Stroke Insights and Answers > Managing Physical Challenges

Many individuals experience tightness in which their hand clenches and/or closes in a partial or full fist. A clenched hand/fist can be not only painful, but the tight tendons and joints often prevent the fingers from grasping or releasing objects during everyday tasks.

Common interventions that should be guided by healthcare professionals include:

• Avoidance of triggers
• Stretching
• Active range of motion exercises
• Joint and soft tissue mobilization and massage
• Hand orthotics and braces
• Oral medication
• Injectable pharmaceuticals
• Electrical stimulation
• Biofeedback and neuromuscular re-education
• Relaxation and breathing
• Non-invasive, brain-computer interface

For upper extremities with little to no movement, interventions using brain-computer interfaces such as the Neurolutions IpsiHand System can be effectively paired with traditional therapy to address movement for improved engagement in activities of daily living.

Always consult with a healthcare professional for guidance and to ensure that the exercises and interventions are safe and appropriate for your specific condition.

For further reading, visit: How To Get Your Hand Working After Stroke and Flexor Synergy, Spasticity, and Stroke

Improving vision after a stroke can be challenging, as the extent of vision loss and recovery potential vary from person to person. However, there are several strategies and therapies that may help enhance visual function and quality of life for stroke survivors with visual impairments. It’s essential to work with healthcare professionals and specialists in vision rehabilitation to develop a tailored plan.

The following are several approaches to consider:

Consult an Eye Specialist:

Start by consulting an ophthalmologist or neuro-ophthalmologist who specializes in stroke-related vision issues. They can assess the extent of your vision impairment and provide a diagnosis.

Vision Rehabilitation Services:

Seek out a vision rehabilitation specialist or a low vision therapist. They can assess your visual needs and develop a personalized plan to improve your functional vision.

Some occupational therapists may specialize in vision rehabilitation to promote engagement in functional activities, assistive devices, and training to help you adapt to your visual challenges.

Eye Exercises:

Work with a vision therapist or occupational therapist to perform specific eye exercises and techniques to improve eye coordination, focus, and eye movement control.

Use Vision Aids and Assistive Devices:

Low vision aids such as magnifiers, telescopes, and specialized glasses can help you make the most of your remaining vision.Electronic magnifiers and screen-reading software can assist with reading and using digital devices.

Adaptive Strategies:

Learn techniques to adapt daily activities to your visual limitations. This includes strategies for cooking, reading, and mobility.Use contrasting colors and increased lighting to make objects more visible.

Visual Field Training:

If you have visual field deficits (e.g., hemianopia), work with a specialist who can provide training to improve awareness and compensate for these deficits.

Cognitive Rehabilitation:

Cognitive rehabilitation programs can help improve attention and memory, which can indirectly benefit visual processing.Consult a neuropsychologist or cognitive therapist for guidance.

Medication:

In some cases, medication may be prescribed to manage certain visual conditions or to reduce swelling or inflammation that may affect vision.Consult with your healthcare provider for medication options.

Stay Informed:

Keep up to date with the latest research and technologies related to vision rehabilitation. New treatments and assistive devices are constantly being developed.

Improving vision after a stroke may require time, patience, and ongoing effort. It’s crucial to work closely with a team of healthcare professionals including eye specialists, therapists, and rehabilitation specialists, to create a comprehensive plan that addresses your specific needs and goals. Additionally, maintaining a positive attitude and seeking emotional support can be valuable aspects of the recovery process.

For more information on different types of visual changes and interventions that can occur after stroke, visit Vision Changes after Stroke.

After a stroke, the risk of falling can increase due to physical impairments, balance issues, and changes in mobility. Preventing falls is crucial to ensure safety and minimize the likelihood of further injury. The following are several ways to prevent falls after a stroke: physical therapy and/or occupational therapy, use of assistive devices (e.g. walker, cane), home modifications (e.g. railings, raised toilet seats), footwear that supports stability and traction, medication management, addressing vision and hearing impairments, and practicing caution and patience. Fall risk assessments, often provided by a rehabilitation specialist, are also valuable in assessing specific impairments and determining a treatment plan to reduce fall risk. Remember to consult with your healthcare provider or therapist for personalized recommendations based on your specific needs and abilities. They can provide tailored strategies and guidance to help prevent falls and promote your safety after a stroke.

Yes, there are several assistive devices available that can help individuals after a stroke regain independence, improve mobility, and perform daily activities. Here is a list of common assistive devices available after a stroke:

• Canes: Canes provide stability and support while walking. There are different types of canes, including a standard cane (single point), quad cane (wider base for additional stability), or hemi-canes (cane with a very broad, 4-post base).
• Walkers: Walkers typically have four legs, provide a large base of support in front of the individual, and offer more stability than canes. Different classifications of walkers include standard walkers, front-wheeled walkers, and rollator walkers.
• Wheelchairs: When a stroke survivor experiences significant issues with walking, cannot walk long distances, or cannot walk at all, wheelchairs can provide mobility and enhance participation in daily activities. Wheelchairs are either self-propelled (manual) or powered (electric).
• Orthotics: Orthotic devices, such as ankle-foot orthoses (AFOs), can provide support and improve foot and ankle alignment. Orthoses can also be used on the hand and arm, such as a resting hand splint or a dynamic wrist and hand orthosis.
• Adaptive Eating Utensils: These utensils have modified handles or designs to make eating easier for individuals with hand weakness or coordination difficulties. They may have larger grips, weight for stability, angled handles, or a special design for enhanced reach and control.
• Reacher / Grabber Tools: Reachers or grabbers are long-handled devices with a gripping mechanism on end. They assist in reaching objects that are out of reach, reducing the need for bending or stretching and minimizing fall risks.
• Adaptive Dressing Aids: Adaptive dressing aids assist with dressing tasks, such as buttoning aids, zipper pulls, magnetic shoe closures, and one-handed dressing tools. They are often designed for individuals that have use of only one hand, limited coordination, or impaired reach.
• Bathroom Safety Equipment: Installation of grab bars, raised toilet seats, and non-slip mats in the bathroom can enhance safety and independence during personal care tasks.
• Communication Aids: For individuals with speech or language difficulties resulting from a stroke, communication aids can help facilitate conversation. These aids might be speech generating-devices, picture boards, or smartphone/tablet applications.
• Stairlifts and Ramps: If it is challenging to get up and down stairs, installation of stairlifts or ramps in the home can provide easier and safer access between levels.

It is important to consult with healthcare professionals, such as occupational therapists or physical therapists, who can assess your specific needs and recommend appropriate assistive devices. Many of these items require a degree of training for proper use and technique.

The ability to walk again after a stroke varies from person to person and depends on several factors such as the location and extent of brain damage, the severity of the stroke, the individual’s overall health, and the effectiveness of rehabilitation efforts. While some stroke survivors may regain the ability to walk independently, others may require assistive devices or ongoing support. Stroke rehabilitation, including physical therapy, plays a crucial role in maximizing recovery and improving mobility.

Physical therapists work with stroke survivors to regain strength, balance, coordination, and flexibility. They develop personalized treatment plans that focus on specific goals, including walking again. Rehabilitation may involve exercises, gait training, assistive devices (such as canes or walkers), and techniques to improve motor skills and mobility.

It’s important to note that the recovery process after a stroke can take time and varies between individuals. Some people may experience significant improvements in walking within a few weeks or months, while others may require more time and ongoing therapy. Additionally, the level of recovery can also depend on the severity of the initial stroke and the individual’s commitment to rehabilitation.

It’s crucial to work closely with a healthcare team, including physical therapists and physicians, who can assess your specific condition and guide your rehabilitation process. They can provide a more accurate prognosis based on your individual circumstances and monitor your progress throughout your recovery journey. They will also help you set realistic goals while providing support and guidance along the way.

Pain in the arm and hand after a stroke can have various causes. It’s essential to consult with a healthcare professional to determine the specific underlying factors in your situation. Here are some possible causes of post-stroke arm and hand pain:

Spasticity:

After a stroke, some individuals may experience spasticity, which is a condition characterized by increased muscle tone and stiffness. Spasticity can cause muscle spasms and abnormal muscle contractions, potentially leading to pain and discomfort in the affected arm and hand.

Shoulder Subluxation:

Weakness or paralysis of the muscles that support the shoulder joint can result in a condition called shoulder subluxation. This occurs when the humerus bone partially dislocates from the shoulder socket, causing pain and discomfort in the arm and shoulder region.

Soft Tissue Injuries:

During a stroke, the lack of oxygen-rich blood flow to the affected area can lead to tissue damage. This damage may result in pain, inflammation, or nerve compression in the arm and hand.

Contractures:

Contractures refer to the shortening and tightening of muscles, tendons, or ligaments, leading to limited joint movement and potential pain. After a stroke, if the affected arm and hand are not regularly moved or stretched, contractures can develop and cause discomfort.

Central Post-Stroke Pain (CPSP):

Also known as thalamic pain syndrome, CPSP is a type of neuropathic pain that can occur after a stroke. It typically affects the arm and hand on the side of the body opposite to the side of the brain where the stroke occurred. CPSP is thought to result from damage to the sensory pathways in the brain, leading to abnormal pain signals.

Nerve Damage:

Stroke can cause damage to the nerves responsible for sensation in the arm and hand, resulting in persistent or intermittent pain, tingling, or other abnormal sensations. The damage is either due to compression from static positions or secondary to moving in a way that causes structural damage. It’s important to note that pain experienced after a stroke is complex and can have multiple contributing factors. A comprehensive evaluation by a healthcare professional specializing in stroke rehabilitation or pain management might be required. They can assess your symptoms, perform diagnostic tests if necessary, and develop a personalized treatment plan to address the underlying causes of the pain. Treatment approaches may include medication, physical therapy, occupational therapy, or other interventions aimed at managing pain and promoting recovery. For more information, visit: Swelling and Pain Post-Stroke

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