Information from the National Health Service on stroke, including learning to spot the symptoms of stroke, tips on cutting your risk and recovering from a stroke.
NHS Choices
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- November 24, 2015
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Based on recent research, tendon transfer surgery offers a possibly valuable option for managing severe upper limb and hand spasticity following a stroke, particularly as a complementary intervention when non-surgical treatments are insufficient.
A clinical review from 2024 emphasises that surgical interventions for post-stroke spasticity and contracture are often under-utilised and that tendon transfer can be a powerful intervention for specific, residual impairments like contracture (which we see quite a bit at ARNI) that persist after conservative treatments like OT have failed.
Successes with tendon transfer surgery are dotted throughout the research; for example, a recent case study published in the Journal of Medical Case Reports (May 2025) details a step-by-step approach combining repeated botulinum toxin A (BoNT-A) injections and occupational therapy with tendon transfer surgery. The surgery effectively addressed residual wrist impairments, resulting in significant functional recovery and improved daily living activities for the patient. It significantly enhanced the survivor's grip strength, range of motion, and ability to perform intricate hand and finger movements.
Beyond physical function, surgery has been shown to enhance survivors' psychological well-being, body image, and social interactions. By making daily tasks easier, it can improve their occupational performance and allows them to regain roles previously lost to their condition.
ARNI insists that rehabilitation specialists should be aware of the functional benefits of surgery and consider it as part of an integrated, multidisciplinary treatment plan for patients with long-term, severe spasticity.
www.ar#tendontransfero#strokerehabilitationb#handspasticityS#upperlimb##physicalmedicinea#occupationaltherapyn#neurorehabilitationb#strokerecoveryk#ResearchUpdatea#SurgicalReconstructionnstruction
Have you tried Constraint-Induced Movement Therapy (CIMT)? Let us know if you have please! Where did you do it; at a clinic or at home? What did you think of it? Did you get any results??
Multiple studies affirm that both traditional CIMT and modified CIMT (mCIMT) are effective for improving upper limb function, arm-hand activities, and daily life performance for us stroke survivors. And emerging trends show that CIMT's effectiveness can be enhanced when combined with other therapies:
o Brain-Computer Interfaces (BCI): Integrating CIMT with BCI shows promise, particularly in improving real-world functional outcomes.
o Telerehabilitation and VR: CIMT delivered via telerehabilitation and virtual reality (VR) offers similar effectiveness to traditional in-clinic therapy, improving accessibility and motivation for patients.
o Electrical Stimulation: Combined therapies using CIMT and peripheral nerve stimulation show superior improvements in motor function.
So, the field of CIMT is rapidly evolving, but ARNI has found, when examining research and practice, that questions remain about the optimal dosage and timing of CIMT interventions.
www.arni.uk#strokerehabR#neuroplasticityi#cimt##physicaltherapye#occupationaltherapye#neurosciencei#RehabilitationResearchearch
Exercises are the best way to improve your gait after a stroke. An ARNI Trainer can recommend some appropriate exercises for you based on your ability level.
Call us on 0203 053 0111 or email support@arni.uk.com to find out if there's a trainer near you who can work with you on your recovery.
www.arni.uik.#strokerecoveryo#strokerehabr#strokerehabR#strokerecoveryexercisesc#neuroplasticityi#exerciseafterstroket#strokeexerciser#strokerehabrehab
Join the conversation: What are your experiences or insights on implementing personalised FES for your more-affected lower-limb to date? Please let us know!
The use of Functional Electrical Stimulation (FES) for lower-limb rehabilitation post-stroke continues to evolve, with recent studies highlighting the benefits of multi-channel and personalised approaches. These advancements are moving beyond traditional ‘one-sise-fits-all’ devices to target specific neuromuscular deficits, leading to more natural and effective gait recovery.
A 2025 study on chronic stroke survivors showed that a multi-channel FES system, designed around muscle synergy principles, led to significant and sustained improvements in motor function. Patients exhibited more natural gait patterns and increased ankle dorsiflexion, even years after their stroke.
Also, we found research published in 2023 which demonstrated that combining FES with core muscle training significantly improved balance, walking ability, and overall lower-limb motor function compared to core training alone. This suggests that FES can enhance the benefits of traditional physical therapy.
Innovations in adaptive, closed-loop FES systems are being developed to enhance gait efficiency and speed. By providing more personalised and context-aware stimulation, these systems could offer superior therapeutic and orthotic benefits.
A 2024 meta-analysis also found that electrotherapy, including FES, significantly increased lower-limb muscle strength compared to conventional therapy in stroke patients. This tends to reinforce the modality's role in improving physical performance.
#FES #StrokeRehab #NeuroRehabilitation #PhysicalTherapy #Neurology #Research #GaitRecovery #FunctionalElectricalStimulation
Hi Roz! Yes, FES has really worked for him, hasn't it? Very good thing too is that he's smart with it and hasn't become reliant on it for his gait control - and yes absolutely I've seen that it's strengthened his ankle (and calf).. and for a stroke survivor with drop foot, wearing Crocs is quite something - I've never tried it; presumed the left one would just slip off my foot or I'd be tripping up constantly 😉 But then, Harry IS rather a special survivor, isn't he Roz 😉 (the lesser-spotted Harry variety) Tom
I was dorsiflexing well using my old oddstock pace fes But got impatient with the pad positions kept changing and it took me too long to set up I'm back in a custom made AFO now and regretting my impatient attitude A great product I'd say
Harry uses lower limb FES device alongside lots of other strengthening, balance etc.. he doesn’t use the FES inside home at all or on shorter outside trips .. We all think it’s improved his strength and stamina both with and without the device .. only this week he’s in Tenerife and managed a whole day at a water park with no aids at all .. just wearing crocs.. fast passes for slides .. and access to the VIP sun longer section for breaks 😂😂😂
I started using FES on the NHS my neurophysio recommended it. It was a total game changer. FES got me running again. I’ve done 3 Half Marathons and countless 10ks. I couldn’t have done it without FES. Yes it’s fiddly & frustrating but in my humble opinion worth the effort & I only had one working arm at the time. It also works on upper limbs but it got too confusing for my addled stroke brain to cope with. Try it & see for yourselves! You’ve got nothing to loose
I’ve used an NHS prescribed Oddstock for a few years, thinking about exploring other options privately. Although i’
Post-stroke rehabilitation is a critical, multi-stage process, yet many survivors report feeling unsupported after formal, short-term hospital therapy ends. This can lead to decreased motivation, learned non-use of affected limbs, and a heightened fear of falling, which can all negatively impact long-term recovery.
The Action for Rehabilitation from Neurological Injury (ARNI) Institute was founded to address this significant gap in the patient pathway. ARNI offers an exciting, innovative, evidence-based program that supports stroke survivors in taking charge of their long-term recovery. The ARNI Approach is distinguished by its focus on three core principles:
Functional Task-Related Practice: Moving beyond passive treatment, ARNI engages survivors in repetitive, meaningful activities designed to retrain the brain and body. This leverages the brain's neuroplasticity... its ability to reorganise itself...to recover lost skills.
Physical Coping Strategies: ARNI instructors teach specific, practical techniques for managing daily life challenges, such as getting up from the floor safely with one-sided weakness. This builds physical resilience and confidence.
Stroke-Specific Resistance Training: Incorporating strength and conditioning exercises adapted for neurological limitations helps build stability and strength, empowering survivors to discard assistive devices and enhance their functional independence.
Implications for Clinical Practice & Research: The ARNI model challenges the traditional paradigm that recovery plateaus shortly after hospital discharge. Its success highlights the value of personalised, intensive, and long-term neurorehabilitation strategies. For clinicians and researchers, ARNI's integration of psychological support, functional training, and strength conditioning offers a powerful framework for enhancing patient outcomes and promoting self-reliance.
Learn more and explore the latest research at the ARNI Institute: www.arni.uk.com
#StrokeRehab #Neuroplasticity #Neurorehabilitation #StrokeRecovery #ARNI #EvidenceBased #FunctionalTraining #HealthcareInnovation
A wave of systematic reviews and randomised controlled trials over the last few years has refined our understanding, confirming task-specific training (TST)'s efficacy while also shedding light on critical factors like intensity and technological integration.
Task-specific training involves repetitive, goal-directed practice of real-world functional tasks, such as grasping a cup or buttoning a shirt, rather than isolated, non-functional exercises. By promoting active problem-solving and engaging neural pathways in a meaningful context, TST harnesses the brain's plasticity to maximise motor recovery.
A recent systematic review in The American Journal of Occupational Therapy synthesised findings from 16 studies involving nearly 700 stroke survivors. The review found strong evidence supporting activity-based TST for improving UL motor function, motor performance, and activities of daily living (ADLs). and a May 2025 study in Clinical Rehabilitation found task-oriented training produced statistically and clinically meaningful improvements in UL function for patients with subacute stroke compared to conventional exercise programmes.
The latest research is also exploring ways to amplify the effects of TST by combining it with cutting-edge techniques; a 2023 network meta-analysis found that combining TST with electrical stimulation is a promising approach for improving UL motor function, especially for individuals within six months of stroke onset.
Interestingly, a group of newer studies are examining dual-task training (DTT), where individuals practice a task while performing a secondary activity. Preliminary results from a May 2025 study suggest DTT can effectively improve UL function and trunk performance in chronic stroke patients.
ARNI says that the evidence for task-specific training in stroke rehabilitation is undeniable. Recent research provides new avenues for enhancing its effects through technology and combination therapies. The message is clear for us stroke survivors: focusing on repetitive, meaningful, real-world tasks is a highly effective strategy for regaining a handle on life after stroke.
Recent research provides a clearer picture of the efficacy of active and dynamic orthotics for stroke survivors. A scoping review published in the American Journal of Occupational Therapy found moderate evidence that dynamic upper extremity orthoses can significantly improve fundamental performance skills like gripping and pinching.
Another recent study in Frontiers in Bioengineering and Biotechnology showed that a wearable hand orthosis combined with self-directed training enhanced upper limb motor function and balance. Key findings from these and other recent studies include:
1. Dynamic orthoses like the Saeboflex, pictured, can be effective in improving isolated motor skills (up to a point). However, the evidence is not yet conclusive that these improvements translate directly into better performance of everyday activities, such as dressing or grooming.
2. A dynamic orthosis is most effective when integrated into a structured, task-oriented rehabilitation programme. Studies show that a higher 'dose' of active training leads to greater functional gains.
3. 3D-printed, personalised orthoses can increase patient satisfaction and comfort, potentially leading to higher compliance with home-based rehabilitation programmes.
ARNI says that active orthotics are a promising tool to augment upper-limb stroke rehab, but their greatest potential is realised when they support active, task-specific training to improve motor skills.
www.ar#strokerehabt#neurorehabilitationb#strokerecoveryk#rehabilitationb#neuroscienceu#strokerehabt#activeorthoticse#occupationaltherapyn#neurology##RehabilitationResearcho#medtechh #MedTech
Exercises are the best way to improve your gait after a stroke. Your ARNI Trainer can recommend some appropriate exercises for you based on your ability level.
Call us on 0203 053 0111 or email support@arni.uk.com to find out if there's a trainer near you who can work with you on your recove#neurorehabilitationa#strokeexerciser#strokerehabr#strokerecoveryo#strokerehabR#neuroplasticityicity
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Did you have significant drop shoulder after stroke? If so, could you tell us how you resolved it??
Living with a dropped or weak shoulder after stroke can be challenging, but here at ARNI we know it's manageable with the right strategies. I myself have severe drop shoulder (Tom). By staying proactive and consistent, you CAN reduce pain and regain function. Here are key strategies to help with a dropped shoulder:
1. Focus on proper positioning and support
• Use pillows and cushions: When sitting or lying down, use pillows to support your arm and shoulder. A lap tray can also be helpful for support while sitting on a sofa or in bed.
• Wear a sling, if prescribed: A therapist might recommend a sling or cuff to support the arm, especially when standing or walking, to prevent the ligaments from overstretching.
• Avoid pulling on the affected arm: It is crucial for anyone assisting you to never pull on your affected arm, especially when helping you stand or move.
2. Incorporate gentle, repetitive exercises
• Passive range-of-motion: Use your un-affected arm or have a caregiver gently move your affected arm. This helps stimulate neural pathways and keeps joints mobile.
• Tabletop exercises: Using a towel on a table, slide your arm forward and side-to-side, assisting with your other hand. This reduces friction and allows for a gentle stretch.
• Shoulder blade squeezes and shrugs: While seated, practice squeezing your shoulder blades together or shrugging your shoulders up toward your ears. Use a mirror to monitor your form.
3. Explore specialised rehabilitation techniques
• Electrical stimulation (E-Stim): A therapist or trainer can use a FES to apply electrical impulses to your shoulder muscles. This can help re-educate muscles and reduce subluxation and pain.
• Mental practice and mirror therapy: Visualising yourself doing exercises can help activate neuroplasticity—the brain's ability to rewire itself. Mirror therapy, which uses a mirror to "trick" the brain into seeing the affected arm move, can also be very effective.
• Weight-bearing exercises: Gradually put weight through your affected arm while sitting or standing. This provides sensory input to the brain, which can help activate muscles.
www.arni.uk.com
#Strokeexercise #Neurorehabilitation #Strokerehab #ARNIstrokerehabilitioninstructortraining
I do the same stretches everyday and then use therabands for resistance exercises, I also have a saebo stim and sleep with a pillow. I’m now 9 months post stroke and it’s improving slowly 😊
A sling can encourage spasticity to pull your arm in and across your chest, i was advised by numerous neuro physio therapists, especially if your unable to move/ exercise the arm.
If you have physio they should put it back in
In rehab I just cuddled pillows with both arms together every day, then when I could stand safely, I'd try pressing outwards to a count of ten or twentywith my arm in doorways or against walls, until I could lift my arm horizontally. As soon as I gpt home I was trying dumbell 'flies working up to 12 to 14kg for repetitions.
Nikki Wiltshire