If stroke survivors fail to move their muscles (either through active exercise or passive range of motion), they may develop a condition called learned non-use. This condition causes your brain to have even more difficulty paying attention to the affected muscles, therefore making it harder to rehabilitate these muscles and over-relying on your non-affected side. This is where the phrase “use it or lose it!” comes from.
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A core part of the ARNI approach is to teach stroke survivors how to cope with falls; the most dangerous part of the balance problems caused by stroke.
Survivors (many of whom have the functional use of just one arm) learn how to get down to, and up from, the floor without any kind of external support to pull themselves up with.
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I need to learn how to get up.with no aids.I asked my NHS physio several times but they just ignored it. Starting with ARNI in the new year
How do I get help from ARNI Stroke Rehab & Recovery as when I had my stroke the covid outbreak started and I had no physio.
There should be funding for those on benefits as our OT is understandably cut short due to the system behind under resourced
Took me 4years but I've lost my ability to do it now. 8 year post and seriously regressing rapidly due to spasticity
I need to learn how to he up and down from the floor xx
In order to efficiently rewire the brain, you need high repetition because that’s how the brain rewires itself. Each time you repeat a movement, the connections in the brain become stronger. If you aren’t consistent, then the connections quickly grow weaker and fail to produce results.
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If you do the maths - it's true!
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Although the brain is in a heightened state of plasticity immediately after stroke, neuroplasticity may be activated throughout the recovery process; whether it has been a few months or a few decades since a stroke, the brain is still capable of healing and rewiring.
Studies have shown that the brain is changing itself throughout an entire life time. This means that recovery is continuous. Whenever you stimulate your brain with positive, consistent and repetitive stimulus, the brain will respond.
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Knowledge is power.; and even more so for stroke recovery!
In the field of stroke rehabilitation there are new advances, major and minor, emerging regularly. You need to keep as current as possible. You need to know what you need. And if you find things that seem appropriate to your needs, investigate them further to work out whether they’re suitable applications to streamline your retraining or self-management.
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Tom doing sledgehammer levering work in his home gym with his homemade loadable axe-lever. Tom had this made at his local blacksmiths. This isn't something for 99.9% of stroke survivors to be doing, but there's no reason not to work your grip and wrist power as hard as possible, however possible, on your stronger and weaker sides. Type in 'weaver stick work' to Google for an example of how to do lever-bar work for wrist power.
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Exercise: Wall squat hold
Did you notice that this technique is called a wall-squat hold? There is a reason that you don’t attempt to turn it into a squat, and try and rub yourself up and down a wall. Such an attempt won’t work for stroke survivors, mainly because the affected foot will slip away, and you could easily be unable to slide up the wall because of the friction involved.
This exercise is to slide down the wall and hold until near failure, then lean forward, push away from the wall and stand upright. You should not feel pain or discomfort in your knees at any time during this exercise. When you think you are coming towards the end of failure, just move to a standing position. Over time, your judgement concerning extending the failure window and successful successful completion of the set will be honed.
Read full Techniquein The Successful Stroke Survivor book by Tom Balchin
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5 Factors You Can Control in Stroke Recovery
Neurological rehabilitation is a complex process, influenced by many factors – most of which are outside of your control. You can’t control your age, how big your stroke was, or how severe your deficits are. You have limited control over your access to skilled therapy and whether you have a solid support network of friends and family in place. While this lack of control can leave you feeling helpless, there are some important aspects of your recovery that you can take responsibility for.
Here's how these 5 personal factors can impact your stroke recovery:
Recognition
In order to improve, first you must have awareness that there is a problem. If you think you speak just fine, it’s highly unlikely you’ll put in the time and effort required to change your speech. Some stroke and brain injury survivors are unaware they have problems with communication or cognition, a condition called anosognosia, so when they come to therapy, they don’t understand why they’re being asked to do the tasks. Building insight into the problem is an important first step in rehabilitation.
Motivation
After you recognize you have a problem, you must have the desire to change. If you know your speech is slurred but don’t care, why would you put in the time and effort to improve it? Some people lack motivation because they’re suffering from clinical depression, while some strokes physically damage the neural networks and dopamine pathways that control motivation. If you are feeling chronically unmotivated to improve a known impairment, talk to your doctor. And remember, it’s the person with the problem who must want to change – not just their family.
Determination
Having the desire to change is a great start, but you also need the resolve to do the work. Changing the brain is possible with repetition and time. There are no easy fixes, so if you really want to change, you have to be prepared to put in the effort – especially when it gets hard. Setting up small tangible rewards for yourself along the way can keep you moving forward when changes in your communication are harder to see.
Direction
You know there’s a problem, you want to change, and you’re ready to work hard – now you need a road map. This is where having a good therapist can help you set realistic goals, helping you know where you’re going and how to get there. You’ll receive instructions, exercises, or activities to help you improve.
Conviction
Deep down, you have to believe that change is possible. Hope is a powerful drug that makes therapy so much more effective. Some people hear from their doctors that they won’t get any better after 6 weeks, 3 months, 6 months, 1 year… These timelines are untrue and can destroy hope. Hope alone won’t make you better, but without hope, progress is rare.
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Have you ever thought about doing core exercises on a chair? (no, me neither). Sit on a hard chair so the back of it is by your good arm. Then lean back, safely, as far as you can, to work your core. So its the same exercise without having to get down to the floor. So wherever you are shuffle forward a bit to give yourself some space to lean back and you can do it anywhere. Clever!
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