Regaining Arm Movement Post-Stroke: Effective Strategies For Recovery

Stroke survivors often experience a range of issues with their arms, including weakness, paralysis, lack of coordination, swelling, pain, and spasticity. However, there are many effective methods to help stroke patients regain arm movement and improve their quality of life. Treatment options include physical therapy, electrical stimulation therapy, constraint-induced movement therapy, mental practice, and medication. Additionally, specific arm exercises can help restore normal function and strength to the arms.

How to Get Arm Moving After Stroke

Repetition of basic arm exercises, such as inner arm and wrist stretches

Repetition of basic arm exercises is key to getting your arm moving after a stroke. Inner arm and wrist stretches are an excellent place to start. These exercises are simple and straightforward, designed to remind your mind and body that progress is possible.

Inner Arm Stretch

For this exercise, you will need a table. Place your hands palms down on the table and rotate your wrists so your fingers point toward your body. Keep your elbows straight and slowly move your body backward until you feel a stretch in the inside of your arm. If you need to, lean on the table for support. This exercise helps to add flexibility and mobility to your affected arm.

Wrist and Hand Stretch

For this exercise, place your forearm on the table with your hand over the edge of the table, palm down. First, gently stretch your ligaments and muscles by dropping your hand down, using your other hand. Then, keeping your forearm on the table, lift your wrist up, down, and sideways with the help of your other hand. This exercise will stretch your wrist and improve its flexibility.

The inner arm and wrist stretches described above are excellent basic exercises to start with. However, as you progress in your recovery, you can incorporate more intermediate-level and advanced-level exercises to restore normal function to your arm. Remember to always consult with your doctor or a qualified healthcare professional before starting any new exercise routine.

Passive exercises, moving the affected arm with the non-affected arm

Passive exercises are an excellent way to stimulate the brain and activate neuroplasticity, helping stroke survivors regain arm movement. These exercises can be done independently by using the non-affected arm to move the affected arm or with the help of a therapist or trained caregiver. Here are some detailed instructions for passive exercises to help get your arm moving after a stroke:

Inner Arm Stretch:

Lace your fingers together and gently stretch by rotating your affected arm palm-side up. Hold this position for 20 seconds, stretching to a strong but tolerable point. Be mindful not to stretch to the point of pain.

Wrist Stretch:

Keep your fingers laced together and gently bend your affected wrist backward. Hold for 20 seconds and then release. You can perform this stretch with either a bent or straight elbow to vary the intensity. Again, aim for a strong stretch without causing pain.

Shoulder Stretch:

Hold both ends of a cane and use your non-affected side to gently lift your affected arm up to the side. You can rest the cane on your leg for stability if needed. Hold this arm stretch for a few seconds and then gently release. Be mindful to stretch only to a point of stimulation, not pain. For an additional stretch, turn your head and rotate your trunk to the same side. You can also try lifting the affected side straight forward and up with your other arm.

Full Arm Stretch:

Hold both ends of a cane and use your non-affected side to gently lift your affected arm up and forward. Again, you can rest the cane on your leg for support. Hold this stretch for a few seconds and then gently release. As with the previous stretch, be mindful not to stretch beyond a point of stimulation. For an additional stretch, turn your head and rotate your trunk to the same side.

When performing these passive exercises, it is important to be mindful of your body's signals. You may feel some discomfort, especially if your muscles are tight, but the stretches should not cause pain. It is also important to be consistent with your exercises and to work within your range of motion. Over time, you may start to see improvements in your arm movement, but it is crucial to be patient and dedicated to your rehabilitation journey.

Electrical stimulation therapy to stimulate nerves and muscle contraction

Electrical stimulation therapy is a treatment option for those looking to regain arm movement after a stroke. The treatment involves sending electrical currents through the skin and into the muscles. This can help to repair tissue, strengthen muscles, and block pain signals.

There are a few types of electrical stimulation. The most common forms include transcutaneous electrical nerve stimulation (TENS) and electrical muscle stimulation (EMS). TENS is often used to decrease pain by blocking pain signals travelling from the body to the brain. EMS, on the other hand, uses an electrical current to cause a single muscle or a group of muscles to contract.

Electrical stimulation therapy can be used in combination with other treatments, such as exercise, phototherapy, and magnetic stimulation. It is important to note that electrical stimulation therapy should not be the only treatment used during rehabilitation.

The placement of electrodes is crucial to the success of the treatment. Electrodes are placed on the skin near the affected muscle to send an electrical current to the area. The intensity of the electricity can be adjusted to achieve the desired effect, such as blocking pain signals or causing muscle contraction.

It is important to be aware of the potential risks associated with electrical stimulation therapy. These include tissue burns, skin irritation, and muscle tears if the electrical impulse is too strong. It is also not suitable for individuals with certain conditions, such as impaired mental status, presence of an implanted electrical device, or wounds that are too moist.

Overall, electrical stimulation therapy can be a valuable tool in the rehabilitation process for those looking to regain arm movement after a stroke. However, it should be used in conjunction with other treatments and under the guidance of a healthcare professional.

Constraint-induced movement therapy, restricting the use of the non-affected arm

Constraint-induced movement therapy (CIMT) is a rehabilitative strategy that improves upper extremity function in stroke patients by increasing the use of their affected upper limb. This is done by restricting the use of the non-affected arm, thus encouraging the use of the affected arm. CIMT was developed by Edward Taub of the University of Alabama at Birmingham.

The therapy involves restraining the non-affected arm for 90% of waking hours, while the affected arm is engaged in a range of everyday activities. The type of restraint used depends on the required level of safety vs. intensity of therapy. For example, a sling or splint may be used, or a mitt placed on the non-affected hand.

CIMT can be challenging and frustrating for patients as they are unable to use their non-affected arm. It is important to note that therapy should be challenging but not frustrating. It is recommended to start with shorter periods of CIMT and work up to longer durations.

CIMT has been shown to be effective in improving motor function in the affected arm. Studies have found that it produces greater improvements in a variety of indicators of upper-limb function compared to control interventions of equal duration and dose.

However, due to its high duration of treatment, CIMT has been found to be infeasible in many clinical situations, with concerns over patient safety and poor compliance. Modified CIMT protocols have been developed to address these issues, with similar efficacy to traditional CIMT but in more manageable durations.

Fine motor skills practice, such as tracing a design or using a pegboard

Fine motor skills refer to the coordination of small muscles in the hands and fingers to perform tasks requiring precision and dexterity. These skills are essential for daily activities such as writing, feeding oneself, and manipulating small objects. After a stroke, survivors often experience weakness in their arms, lack of coordination, and changes in muscle tone. Fine motor skills practice can help improve these symptoms and restore arm movement.

Tracing a design is an excellent way to build fine motor skills. It helps create muscle memory and improves pencil control, which is essential for legible handwriting. Setting up a simple tracing binder with various tracing worksheets, from easy to difficult, can make this practice convenient and enjoyable. Dividers, stickers, and a progress chart can also be included to make the activity more organised and motivating.

Using a pegboard is another effective way to improve fine motor skills. This involves picking up small objects, such as beads, and placing them onto the pegs of the board. This activity requires precision, coordination, and dexterity, which can help strengthen the neural connections between the mind and arms.

Other fine motor skills activities that can be beneficial for stroke survivors include:

• Squeezing sponges and transferring water from one container to another.
• Using tweezers to drop crumbled paper into a cup.
• Manipulating clothing fasteners such as buttons, zippers, and snaps.
• Squeezing coloured water with pipettes into cups.
• Cutting straws and threading them onto a pipe cleaner.
• Playing with playdough to strengthen hand muscles.

Frequently asked questions