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Gabis student 2 225x300 - WHY USE A TRAINING DIARY IN REHAB? - Stroke Exercise Training - online courses for therapistsLots of people know that recording what they do in retraining helps them to improve their retraining after stroke.

You can do the ‘Basics Is Best’ approach: concentrate on doing during your self-retraining time, what you can do, with reference to a customised plan. And then record it. And then refer to your recording when you need to.

BUT THIS ALL VARIES ACORDING TO WHO YOU ARE.

Do you need a planner? Yes and no. Many people prefer to go freestyle (loose-plan), and since I had a stroke in 1997, I’ve done just that. This is because you can ‘group around’ just 4 or 5 of the most essential exercises to do and progress at them.

Do you need to record training? Yes. And I’ll explain why, below.

Do you need to evaluate your training records? Yes and no. I’ll explain more below, don’t worry!

I hope the above doesn’t make you run a mile! Because as with all things, retraining can be much more complex than this if you wanted it to be. But believe me, it doesn’t have to be. It can be ultra-simple.

Let me prove it to you. But bear in mind that my ‘big own secret’ to my success has always been the recording of training.

I’ve returned from total paresis on one side of my body to near full function. But I still need to retrain, 24 years on, in a way that mirrors those wanting to get stronger and fitter. The big key that has emerged from the research, as far as I’ve concerned, is that increasing one’s performance in both aspects plays a direct part in increasing functional control. Plus smart use of the adjuncts (the myriad of interventions available to you).

First, confusion must not be allowed into your retraining. A (loose) plan is needed

A simple way to view improvement is to think about the word ‘progression‘ as it applies to you. Progress is fulfilling and exciting…and it personalises your training. It creates interest in your own improvement. So how can you measure progress? I put it to you that measuring progress yourself is hard! Even neurophysios ‘measuring’ your status and improvement can be wrong, although they can certainly help you to narrow down a picture for you of your own presentation at a point in time.

A few of the people who I’ve trained become upset because they don’t feel they are getting much more progress, even though they feel they are working as ‘smartly’ as possible, and think it’s because they’re doing something wrong. When one analyses their self-training, it’s almost always because they have missed out being guided onto training on the basics, given no progressive training plan that stands a chance of working for them and they also don’t actually record progress even though it is always strongly advised by neurophysios.

training tracker - WHY USE A TRAINING DIARY IN REHAB? - Stroke Exercise Training - online courses for therapistsAt ARNI, for instance, when these people are reminded how they really were physically and mentally a few months before, they can see that actually, progress is still coming in steadily and well. Often, once the ‘big fixes’ have worked, there is a period where progress cannot visibly be seen week to week, and may often appear to be going backwards. It is at these points that the steady recording of training details pays dividends to put progression in perspective.

Remember, your recovering brain may play tricks on you. Even after, say 6 sessions of working with ARNI, you have moved from nearly being able to shuffle along with two helpers holding you up, to being able to get off the floor unaided and walking independently without a stick for twenty yards, you may still think you’ve not made progress. You might laugh, but I’ve seen it happen too many times for it to be amusing anymore.

It’s fair to say that even though I have told so many people about how well training diaries which accompany retraining work, only a few people have ever shown me that they use them.

The people who do have all excelled in their retraining and progressively got back new movement evidenced by ability to do new tasks and activities. This is why I really want you to record your progress.

Recording of ‘work done’ is something that can be done really easily. ‘Many a mickle makes a muckle’, and all that. All you need to do is make notes in a box or just tick pre-made boxes. And days go by into months, into years, very quickly.

You’ll create your very own ‘record of success’. Why wouldn’t you do it, really?

Some people can get away without using a training diary, but it is not a good idea. It creates interest and a bond to training. It means that training is not just an abstract thing you do a couple of times a week: it means that you are ‘tied’ to it.

If the stroke has not affected your writing, reading or vision, buy (or ask a friend or relative to buy for you) a diary. or use an Excel spreadsheet or something similar if you are computer literate. It’s the cheapest and best thing you can do for your own rehab.

If you get a diary, make sure it’s A4 size. Through experience I’ve found that the A6 or A5 diaries don’t give me the feedback I need. Buy one with a week spread out over 2 pages. Basically, you want to be able to see your whole week.

Dr Tom Balchin ARNI STROKE training diary mine Copy - WHY USE A TRAINING DIARY IN REHAB? - Stroke Exercise Training - online courses for therapistsGet the leather bound variety: why not? You’re worth it. Get one with gold-blocking on the front. Why not? This needs to be something visible and ‘of worth’, not something that can get lost. A coffee-table thing. You are not only going to record the exercises you did in this diary, but you will record briefly how you felt and other details which I’ll note further down in this info-blog.

In the end YOU need to make sure that YOU invest the time in YOU. And, this time should be recorded. Otherwise you can simply go into a ‘holding pattern’ of neither doing badly, but not doing particularly well either.

Remember the ‘toy duck in a bath syndrome’ analogy from by book/manual: The Successful Stroke Survivor?

At its most simple (and it should be simple), a glance to last week’s note should be all that’s required to set a planner of ‘what to shoot for’ this time. In terms of the other aspect (what are you finding it easier to do?), this can also be a place to record that information and information on progression can be gleaned from tiny but progressive gains made in a tiny core group exercises (no more than 4, trained weekly), with 3 minor ones trained daily, plus fitness work. This does of course require you to be cognitively ok also, in order to this. Further external measures are also vital indicators but often not fully necessary (or consistently necessary).

2021 07 29 17 55 52 300x244 - WHY USE A TRAINING DIARY IN REHAB? - Stroke Exercise Training - online courses for therapistsMy ARNI trainers all keep records of their sessions with survivors (we send this to the survivor and instructor to work with together). This has been ARNI protocol for at least the last 10 years, and it works well.

Instructors set ‘homework’: one to five key movements, that if worked upon, might open up scope for new function. And there is usually a very clear correlation between those who indicate that they are not doing any rehabilitation work outside of class, and non-progress.

We have even had some stroke survivors who, in class are extremely dedicated. But when they turn up each week and are questioned and their training records (of whatever sort) noted, it’s clear they have done nothing. In the end, you don’t ask. And in the end, they sometimes leave because their progress is not as it should/could be.

I’ve also found that the oldest stroke survivors usually accept that a high level of inability to perform activities will be with them through the rest of their lives, and do not believe that it is worth the effort and time trying to change things a little. I do understand this belief and it’s ok. But I wish to offer my own belief that whoever you are, whatever your age, you should do your best to help yourself consistently. If not for yourself and for your own life-state from now on, then for those who love you and care for you.

You can’t rely on your best friend, your partner or your parent telling you that you ‘seem to be doing much better.’  This isn’t good enough, and it’s hardly objective enough. These loved ones may not tell you the truth or they may not know it. Progression is notoriously hard to ‘measure’. So, you don’t need to. All you do is record what you do. You need to start to record your training then gently create your own feedback (whatever you like)… not just by recording what you manage to do, but how you feel about it too. This feedback should be encouraging but critical: reflecting the truth as far as you can see it. You’re not a neurologist or neurophysio (or unlikely to be), and it doesn’t matter at all.

All you’re doing is recording what you’re doing, and recording how you feel about it. Plus additions like weight, supplementation, sleep patterns, medication – if you want to/need to.

I did, and again it was a big key to my recovery. Did any physio show me how to do this stuff? Absolutely not. I needed to do it because I WANTED my recovery to be excellent. And I took my cues from what I could find out at the time, particularly in hand-exercise books (piano-exercises) and formative weight training books.

So, why record?? The reason is that the value is largely in the process of recording, itself. Hardly anyone gets this.

Writing, if one can do it (or typing, I’m sure), also may well contribute to ‘hardwiring’ what one has written or typed into the brain in comparison to just doing something and trying to remember what one has done into the brain.

Furthermore, to be filling in your diary week on week means that you are planning your week around your retraining, even loosely. And you will find that it is a source of enormous self-pride.

POST IT NOTES FOR ARNI STROKE REHAB TRAINING BRAIN NEUROREHAB 300x169 - WHY USE A TRAINING DIARY IN REHAB? - Stroke Exercise Training - online courses for therapistsThe other big key to recording, which I’ve noted no-where else in my texts for survivors, is advice to:

  1. Have a plan from the last time you recorded
  2. Make rough notes on a Post-it, or jotter.
  3. Take that Post-it into training and annotate it by noting sets and reps with marks and/or numbers and scribbles. 
  4. Then ‘transfer this info into best’ by writing it up in your proper A4 diary.

In this way, you have clear, legible detail that you can add to as you write it all down. Your diary will constantly reinforce the fact that, even if things are ‘going wrong in your progress’, that you are actively doing something about your own physical condition. Week on week, year on year.

At points along the way, you will begin to see patterns of development (or things you can work on) based on the data tracked in your diary. This is useful information for assessing goals. Compared to the amount of hours you will spend with progressively more movement in your lifetime, the few minutes a day (or every couple of days) it takes to make your diary entry is a tiny investment that will reap huge dividends.

Some people never give up their training diaries, and consequently have an amazing record of their rehabilitation. A memoir of lessons learned and goals achieved. What begins as a simple tool to improve training turns into a personal history, an archive, of your life as a stroke survivor rehabilitating.

I personally started to record my own training roughly a year after I had my stroke, and although they morphed into mainly records of my weight training progression (probably a natural requirement for very many other survivors too), it is incredible to look back on now and see what has been achieved. I still have all seven, in a pile. I only stopped because I was doing such freeform training, that I felt that I was at a stage where training (and experimental training) was so much part of my life and routine anyway that recording was unnecessary.

The best advice for stroke survivors reading this, is that at whatever point you are, to start recording your retraining, it will immediately add a sense of purpose, a seriousness and dedication to incremental development. You can easily that a training diary is one of the keys to real body transformation, and it’s so easy to do. I challenge you to do the same.

2021 07 29 17 34 18 231x300 - WHY USE A TRAINING DIARY IN REHAB? - Stroke Exercise Training - online courses for therapistsI buy a training diary for myself and my training partner every year – to just list a few key lifts (the big four) and this has again led directly to solid progression all over again. It’s great.

I’ve also got a much smaller notebook next to my bed where I chock in the date and number of sets and reps of lying on bed hamstring curls and pull-ups. Performance on both of these, for me at any rate, can diminish quickly. So I need to keep track – and not stop.

Some stuff like treadmill 45 degrees fast-walking/weighted-walking doesn’t need to be done, but a marker per day such as half a mile or a mile is a good one. My treadmill is in my office, so it’s hardly a hardship.

Depending on how much you want to use your training diary, besides recording training sessions, you may also decide to use it to record the times when you felt happy because you recognised that progress had been made as you did a specific thing. If you recall something like this, when filling in your training diary, record it too. The more information you gather the better job you (and your therapist or trainer if you have one) can do at managing your training. I remember that for years, we gave stroke survivors who came to see us a ‘Critical Incident Book’. This was not to record how many times they fell over!

We asked them to record any incidences when they found themselves doing something new. The result was a surge of confidence because when they were actively looking for the beginnings of new movements, typically they found themselves doing something unconsciously that they could not do before. One of my clients found that she was reaching for a fridge handle with her paretic hand and trying to open it, so I made sure that she tried to do it again like this each time she encountered her fridge. This became a ‘no-brainer’ ADL task for her, and she trained her brain to do it better and better over time.

In the same way, another lady recorded that she had just walked over a small bridge at her workplace without having to hold on. Even though she moves slowly due to her foot falling to the outside, it is a source of pride to her that she does not hold on, and never allows herself to do it again. Conquering this also means she has also become much better at not clutching onto walls when walking in big rooms. Many stroke survivors will go all the way round the whole wall of a room, however big it is, to avoid walking across it.

training tracker - WHY USE A TRAINING DIARY IN REHAB? - Stroke Exercise Training - online courses for therapistsSuch incidences are exciting because they show that the training is ‘working’, Certainly function is unlikely to be as efficient as before. But switched-on stroke survivors will then use these indicators of movement and work on them as triggers for their everyday rehabilitation.

So, doing it (safely) is important. Recording it is equally as important. You are training for you. You must be 100% honest when entering data. Record the quality of your repetitions: the form you use for each exercise must be as consistent as possible every time you train. If you did five good repetitions of a technique, but the sixth needed a tad of help from a family member or trainer, don’t just go ahead and record all six as if they were done under your own steam.

Sounds strict? Yes… but it can become a habit very quickly, and you’ll be very glad you did so. Record the ones you did alone, but note the assisted repetition as only a half repetition.

The order in which you note your exercises is also important for comparison purposes, and this is especially important for strength sessions. If one week the ‘getting up from the floor technique’ is your first exercise and the following week you train this movement at the end of the session, for obvious reasons, you cannot fairly compare your performance over those two sessions. You must, please, be forgiving to yourself regarding your own performance. Training progress is most definitely not linear!

This point goes way back to previous blogs of mine about the nature of success in stroke rehab and also to the points made about creativity in retraining.

Your mission now is to take as much control over your life as you can. Learn from your mistakes. Capitalise on the good things you have done. Do more of the positive things you are already doing and fewer of the negative things. It’s not a daunting task. Just set up a spreadsheet on the computer or use an A4 diary if you can. There are also A5  dedicated training diaries available from ARNI Charity site (shown below), but really, it’s much better to get your own A4 one.

diaries pic Copy - WHY USE A TRAINING DIARY IN REHAB? - Stroke Exercise Training - online courses for therapistsIt can make you obsessive about self-rehabilitation. But I’ve not met very many people of the thousands of survivors I’ve met who really are. In fact, there’s no need to be this way.

Short, progressive 45 minute max sessions daily or once every two days, with additional high dosage daily upper limb work and moderate daily fitness work as required, works much better.

Remember, the more information you gather over time, the better job you (and your physiotherapist or trainer if you have one) can do at managing your training. So the better records you keep, the better you are going to get. This is exactly the zone in which you need to be operating in as a successful stroke survivor, where each mini-success build on mini success. Iterative success. And you’ll see these successes translating into more functionality in daily life.

Many factors like fatigue or pain may mean that you simply won’t be able to do so much rehabilitation for yourself at first – but these require observation, evaluation and management. You will soon understand that retraining can help you with each of these two – and so it will merge with your lifestyle… and that lifestyle is certainly not all about retraining. It just becomes something you ‘do’, alongside everything else in your life. And that’s the free key to stroke rehab success I offer to you today!

And as a reward for reading this far (!), do feel free to email me personally on tom@arni.uk.com to ask for my whole 7 DVD set for just £30 including postage and packing. This is down from the original £100 including postage and packing.

See video below (which has sound switched off: it’s not your pc!).

Btw, there is no sound on this sample, just a quick look for you:

 

Is your rehab on pause or are you just needing more? Or do you know someone in this situation? Is physio just too expensive or unavailable? Are you currently still in a wheelchair or just not doing enough to progress? Do you know how to? Or, do you have just a few limitations from stroke?

front page flyer 212x300 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsWhatever your status, whoever you are, to mark 20 years of ARNI, we would like to offer you today the Successful Stroke Survivor DVDs (Full set) (all 45-60 mins) with a massive £50 off!  

7 DVDs for just £39.60! Please hurry while stocks last at ARNI, to avoid disappointment. Read the many testimonials below.

With this offer, 4 of the 7 DVDs can be gained for free!

Learn how ARNI Rehab Concept align directly with the latest evidence base for stroke rehabilitation interventions and get to practise them alongside Dr Balchin as your guide, at home.

PLEASE HELP OTHERS: If you have a family member or friend who has had a stroke, would you forward on this offer to him/her/them, if appropriate?

If you are a stroke survivor, by following the advice in these 7 DVDs you will totally transform yourself. You will be able to consider careful reduction of the use of a wheelchair, stick and rigid plastic orthotic, as appropriate. Amongst many other things, Dr Balchin will show you a totally innovative method to get down and up from the floor, how to do it in a totally safe way and run you through all eventualities.

2016 10 31 00 44 06 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapists2017 04 23 02 23 40 300x271 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsHe will show you how to recover balance, how to walk and turn without problem, how to cope with drop foot, how to reach, grasp and release well again, how to become stronger and robust.. and how to tackle all sorts of activities of daily life that you hadn’t dreamed possible after stroke.

Importantly, he will show you how to become more self-reliant rather than dependent on others.

Contained in these DVDs, is a wealth of information relayed by Dr Tom, who has ‘been there’. A stroke survivor himself, he shows you exactly what to do to make an incredible recovery: you will not BELIEVE what can be done!

dvds back - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsYou can do it: Dr Tom will show you how, and in the Bonus DVD, will also show you a full training session with a stroke survivor so you can see how everything works.

To mark 20 years of ARNI: £50 off Full Set of Stroke Rehab 7 DVDs.

CLICK HERE TO GET YOUR DVD SET!

Make sure to select the ‘DVD Set by Post’ in your video type to take advantage.

Reviews:

  1. Thomas Eldred (Verified Purchase)  (USA)

    2016 11 05 02 19 29 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsMy husband had a stroke 2 years ago. He works hard every day to rehab, and Tom Balchin’s book and videos are so helpful. My husband, also named Tom, has not learned how to get up off the floor, however, or to get down. He never felt confident practicing that and in all the PT he did, no-one ever suggested it. Tom is very strong and except for his first week at home from hospital, he had not fallen until last week. Now he is willing to learn the technique, but we cannot go to PT due to Corona Virus, and I am not confident to do it without help. However, we are learning the technique, and I am practicing it, and at least if he falls again, we will have a strategy! I really thought he would be able to get up if he fell, but he couldn’t. Thank God for our neighbor! We are really also grateful to Tom Balchin for dedicating himself to helping stroke survivors. My husband, Tom, is 75 years old, a retired police officer and a determined man, but we needed Tom’s DVDs to help with rehab at home. Thank you.

  2. Elvira Oravecz Péter (Verified Purchase)  (Hungary)

    2016 10 31 02 57 28 Copy - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsVideo 1 could take away fear and insecurity – huge obstacles of living at our best capacity even surviving a stroke or other brain injuries – of falling and laying on the flour at the mercy of others by teaching us techniques and strategies how to successfully manage these scary situations. In video 2, in 38 minutes, if I counted correctly, we got 11 new exercises, techniques and movement patterns to further improve our strength and skills for controlled and precisely executed muscle work necessary for self-management. It is better to call this target-oriented functional training, as these exercises have deeper aim then just moving the body, increasing muscle strength and joint flexibility. The goal is to cope smoothly and well with the smaller and greater challenges of everyday life.
    pic11 212x300 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistspic19 Copy 1 300x245 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsAnother video is focusing on walking. It is full of clear explanations and easy to follow demonstrations of simple and short exercises, techniques, helpful ideas and tips that all support the different phases of using and re-using our legs from hip to toes. If you want to help a stroke survivor or you are a stroke survivor who is ready to get back this vital skill, this part is a must. In another of the videos Dr Tom gives a list and lovely demonstrations of task specific and stroke survivor adapted strength training exercises. Again a must to watch for ideas.
    2016 10 31 00 56 08 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsThe fifth and sixth videos again are a never-miss piece, full of exercises that all focus on helping to get back the function of the upper limbs which is more difficult than regaining back the strength and function of the lower extremities. Retraining 3-4 days per week is the key to success. Dr Tom with his demonstrations and explanations again gives you all the tools, tricks and encouragement to reach this goal.
  3. Petr Pokorny (Verified Purchase) 

    2016 11 05 01 59 02 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsThese videos are such good guidelines for upper limb rehabilitation. I watched the upper limb volume (along with the volume 5) several times and keep coming back to it in order to remember the techniques as well as for getting further inspiration. I always find something new in it. One thing is to understand the material and another one is to successfully apply these methods to a client who had a stroke. These functional stretching techniques differ so much from traditional physiotherapy and are much more logic within this holistic concept. Moreover, they work.

  4. 2016 11 05 02 10 56 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsEnikő (Verified Purchase ) 

    All DVDs are very important to us for my husband, every move is very precious every minute, thanks for the help, we work every day, we learn. We want good health and good luck Enikő and Ernő

  5. Tim Webster (Verified Purchase) 

    Full of practical tips, drills and ideas, “THE SUCCESSFUL STROKE SURVIVOR” videos are an excellent resource for stroke survivors.

  6. Suzie (Verified Purchase) 

    I definitely recommend these dvds, beautifully presented and easy to follow and very inspirational. I use them now in addition to my private physio to help in my recovery, only wish they were available earlier. Lots of training strategies and exercises developed by Tom, a true expert and stroke survivor. Don’t hesitate buy the complete set.

  7. 2016 11 05 02 09 42 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsNicole Wright (Verified Purchase) 

    I am an ARNI instructor in training and I am finding these videos essential in helping me become a knowledgeable, effective and inspired trainer. I purchased the complete set, along with Dr Balchin’s Stroke Survivor book and I refer to them on a daily basis and I know they will continue to be an indispensable tool in my development. Each technique is clearly explained and demonstrated by Tom and the great thing is that you can pause at any point to try it yourself, or listen back to something. If you are a carer, friend or family member, wanting to help a loved one who has had a stroke then these DVDs are a must.

    pic3 300x209 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsI found DVD 7 really informative and useful. Seeing Brendan training with Tom and Gabby helps me understand how I can effectively work with stroke survivors in a safe yet challenging way. Seeing some of the functional limitations Brendan has, but how these can effectively be worked on by doing the techniques in the DVDs and stroke survivor book is inspiring. I actually met Brendan at a training day a couple of months ago and I can honestly say that his gait control and upper limb function had both improved and he did tell us that he is still practising most techniques on a regular basis.
    DVD 6 is a really useful demonstration on creating your own task related and challenge boards. Tom gives step-by-step instruction to how to make one (I particular like his comment on what DIY stands for!) and then shows you how to use it to effectively train upper limb functionality. Being able to see this process and stop and stop the video as many times as I need is indispensable in helping my understanding and my journey to hopefully being a highly effective ARNI instructor.
  8. pic18 Copy 300x288 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistspic7 300x218 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsMark Bowra MBE (Verified Purchase) 

    As a former Royal Marine, these exercises have been paramount in improving the functional use of both my arm and hand. I would wholly recommend ‘DVD Volume 5’ to anyone who wishes to improve their condition, following a stroke.

  9. Russ Kennedy (Verified Purchase) 

    It’s my pleasure to recommend the Stroke Solutions DVD. I purchased the book, The Successful Stroke Survivor, about five years ago but found that I needed to be shown how to do certain exercises. Since I have obtained the affordable and worthwhile DVD, I continually refer to it. I wish that you had been able to make it available sooner. Many thanks. Russ Kennedy PhD, MBA, MPH

  10. Justin Smallwood (Verified Purchase) 

    2016 10 31 00 41 17 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsDon’t muck about umming and aahing! Just get the lot! Tom will then help get you going. Tom is really easy to listen to; clear and thoughtful. Then, when he gets down to it, he shows you how it’s done. Tom is strong and agile but his fluent movement is as a result of hard work. If you get half as good as Tom, you’ve gone a long way. The DVDs are, in my view, essential viewing for stroke survivors, their family and friends and those training to become rehab trainers.

  11. Peter Corfield (Verified Purchase) 

    I had an AVM stroke 1st June 2010.We were in France. My wife found me on the floor having returned from an art experience there was no way of telling how long I had been there. Maybe 4/5 hours or longer a helicopter was called from Dijon I was flown to a hospital in a coma. Missed out on the view. They did an emergency craniotomy to repair the vein that had burst .I was put in an induced coma for about 2 and a half weeks. When I awoke I was hemiplegic left side. Enough about me. These DVDs are so Amazing I can’t tell you how good they are in words try them yourself. I may even do some of the exercises as my you tube stroke blog when I have enough time in the day . You may have seen me armchair gardening filling and emptying the dishwasher fetching the wood. Everyday life can be achieved after stroke and I owe it all to Dr. Tom Balchin and Arni Institute. Buy the DVDs they are Awesome.

  12. Nick Cole (Verified Purchase) 

    pic4 300x268 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsThe experience of stroke can be totally bewildering for the patient and their partners/loved ones. One moment getting on with your life fine and the next – BAM! – you’re flat on your back in a hospital bed with only half of your body working properly! Thankfully, a friend with MS put my wife in touch with Tom Balchin (way back in 2005) and since that time I’ve had two ARNI Instructors.

    Finally, all his knowledge is distilled into a set of DVDs. They’re pure gold dust, refined over many years experience working with stroke survivors of all ages. I’m working through the exercises in the DVDs and they still form the basis of my twice-weekly physiotherapy and self-rehab programme.

  13. Louis Rowson (Verified Purchase) 

    Found the DVDs very inspirational, I have had a lot of help from the wonderful therapists in North Devon, but need now to move on and I believe Tom’s DVDs will help me. My initial prognosis left me wheelchair bound, but with determination and support I can now walk with support, my left hand is still of very little use but I have been given fresh motivation by the DVDs.

  14. dvds front - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsElizabeth Wallfisch (Verified Purchase) 

    These DVDs are beautifully and compassionately presented by Dr Tom Balchin and his team! Every move, exercise, strategy is clearly described and demonstrated, with many repetitions of the complexities of some of the coping strategies and functional training techniques and drills. I recommend these to every stroke survivor and their families, and carers. As an adjunct to ‘The Successful Stroke Survivor’ the DVDs give strong visual and aural cues to the descriptions in the book. This actually makes the learning of, and thus the effective implementation of the strategies, much more accessible.

  15. Gary Sacheck (Verified Purchase) 

    I am a stroke survivor and agree with the statement that, “knowledge is power” and this video plus all those that accompany this in Tom’s collection deliver that specific knowledge that a stroke survivor needs. This video like all in the collection inspire and provide the variety and “make it fun & interesting” style in your exercises to help you keep your rehab progressing.

    2021 01 20 15 52 58 300x226 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsVideo 1 is excellent functionally and inspirationally. As a recent stroke survivor being able to get down to and up from the floor safely is huge! Yesterday, I fell suddenly outside in the yard. I am not sure how my fall occurred. One minute I was upright the next minute flat on the ground on my bad side. Stunned for a short time I remembered the technique I learned from this video and was up on my feet in seconds. Success!
    Video 3 is an excellent video and important for us stroke survivors to have as a guide. Great “stuff”! Many great exercises for us stroke survivors all condensed in one video narrated and per formed by one of us, a stroke survivor. If you want to continue your journey of post stroke function & balance improvement get this video.
    Untitled 2 300x298 - A GIFT FOR YOU TO MARK 20 YEARS OF ARNI! CLAIM £50 OFF SET OF 7 STROKE REHAB DVDS! - Stroke Exercise Training - online courses for therapistsVideos 5 &6 have great demonstrations and specific recommendations on objects you can create yourself at home to help you in your upper limb recovery. Recovering upper body strength is very important for me. However my dilemma was how to begin on my own. This video gave me wonderful direction in that regard. If as a stroke survivor, you dream about regaining the techniques necessary to effectively get around in public you need this video. If you want to try and improve your function after your stroke this video is excellent. Overall, Tom’s performing the activities and narration are great! There are no guarantees in stroke recovery but this video certainly gives hope and encouragement. Personally I am very pleased that my road to recovery is helped by this video.
  16. Owen Thomas (Verified Purchase) 

    Very informative and helpful: clear and concise instructions with great attention to detail on technique! Thank you!

new008 225x300 - CARDIAC REHAB: DO STROKE SURVIVORS THINK IT'S WORTH DOING? - Stroke Exercise Training - online courses for therapistsResearch has suggested a lack of physical activity as a significant risk factor for stroke, suggesting increasing exercise and physical activity levels may aid stroke prevention by providing significant health benefits. Strong evidence exists to support this, suggesting aerobic exercise improves an individual’s heart health and vascular profile, through reducing total and low-density lipoprotein cholesterol, reducing blood pressure and enhancing glucose regulation. These health improvements can prevent many stroke-inducing conditions, including obesity and type-2 diabetes, suggesting the positive role of exercise in preventing recurring stroke.

Additionally, research has also indicated exercise following a stroke helps to improve balance and mobility, reducing the severity of any remaining disability, minimising the long-term physical impacts. The evidence also indicates that aerobic activity following stroke may increase the individual’s independence and quality of life.

arni charity stroke exercise training 300x169 - CARDIAC REHAB: DO STROKE SURVIVORS THINK IT'S WORTH DOING? - Stroke Exercise Training - online courses for therapistsAerobic physical activity can also provide psychological benefits. Mental health benefits have been observed in a number of research studies, with concomitant reduction of depression rates being noted.

Do cardiac rehabilitation exercise classes generally gain uptake with stroke survivors?

Cardiac rehabilitation exercise classes can be incorporated into post-stroke rehabilitation protocols in the UK, to help stroke survivors achieve these benefits. Such programmes often feature 10-12 weeks of group exercise classes and health education sessions. But, despite the benefits noted, uptake in these exercise classes is significantly poor amongst strong survivors, with less than 50% of UK stroke survivors participating in cardiac rehabilitation post-stroke.

Nottingham University researchers note that little has been proven about why participation in these exercise classes is so low. Perhaps, for some survivors, a lack of understanding of the benefits. For others, a lack of motivation. For others perhaps issues with accessing and participating in the classes. Many other factors (and combinations of) can cause non-attendance. Maybe many can’t find them, or if they do try them, find that they don’t help their situation and prefer to reduce their cardiovascular risk without being in a group.

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The national situation has, of course, lately been an over-riding issue as classes have been unavailable for well over a year, although some have found reasonably efficient ways to run group exercise classes online. ARNI however, has found that ‘bringing the training to the survivor’ to be the most powerful way to continue throughout lockdown: by training people in one to one situations, outside, on well-matted areas when the weather permitted. And if the person was able at least to sit (or/and stand outside).

A question for you….

Have you ever taken part in a cardiac rehabilitation class or ANY other form of structured exercise class?

If so, would you help ARNI friends at Nottingham University understand your experiences with cardiac rehabilitation?

This research will be investigating factors influencing participation and access to cardiac rehabilitation or similar exercise classes amongst stroke survivors. It will simply involve you taking part in a one-off online interview (approximately 45 minutes), where they will ask you about your experiences. This interview will be conducted remotely over Microsoft Teams or over the telephone… so you won’t need to leave the comfort of your own home. As a thank you for your participation, all participants will be entered into a prize draw following completion of the interview.

nottingham university 300x91 - CARDIAC REHAB: DO STROKE SURVIVORS THINK IT'S WORTH DOING? - Stroke Exercise Training - online courses for therapistsNottingham University hopes this research will help them to add to the evidence of how we can improve UK cardiac rehabilitation opportunities amongst stroke survivors…

Please contact the co-investigator right now: Emma Martin at mzyerma@nottingham.ac.uk

See flyer.

Emma will be very happy to answer any and all questions, and thanks you very much for considering helping her and the team at Nottingham University!

THERAPY AFTER STROKE ARNI R 300x142 - MEASURING HOW YOUR MOVEMENT IMPROVES AFTER STROKE - Stroke Exercise Training - online courses for therapistsStrong evidence exists that physiotherapy improves the ability of people to move and be independent after suffering a stroke. But at six months after stroke, we know that many people remain unable to produce the movement needed for every-day activities such as answering a telephone. So, what can be done?

1. First, it’s important to be able to recognise if a physiotherapy intervention is really aiding a survivors’ abilities to undertake everyday activities or whether the intervention is doing less than it than it purports to/would ideally do.

This requires a deeper knowledge of the biological underpinnings of neuromuscular function. Neuromuscular function includes the ability to use weak muscles in the right order and at the right time during movement and performing everyday tasks in the same way as you did before the stroke.

SLEEP AFTER STROKE 300x136 - MEASURING HOW YOUR MOVEMENT IMPROVES AFTER STROKE - Stroke Exercise Training - online courses for therapists2. Second, to optimise a physiotherapist’s chances to advise/work on an optimal combination of rehab interventions for each individual after stroke, it would be ideal to find out what kinds of sleep patterns are most beneficial for them.

Physiotherapists need to be able to have the same opportunity to diagnose how to help each stroke survivor gain the kind of very accurate movement measures at any point in their rehabilitations that currently, only specialist University facilities can routinely produce. This equipment is obviously expensive and can only be used in large specialised laboratories.

8 300x110 - MEASURING HOW YOUR MOVEMENT IMPROVES AFTER STROKE - Stroke Exercise Training - online courses for therapistsIdeally, more portable equipment should also be able to be accessed by therapists, which would cost less and is designed for use in small spaces. But such equipment would have to also be sensitive enough to provide meaningful feedback for therapists in a similar way to those used by the specialist labs. Such feedback could then be very useful for therapists and survivors to create optimal rehab plans together which would really enable the survivor to work on his/her edges of current ability.

4 - MEASURING HOW YOUR MOVEMENT IMPROVES AFTER STROKE - Stroke Exercise Training - online courses for therapistsA School of Health Sciences research team at the University of East Anglia (UEA) headed up by Professor Valerie Pomeroy are attempting to find out if this can be done, and will also examine how sleep patterns affect rehabilitations.

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The UEA would like to invite YOU to come TWICE to their Movement and Exercise Laboratory (MoveExLab) to get involved with this Project if you can/if it’s appropriate for your circumstances.

Dr Balchin says: you never know how such involvement can directly or indirectly push your own rehab forward, at whatever time away from stroke you are. Knowledge is power, Anything that can give you clues and cues about the state of your rehab and current/future interventions can be useful.

6 - MEASURING HOW YOUR MOVEMENT IMPROVES AFTER STROKE - Stroke Exercise Training - online courses for therapistsGo for it if you can/if it’s appropriate for you!

Inclusion criteria: you need to be 18 or above, have had a stroke at any point in the past, be discharged from NHS stroke services and be without an allergy to latex.

What you’ll be doing:

5 300x195 - MEASURING HOW YOUR MOVEMENT IMPROVES AFTER STROKE - Stroke Exercise Training - online courses for therapistsUpon application, if no contra-indications are revealed, you’ll be invited to undertake 2 assessments at the MoveExLab.

These assessments (around 90 mins to complete each) will be between 2 and 4 months apart. In each, you’ll have EMG electrodes placed on your skin using hypoallergenic sticky tape. These will measure your muscle activity as you move and don’t hurt at all, but just record your natural muscle activity during movement.

8 - MEASURING HOW YOUR MOVEMENT IMPROVES AFTER STROKE - Stroke Exercise Training - online courses for therapistsThey’ll then place reflective markers on your skin. These markers are tracked by infra-red cameras placed at the top of the walls of the MoveExLab.

You’ll then be asked to pick up a telephone several times, which is placed a number of different positions, whilst your performance on the tasks is recorded (and reconstructed on the computer).

Then you’ll complete some questionnaires about how you sleep.2 - MEASURING HOW YOUR MOVEMENT IMPROVES AFTER STROKE - Stroke Exercise Training - online courses for therapists

Then you’ll wear a motion watch on each wrist for 7 days to measure your everyday activity, which you’ll then send back in an SAE.

The Team will be in contact with you throughout the period of your involvement.

Travel expenses can be reimbursed for return journeys of up to 50 miles (ie, 25 miles each way).

If you are travelling in from further away, you can claim travel expenses for your journey up to 50 miles in total as well. 

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Apply now by speaking with the principal investigator: Professor Valerie Pomeroy..

Email: v.pomeroy@uea.ac.uk  Phone: 01603 59 1923

3 - MEASURING HOW YOUR MOVEMENT IMPROVES AFTER STROKE - Stroke Exercise Training - online courses for therapistsOr get in touch with her personal assistant: Pel Fordham.

Email: p.fordham@uea.ac.uk   Phone: 01603 59 1923

Both will be very happy to answer any questions you might have.

Location: School of Health Sciences, Queen’s Building, University of East Anglia, Norwich Research Park, Norfolk, NR4 7TJ

2021 04 13 16 27 47 - CAN STROKE SURVIVORS IMPROVE MANUAL FUNCTION VIA VIRTUAL REALITY? - Stroke Exercise Training - online courses for therapistsVirtual Reality (VR) allows an individual to interact with an artificial world through hand controllers and headsets. It was created for gaming, but research has shown how it may be applied to various health settings.

There is a growing evidence that indicates that VR can possibly improve motor function by providing a fun and motivating environment that can link to physical movements to encourage adherence to rigorous upper-limb task-based stroke recovery programmes. Current clinical evidence shows that VR-based rehabilitation is beneficial as an adjunct therapy to convenient rehabilitation therapy, but it is unclear who benefits most from VR rehabilitation (e.g., severity of impairment, time since onset of stroke, what type of VR (e.g., immersive vs. non-immersive), what kind of feedback is more effective).

2021 04 13 16 28 32 Copy - CAN STROKE SURVIVORS IMPROVE MANUAL FUNCTION VIA VIRTUAL REALITY? - Stroke Exercise Training - online courses for therapistsAlthough delivery hardware and software have  improved over recent years, the evidence indicates that VR platforms do not suit all stroke survivors. Nevertheless, VR-based kit is being designed by commercial enterprises for stroke survivors to try, and this is on the whole, a good thing.

The University of South Wales research is aiming to improve finger function using virtual reality in post-stroke survivors. The researchers are working with TG0, a company that has created a new VR hand controller called etee. etee has the capability of tracking fine finger movements, which when embedded in a virtual reality environment, can offer realistic visual feedback; a key factor in therapies such as mirror therapy.

This is a pilot study to test the feasibility of using VR for stroke survivors.

vr - CAN STROKE SURVIVORS IMPROVE MANUAL FUNCTION VIA VIRTUAL REALITY? - Stroke Exercise Training - online courses for therapistsIf you think you fit the participant criteria below and are kindly interested in helping Bethany Strong a post-graduate student studying at the University of South Wales with the work to test the feasibility and effectiveness of using the VR, please email the team (Dr Biao Zeng, Professor Peter McCarthy, Dr Ali Roula and Bethany Strong) at bethany.strong@southwales.ac.uk for details.

The team is looking for people who:

1)       are over 18 years old.

2)       can give informed consent.

3)       are 3 months or more post-stroke

4)       have reduced control in one hand

5)       have access to the internet and a windows laptop or computer

6)       can understand and read English

7)       do not have any great problems with their vision

8)       do not have any history of motion sickness

9)       do not have Aphasia. (Aphasia is when a person has difficulty with their language or speech).

10)     are not using the Nine-Hole Peg test (9HPT) as part of their usual care/ rehabilitation.

If this technology shows promise, the researchers hope to include participants from the above groups in future studies.

Please download details of the study by clicking this link.

KESS 2 300x195 - CAN STROKE SURVIVORS IMPROVE MANUAL FUNCTION VIA VIRTUAL REALITY? - Stroke Exercise Training - online courses for therapiststgo - CAN STROKE SURVIVORS IMPROVE MANUAL FUNCTION VIA VIRTUAL REALITY? - Stroke Exercise Training - online courses for therapistsesf 300x218 - CAN STROKE SURVIVORS IMPROVE MANUAL FUNCTION VIA VIRTUAL REALITY? - Stroke Exercise Training - online courses for therapistsuniversity of south wales - CAN STROKE SURVIVORS IMPROVE MANUAL FUNCTION VIA VIRTUAL REALITY? - Stroke Exercise Training - online courses for therapists

P1010397 1024x768 - ARNI APPROACH FARES WELL IN SYSTEMATIC REVIEW OF EVIDENCE BASE - Stroke Exercise Training - online courses for therapistsA systematic review and thematic synthesis of qualitative research concerning venue-based exercise interventions for people with stroke in the UK has just been published in the journal ‘Physiotherapy’. The available evidence base analysed found that the ARNI fares better than Exercise Referral Schemes in terms of survivors making important improvements in activities of daily life (ADL). including eating, dressing and household tasks. ARNI has been found to improve physical function and mobility and importantly, is non-ambulant people inclusive.

This synthesis by Sheffield-Hallam University researchers Rachel E Young (Senior Lecturer in Physiotherapy & Specialist Neurological Physiotherapist), Dr David Broom (Reader of Physical Activity and Health), Professor Karen Sage (Professor for Allied Health Professions), Kay Crossland (Clinical Specialist Physiotherapist) and Dr Christine Smith (Deputy Head, Department of Allied Health Professions) makes the salient point that exercise following stroke leads to reduced physiological risk factors, improved physical function and mobility.

It is reasonably well-known that in general, exercise after stroke participation is known to be associated with significant improvements in quality of life. Data relating to the effects of exercise following stroke suggests that participants perceive improvements in physical function, participation and psychosocial wellbeing.

StrokeLutonNews 1 1024x648 - ARNI APPROACH FARES WELL IN SYSTEMATIC REVIEW OF EVIDENCE BASE - Stroke Exercise Training - online courses for therapistsBut it may be less well-known that engagement with exercise amongst the UK stroke population does not meet published recommendations and that exercise referral participants advised to go to gyms report feeling intimidated in the traditional gym environment. Moreover, that long-term adherence to exercise referral programmes is less than 50%. This is not good at all.

ARNI Approach on the other hand, is known for primarily being a one to one approach with the point that all stroke survivors are different and often require highly customised rehab/exercise teaching/support in their own homes even to be able to get out and re-join the community. Further, some survivors have no desire to go to gyms or involve themselves in groups.

But ARNI does run also a number of small groups around the UK, eg. ARNI Port Talbot, Wales – BBC News Report from 2015.

Please read also this prior ARNI blog article: Exercise After Stroke: Everything You Need To Know.

The ARNI group work follows a similar kind of methodology/protocol that one to one the intensive type of exercise/rehab training that ARNI is well-known for. Therefore ARNI group training is highly adaptable, hard work (makes you sweat!) and highly differentiated throughout sessions rather than a ‘one size fits all’ approach (as noted by the last bullet point, below).

This systematic review compares studies of ARNI groups and UK exercise referral schemes. Of all studies, one concerning ARNI had the greatest age-range: 19-84. 

Rachel Young reflects (to me) on the benefits of ARNI Approach from the data she sees:

  • IMG 1021 1024x768 - ARNI APPROACH FARES WELL IN SYSTEMATIC REVIEW OF EVIDENCE BASE - Stroke Exercise Training - online courses for therapistsParticipants on ARNI programmes feel challenged to push the boundaries of their recovery and experiment with new activities.
  • The ARNI programme offers a de-medicalised experience and facilitates people with stroke to gain confidence in their local communities and public venues.
  • ARNI exercises are associated with improved physical function and mobility.
  • The ARNI intervention is inclusive to non-ambulant people with stroke, who report equal benefit and improved quality of life associated with the programme to their ambulant peers.
  • The ARNI approach incorporates a peer leadership model which fostered an atmosphere of group support and encouragement.
  • The ARNI model integrates group exercise with individualised goals and activities to capture the benefits of peer support with an individualised programme.

As noted in the second sentence of this blog, the impact of exercise upon Activities of Daily Living (ADL) was mixed when scrutinising data from those doing Exercise on Referral (ERS) schemes, with participants from two of the studies suggesting that they did not experience improved performance in ADLs. In contrast, participants who had engaged with the ARNI programmes identified specific improvements in ADLs including eating, dressing and household tasks.

Exercise referral schemes (ERS) were perceived as a substitute for physiotherapy. In contrast, participants from the Norris et al (2010) study concerning ARNI stated that they had felt “mollycoddled in hospital” and that the ARNI programme was the opposite to “half-baked physiotherapy.”

Analytical theme 1: “Training principles as a foundation for programme design.”

The ARNI Training principles as a foundation for programme design were found to be a significant factor:

The synthesis found that all participants on ARNI programmes experimented with attempting new things, and tasks they thought they could not do. Participation in the ARNI programme had re-introduced experimentation which is likely to have increased confidence. For example: “I’m finding I can stand up now without having to push myself up on my hands. I’m doing that more often. I’ve even tried a couple of times from the settee, which is low down, and I’ve done it.”

The synthesis also found the the ARNI training described as a physical challenge both in its intensity but also the activities undertaken in the  programme. For example: “Challenging, I found it was very challenging, just the first day when we had to sort of actually walk on a mat without a stick…I felt that was really challenging…but also encouraging, to do more than I thought I could.

In some contrast, in relation to Exercise Referral Scheme, the synthesis found that some participants viewed the focus of gyms to be on fitness rather than rehabilitation and whatever they did in the gym would not further their functional ability. For example:  “Once they’ve assessed you, you’ve got this key you put in the machine, it tells you how long you’ve got to do and everything. With a computer you don’t need an instructor”

Analytical theme 2: “I’m not just a stroke patient anymore”

The synthesis found there was a sentiment that the individuals’ capacity had been artificially limited and that was now being tested by the ARNI Programme.

Implicit in many of the comments taking part in the ARNI Programmes was the idea that the individual had been challenged to reconceive their own possibilities. For example:  “Whatever you do don’t medicalise it .. I think one of the key benefits of this is that it’s not another bloody appointment. You know it’s not the hospital… it’s also a community facility .. it introduces you and makes other things accessible”

A commonality of all approaches in rehab/exercise after stroke was revealed by the synthesis too: Post-stroke self was portrayed as fragile. Lack of confidence and purpose and perceptions of how people viewed them post-stroke made it easy for participants to retreat into “safe environments”. For example: “The fact that I could contribute and I still had something to give, I wouldn’t say to society. But I wasn’t just a has-been. When you do come home from having stroke you do feel that you are a has-been”.

P1010442 1024x768 - ARNI APPROACH FARES WELL IN SYSTEMATIC REVIEW OF EVIDENCE BASE - Stroke Exercise Training - online courses for therapistsThis does make the requirement for the stroke survivor to ‘take back control’ and become as autonomous as possible in his or her ADLs, as key to progression and ‘beating/managing’ the effects of stroke.

When it is borne in mind that these group studies show data from just 6 to 12 one hour sessions, the heightened ARNI training effects of intensive one to one retraining with a exercise professional can be possibly be surmised… and many are shown here in ARNI  Rehab  Testimonials

A sentence needs to be highlighted from the conclusion of this synthesis: ‘Rehabilitation services need to collaborate with exercise providers to facilitate a positive transition towards long term exercise participation.’

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115 1150203 clip free bullet points clipart bullet point transparent 150x150 - ARNI APPROACH FARES WELL IN SYSTEMATIC REVIEW OF EVIDENCE BASE - Stroke Exercise Training - online courses for therapistsTom says: ‘This is exactly so. Healthcare professionals would like there to be a seamless provision of support and ideally, rehab plus exercise. But public often find out upon discharge that the wait for a community OT or physio to come and help can be up to 12 weeks (or more). The therapy may or may not be beneficial enough or continue long enough. Some last for 6 sessions (of 45 minutes or so). The survivor most usually isn’t taught how to help themselves’.

115 1150203 clip free bullet points clipart bullet point transparent 150x150 - ARNI APPROACH FARES WELL IN SYSTEMATIC REVIEW OF EVIDENCE BASE - Stroke Exercise Training - online courses for therapists‘Group classes, if they exist for stroke, are extremely patchy around the UK and often the survivor is in no fit state at all to attend. Often the group classes are not ‘retraining focused’. If they are, they’re at best run by stretched physiotherapists who are not exercise professionals… although some are and of course there is natural cross-over’.

Untitled 1 1024x571 - ARNI APPROACH FARES WELL IN SYSTEMATIC REVIEW OF EVIDENCE BASE - Stroke Exercise Training - online courses for therapists115 1150203 clip free bullet points clipart bullet point transparent 150x150 - ARNI APPROACH FARES WELL IN SYSTEMATIC REVIEW OF EVIDENCE BASE - Stroke Exercise Training - online courses for therapists‘So the survivor is left with, if they want to rehabilitate optimally, attending a really good physiotherapy clinic once a week – go to somewhere like Hobbs Rehabilitation or PhysioFunction which are both great. Or they can ask for for an ARNI Instructor to come to their house weekly or daily. ARNI is very affordable and has a 20 year history of rehab/reintegration-to-lifestyles successes.

115 1150203 clip free bullet points clipart bullet point transparent 150x150 - ARNI APPROACH FARES WELL IN SYSTEMATIC REVIEW OF EVIDENCE BASE - Stroke Exercise Training - online courses for therapistsAn outstanding free (but by its nature, quite booked up) Queen Square Upper Limb Clinic set up by Professor Nick Ward (see prior blog page for interview). Rehab services like Professor Ward’s Institute of Neurology have recognised this synthesis’ conclusion above a long time ago (at least 12 years now),  and have made strenuous efforts to work with/teach exercise & rehab trainers about neurorehabilitation and the potential of the brain to adapt via repetitive activities. And how to steer rehab re-training efforts optimally.’

115 1150203 clip free bullet points clipart bullet point transparent 150x150 - ARNI APPROACH FARES WELL IN SYSTEMATIC REVIEW OF EVIDENCE BASE - Stroke Exercise Training - online courses for therapistsTom has consistently noted that Neuro-services and experts in Neurorehabilitation, working hand in hand with exercise professionals (as far as their very limited time can allow) to provide support/learning for that next ‘rung’ (the rehab/exercise professionals) who CAN offer long term rehab, is THE key.

Synthesis:

Young, R.E., Broom, D., Sage, K., Crossland, K., Smith, C. (2021) Experiences of venue-based exercise interventions for people with stroke in the UK: a systematic review and thematic synthesis of qualitative research. Physiotherapy, 110:5-14. Read here

Are you a stroke survivor who is struggling to sleep? If so, you are not alone.

Research has found that sleep problems are much more common for stroke survivors, compared to in the general population. This is an issue because sleep is so important for many reasons. A lack of sleep can have a negative impact on our mood, reduce our alertness and concentration and can even affect our learning of things, including motor skills.

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Researchers led by Professor Heidi Johansen-Berg, together with the Oxford Centre for Enablement and the Oxfordshire Stroke Rehabilitation unit, looked at sleep quality in 59 brain injury and stroke patients in rehabilitation units. They found that those who had a better sleep quality saw greater improvements throughout their rehabilitation. Patients with better sleep showed less overall movement impairment in their affected arm and legs and were more mobile when they were discharged from hospital.

2021 03 02 16 16 20 - OXFORD UNIVERSITY RESEARCH TO IMPROVE THE SLEEP OF STROKE SURVIVORS - Stroke Exercise Training - online courses for therapistsProfessor Johansen-Berg and Dr Fleming have expanded this study, assessing stroke survivors in the community.

In total, 70 stroke survivors and 76 people who hadn’t had a stroke took part, by answering questions about their sleep and wearing an activity monitor at home. Some had experienced stroke fairly recently (within the past year), whereas others had their stroke many years prior to taking part in the study.

Similar to what they found for people in hospital, stroke survivors rated their sleep as significantly worse than people who hadn’t had a stroke, and spent more time awake overnight.

2021 03 02 16 15 28 300x102 - OXFORD UNIVERSITY RESEARCH TO IMPROVE THE SLEEP OF STROKE SURVIVORS - Stroke Exercise Training - online courses for therapistsThis did not seem to relate to how long it was since the stroke occurred, leading researchers to conclude that sleep problems can persist long term after a stroke. People who reported difficulty sleeping were also more likely to have low mood, such as symptoms of depression.

Using this information about how important sleep is in the recovery of stroke survivors, the researchers are now hoping to find ways of improving sleep for stroke survivors, both in hospital and later when they are home.

This is why they are currently running the INSPIRES study (Improving Sleep in Rehabilitation after Stroke), which is a study looking at a sleep-improvement programme for stroke survivors in their homes. If you are a stroke survivor who wants to improve their sleep, take a look at the information from the Team below!

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Some wonderful ARNI members have already taken part in the study, and so far the study has over 50 people participating. If you would like to improve your sleep and help with some research that aims to positively impact the lives of stroke survivors in the future, please do get in touch with the Team:

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bolt burdon kemp 2 150x150 - ARNI CHARITY PARTNERS WITH BOLT BURDON KEMP SOLICITORS - Stroke Exercise Training - online courses for therapistsBolt Burdon Kemp (BBK), a very highly-regarded Brain Injury Solicitors firm in London, have become Corporate Partners to the ARNI Charity for Stroke Survivors!

This is hugely exciting for us and we would like in particular to thank Hokman Wong, Senior Solicitor and specialist in cases where adults have suffered brain injuries for suggesting and working to fruition this incredible partnership and Partner and Head of the Adult Brain Injury team, Suzanne Trask, for agreeing in principle, then verifying and working closely with Hokman to bring about this Corporate Partnership.

It is necessary to define terminology. BBK want to support ARNI and the people that it serves, by bringing its resources, time and contacts to bear help the Charity. Those who the Charity and BBK support are most generally the same, creating a symbiotic relationship that works well for both parties. In this instance, helping both to raise issues and provide concrete help for survivors of brain injury. Whilst BBK may provide some financial support to ARNI, given the demand for ARNI’s valuable service, any and all financial or other support you are able to donate to ARNI will be gratefully received!

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  1. The first activity has been for Hokman Wong, who is particularly concerned with Rehabilitation Prescriptions (RP) for those with TBI to interview the ARNI Director about the state of play for stroke survivors in this area. Dr Balchin is a founder member of the ABI Alliance, created by Professor Mike Barnes, which campaigns to highlight the role of the RP and to ensure that post-discharge, the individual with ABI and/or their family/carers have a copy of it, an appointment with the GP to discuss its contents and a plan for accessing the neurorehabilitation services detailed in it.

Rehabilitation Prescriptions: Are Stroke Survivors Being Let Down?

In 2010, the Clinical Advisory Group recommended every patient admitted to a Major Trauma Centre should have their rehabilitation needs assessed and documented through a Rehabilitation Prescription (RP).  Ten years later RP’s are still not being consistently and effectively used to the detriment of patients and the people who support them.

Here I talk briefly to Tom Balchin, founder of Action for Rehabilitation from Neurological Injury (ARNI) about his experience with RP’s and how it could benefit stroke survivors if used properly.  Tom suffered a haemorrhagic stroke when he was 21.  Through hard work and determination he overcame the effects of his stroke.  For the last 20 years Tom has devoted his life to helping other stroke survivors make a functional recovery through a specialist rehabilitation and exercise programme he developed based on his own experience.  The ARNI programme is backed by a number of clinical studies and Tom’s methods are endorsed by senior doctors.

1) Question: What is a rehabilitation prescription?

Tom: The notion of an RP first came out of Trauma Services a decade ago.  At this time there was a growing understanding as patients moved between stages of recovery in acute centres to rehabilitation in the community, there was often a steep fall-away of information available to professionals and patients.  Such information is essential to guide a patient’s rehabilitation to ensure the best outcome. The RP itself should identify the rehabilitation needs of a patient and how these needs will be met.  It should be started within 3 days of admission to a Major Trauma Centre by a suitably qualified member of the rehabilitation team, usually a Band 7 physiotherapist.  The RP ought to be regularly reviewed and updated by the multidisciplinary team (MDT).

2) Question: What information should a rehabilitation prescription contain?

2021 02 08 16 31 03 300x181 - ARNI CHARITY PARTNERS WITH BOLT BURDON KEMP SOLICITORS - Stroke Exercise Training - online courses for therapistsTom: From a patient perspective the main aim of an RP is to document neurorehabilitation needs in order to plan treatment to meet those needs.  Neurorehabilitation is multidisciplinary, with core specialties including occupational therapy, physiotherapy, speech and language therapy and neuropsychology. The RP should contain information on various aspects of recovery including: description of injuries/illness; psychosocial background; treatment to date; clinical restrictions; and individualised description of rehabilitation needs.  There should be enough information for each specialist in the MDT to plan and deliver ongoing rehabilitation to maximise the potential for optimal outcomes.

3) Question: Who should be given a rehabilitation prescription?

Tom: A copy should be given to both the patient and/or family as well as their GP.  However, as Professor Mike Barnes, ABI Alliance Chair, has stated ‘the RP has no value if the individual with an acquired brain injury and their GP don’t receive a copy.  If the individual and the GP don’t know what rehabilitation is required then no access to services can be planned or implemented’.  There is a view, clinically and in the community, that use of RP’s is sporadic.

4) Question: Turning to stroke, why are rehabilitation prescriptions important for survivors?

Tom: When the patient reaches the community, past the realms of NHS help, an RP that can be used to inform ongoing rehabilitation is ideal.  Some patients, or most often their families and or carers, are very careful to keep as much information as they can.  However, often patients seem to travel away from the clinical remit without copies of MDT discharge notes and no guidance about ‘what to do’ when they get back home.  Particularly during this unprecedented period, when the disruption to health and care services caused by COVID-19 meant national stroke initiatives across the UK have been paused or slowed.  It is not surprising that this is happening.

5) Question: Can you give an example of recent disruption to stroke services?

Tom: As far as recent patient-care is concerned, telehealth is being utilised like never before.  A recent Stroke Association survey of almost 2000 survivors makes interesting reading.  44% had appointments related to their stroke online or over the phone during the pandemic.  28% had therapy (including physiotherapy, occupational therapy and speech language therapy) online or over the phone.  Unfortunately, virtual methods of healthcare have not been an option for everyone and the number of stroke survivors who had therapy cancelled or postponed is double the number who received therapy online or over the phone pre-pandemic.  This shows many have gone without their usual rehabilitation support.  For patients who have gone without, or had very little therapy, and have the means to afford private support, an RP would be ideal to inform an independent therapist or trainer.

6) Question: What is your experience with rehabilitation prescriptions in stroke survivors?

Tom: They basically don’t happen.  Even now, senior clinical therapists around the country have only heard rumours about them being created and are not at all clear what form these would take. I talked to Professor of Healthcare Research at Nottingham University, Avril Drummond, about RPs for stroke survivors.  Professor Drummond is aware of most nuances of the national situation and forthcoming initiatives in stroke.  After a few weeks of asking colleagues about RPs for stroke survivors she ‘drew a total blank’.  Further questioning to some national Leads revealed they ‘don’t know’. If national Leads don’t know, then we can be pretty sure that nothing is going to take place on this any time soon.  This is a shame because it would be invaluable for a patient to know any therapist or trainer they choose to work with can gain access to a simple ‘passport’ containing up to date information on their rehabilitation needs. Ideally, an RP would be updated as a patient moves forward in their life after stroke.  The RP would be accessible by other rehabilitation professionals.  Assisting professionals is essential to getting the best outcome in the most efficient way.

7) Question: What is required to ensure rehabilitation prescriptions are used effectively?

Tom: The answer would have to be a comprehensive national rehabilitation strategy to roll-out RP’s as a requirement to give to patients and professionals; to provide clear data to refer to as patients move away from acute services to community services and beyond.

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2. Hokman last year wrote a superb Review of ‘Had a Stroke? Now What? Hospital to Rehabilitation and Beyond’. Thank you Hokman!

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3. BBK and ARNI are now working on a 3-hour Zoom-based Stroke Rehabilitation Conference/Workshop in April 2021 for professionals and patients – and are working on the schedule at this moment. Exciting times: thank you for supporting ARNI by reading these posts and even forwarding them on to interested friends and colleagues! The more people we can reach the better.

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If you feel you need advice, may have a Brain Injury claim or are enquiring on behalf of a loved one, please contact Hokman direct, free of charge and in confidence to discuss at hokmanwong@boltburdonkemp.co.uk. Please tell to him that you saw his name and email on the ARNI site.

Life is rather restricted at the moment. It’s not that great. Is your rehab on pause? Are you currently still in a wheelchair? Or, do you have just a few limitations from stroke? Or do you have a friend or family member who is??

front page flyer 212x300 - IS YOUR REHAB ON PAUSE?? GET HALF-PRICE 6-7 HOURS OF TOP VIDEO REHAB GUIDANCE! - Stroke Exercise Training - online courses for therapistsIf this is the case, ARNI would like to help you rehabilitate your balance control, cope with foot drop, get stronger, reduce spasticity, recover the ability to grasp & release objects and become self-reliant rather than dependent on others.

Whatever your status, whoever you are, ARNI would like to offer you the full 7 Successful Stroke Survivor videos (45-60 mins) either in physical format, or convenient online anytime streaming access format to any device, for half price to give you encouragement to persevere..

Learn how ARNI Rehab Concept align directly with the latest evidence base for stroke rehabilitation interventions and get to practise them alongside Dr Balchin as your guide, at home!

The Full Set (physical or streaming) is £98.00 incl p&p – but get yours now for £48 (incl p&p)!
 Individual DVDs (physical or streaming) are £20 incl p&p – but get yours now for £10 (incl p&p)!

(Your price is lower than the cost-price for the ARNI Charity)

2021 01 20 16 05 05 150x150 - IS YOUR REHAB ON PAUSE?? GET HALF-PRICE 6-7 HOURS OF TOP VIDEO REHAB GUIDANCE! - Stroke Exercise Training - online courses for therapists

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pic10 150x150 - IS YOUR REHAB ON PAUSE?? GET HALF-PRICE 6-7 HOURS OF TOP VIDEO REHAB GUIDANCE! - Stroke Exercise Training - online courses for therapistspic19 Copy 1 150x150 - IS YOUR REHAB ON PAUSE?? GET HALF-PRICE 6-7 HOURS OF TOP VIDEO REHAB GUIDANCE! - Stroke Exercise Training - online courses for therapistspic18 Copy 150x150 - IS YOUR REHAB ON PAUSE?? GET HALF-PRICE 6-7 HOURS OF TOP VIDEO REHAB GUIDANCE! - Stroke Exercise Training - online courses for therapistspic14 Copy 150x150 - IS YOUR REHAB ON PAUSE?? GET HALF-PRICE 6-7 HOURS OF TOP VIDEO REHAB GUIDANCE! - Stroke Exercise Training - online courses for therapistspic5 150x150 - IS YOUR REHAB ON PAUSE?? GET HALF-PRICE 6-7 HOURS OF TOP VIDEO REHAB GUIDANCE! - Stroke Exercise Training - online courses for therapistspic4 150x150 - IS YOUR REHAB ON PAUSE?? GET HALF-PRICE 6-7 HOURS OF TOP VIDEO REHAB GUIDANCE! - Stroke Exercise Training - online courses for therapistsYou’re so welcome to take advantage of this offer, which is time limited until 1st March 2020, by calling the ARNI Central Number

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Please do leave your name and number if we are unavailable and we will call you back.

 

The evidence base shows that you MUST perform some exercises routinely to help yourself to recover well.

But what do you actually do?? Dr Tom Balchin shows you the best (most generalisable) strategies from the best-selling manual The Successful Stroke Survivor.

button get yours now 1  300x43 - IS YOUR REHAB ON PAUSE?? GET HALF-PRICE 6-7 HOURS OF TOP VIDEO REHAB GUIDANCE! - Stroke Exercise Training - online courses for therapists7 DVDs of 45-60 minutes each, filmed in full HD 1080p clarity, this superb quality DVD set or online programme will be your accompaniment to progressive rehabilitation.

Get YOURS or a set as a gift for a friend today. Call: 0203 053 0111

Please remember to leave a message if you are forwarded to an answerphone: we WILL get back to you!!!

Stroke often causes major changes to someone’s identity and sense of self in a range of contexts, through changes to work, relationships and hobbies. 

This comes as a consequence of a range of factors, including the long-term impact of the stroke (to language, movement etc.), situational and psychological changes. However, according to the team, little is known about the extent to which stroke impacts identity, or what factors contribute.

ARNI CHARITY STROKE REHABILITATION ASSESSMENT COGNITION CAHAI 2 - Cognitive Functioning: Identity and Mood in Stroke - Stroke Exercise Training - online courses for therapists

The University of Surrey is now carrying out a research study into Cognitive Functioning and its Relationship with Identity and Mood in Stroke: please read on!

 About the Research

This study is about the impact of stroke on identity: assessing the relationship of changes in sense of self to other direct or indirect causes of stroke, such as mood, language and memory. For their analysis, the team are looking for a wide range of survivors, not only those with perceived difficulties with the above issues following stroke, but also for those without.

Taking part will allow them more insight to the psychological impact of stroke. The team emphasises that while this is unlikely to have personal benefit for the person taking part, the study will publish anonymised data in scientific journals, therefore increasing understanding and potentially improving psychological care.

Open to Recruitment

You may be able to take part if:

  • You are over 18 and have had a stroke at least 6 months ago.
  • You do not have any further neurological conditions, such as Alzheimer’s.
  • You do not have a current psychiatric disorder that is not under effective management.
  • You are able to provide informed consent.
  • You are able to complete a questionnaire either independently or with help from a caregiver.

If you are unsure of whether you are able to take part, please contact us (h.thompson@surrey.ac.uk).

What You Will Need to Do

A team member will ask you to fill out an online survey, which will take approximately 30 minutes. These will ask questions about you, your stroke, your identity pre and post-stroke, and about your mood.

Then the team will follow this up with a virtual Zoom session also lasting approximately 30 minutes. Here, you will be asked to carry out some language and memory tests. The tests are similar to activities you may possibly have done with a speech therapist or psychologist.

surrey - Cognitive Functioning: Identity and Mood in Stroke - Stroke Exercise Training - online courses for therapistsFor those who do not have access to a computer there is the option to complete the study by phone or post – this may just take a little longer.

What Happens Next

The results may be disseminated in undergraduate dissertations, at academic conferences and in journals, but your part will remain anonymous. The team aims to send you an overview of the findings of their study, along with any further implications, once the research is complete.

Please contact Dr Hannah Thompson at h.thompson@surrey.ac.uk  if you have any questions or require any further information.

If you do not have any further questions and would like to take part, please see the link to the online survey below. You can fill this out in your own time. 

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The team will contact you shortly after you have completed the survey to arrange the second half of the study.

If you would prefer to complete the whole study over the phone or via Zoom. please contact Dr Hannah Thompson or one of the other members of the team:

Carmen Rumbold: cr00473@surrey.ac.uk

Chloe Christaki: cc01485@surrey.ac.uk

Chelsea Mathias: sm02350@surrey.ac.uk

2020 12 31 21 40 13 150x150 - Cognitive Functioning: Identity and Mood in Stroke - Stroke Exercise Training - online courses for therapistsFor more Information on Cognition, you can get a copy of:

Had a Stroke? What Now? (2020)



ARNI