range of motion at least three times a day.
Gently stretch tighter muscles to a point of slight discomfort.
Then hold the stretch for at least 60 seconds.
Although these stretches are helpful in preventing spasticity and other problems, they don't directly address the primary impairment -- control of the arm, Ryerson says.