The hand is one of the most fascinating and sophisticated motor systems your body possesses, with inherent paradoxes when it comes to stroke. For example, if you have high tone, you might be cursing your bad luck. But actually, you should be thankful because the evolution towards increased tone in your hand is a very good thing. It is the clearest sign that you are recovering from a severe sensory loss. The mechanisms of recovery of hand motor function after stroke are to date, poorly understood, but we know that as the brain starts to recover the muscle tone increases – and then control can be regained… in many cases to the point that normal use returns.

For others, the tone in their hands can exasperatingly remain very much more increased and they cannot work out how to get over that final hurdle to start regaining control. Actually, most stroke survivors I’ve met are so badly uninformed about their own limitations that they do not know how the tone that is affecting them works… meaning that it is very hard to understand how best to tackle it. So, let me tell you what I’ve found out myself, through research and practice. At the very basic level, you can achieve a great deal by simply trying extremely hard to work your fingers … basically, doing the maximum.  Spasticity essentially keeps the muscles from being torn, and so if you do the kind of task-related training our Instructors show you how to do, you are essentially convincing your plastic brain to change the strong protective messages it is sending to your hand, and start rewiring.

The hand of the stroke survivor

In the non stroke survivor, most upper-extremity actions are initiated by the hand. Movements begin with finger or wrist motion and are followed by elbow and then shoulder motion for use in functional upper extremity tasks. It is posited in the research that for stroke survivors, this pattern happens the other way around. Most active movement is initiated from your shoulder, leaving the hand with minimal control. You need to know this, because it affects your choice about whether to concentrate hard on working only your hand or working hard on your arm hoping that such efforts will initiate and strengthen the movements in your hand.

Let’s look at how your hand movements happen. The non-stroke survivor’s fingers can be straightened or curved into hundreds of various positions and the thumb can meet every part of the finger on the frontal surface. For stroke survivors, however, this movement is limited by the muscles.

It is actually the soft tissue shortening of the long finger flexors that is probably the single most limiting factor to regaining hand function. This can be graded on a scale of spasticity such as the Modified Ashworth Scale with scores ranging from 0 (no tone) to 4 (rigid) or the Tardieu scale which also differentiates spasticity from contracture.

I know that your hand may seem the hardest of all limbs to achieve movement return from, but I am here to tell you that you CAN regain a great deal of movement, however hard it may seem initially for any results to come through from your training. It is NOT easy and even after substantial recovery from stroke, individuation of finger movements remain reduced, both for flexion/extension and for adduction/ abduction motion of the fingers. You must take on board that results with the hand are not instantaneous, rather, you will find (as all our stroke survivors do) they are very slow and incremental. But don’t make the biggest mistake of and think that you cannot progress to a very good degree with your hand using the ‘slow and steady cooking’ method – and don’t even begin. NeuroGripper is here to help you.

ARNI urges you to trial it, see what happens and feedback on results.