Functional Arm Exercises After a Stroke continued...
Unfortunately, few centers offer CIMT for two main reasons, Stein says. Insurance doesn't pay for it and high-intensity, short-duration therapy is difficult for many patients. "You also have to have a certain degree of movement to participate in CIMT," Stein says. However, variations of this therapy -- spread out over a longer period of time -- are being tried and have been shown to be useful in limited studies, he says.
Ryerson adapts techniques used in the EXCITE trial to encourage use of the hand and arm. She provides patients specific, simple arm movements that don't require hand manipulation. These are activities that most should be able to do, even with severe stroke damage.
These are examples of activities Ryerson suggests trying daily:
- Put your fingers around a refrigerator door handle. Or put your fingers around a drawer handle. Open and close the door or drawer.
- Hold a plastic shopping bag in your affected hand and carry it across the room. Practice putting something light in the bag.
- Pull laundry out of the dryer and carry it in a small bag.
- Carry light objects, supporting them against your body with your upper and lower arm.
- Put a soap dispenser on your hand. Then put it on the table and turn it over more than once.
- Put a tube of toothpaste in your affected hand. Try to squeeze it while you manipulate the tooth brush with your unaffected hand.
- Flip a light switch on and off with your affected hand.
"It's important to keep the sensory messages going into the brain to prevent the nonuse cycle," she says. The sensory information you get from touching may lead to greater recovery. And, doing activities like these also help you gain independence while you're recovering. For example, using a bag to carry objects to and from the refrigerator can free your other arm for use with a cane, if needed, Ryerson says.
Arm-Strengthening Exercises After a Stroke
In the past, there has been some controversy about strength training for the arm and hand after a stroke. It was thought that strengthening spastic muscles might do more harm than good. Now research indicates that strengthening spastic muscles can even reduce spasticity.
A recent review of 13 studies including 517 stroke patients with mild to moderate impairment of their arms found that strengthening hands and arms with small weights, resistance bands, and pulley weights could be done without increasing spasticity and pain.