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Following a stroke, your arm may be weaker, tighter or you may find it hard to control the movement. You may also struggle to feel it or sense when it is being touched.
Below, we have provided a more detailed overview of why you experience these various symptoms and how you can manage or improve them.
A stroke can damage parts of the brain that control signals to the muscles. This can cause them to get weaker because you are not able to use them. With time, they gradually become more deconditioned and weaker. Doing exercises aims to improve strength in your muscles and help your brain to recover the parts of it that control your muscles.
We have provided an overview of some exercises that could support your recovery.
If your occupational therapist or physiotherapist has advised that you need support when you are completing exercises, try some of the Assisted Exercises. Ensure you seek help of a family member or carer. Your helper will need to adjust the level of support they give you depending on how much you can do.
If you can complete exercises without support, please review the Independant Exercises.
GRASP is an arm and hand exercise program for people with stroke. It can be undertaken by the patient on their own. It is highly recommended that it is completed with assistance from caregivers or family members. They advise a minimal movement criterion of some wrist and shoulder movement.
They offer the program, manual and GRASP books free of charge. Visit their website for more information
Queen Square offer an intensive 3-week upper limb programme that focuses on individualised goals relating to functional tasks.
For an individual to be referred, they must have some forward reach and at least the beginning of thumb and/or finger extension. They also need to be able to participate in goal directed training and tolerate a 3-week intensive programme. Therefore, some people who have very stiff and painful shoulders and/or problematic spasticity in the wrist and fingers need local review before being considered for the programme.
If you believe you fit the criteria to be referred, please discuss this with your GP, physiotherapist or occupational therapist.
A stroke can damage part of the brain that control signals to the muscles. This can result in an increase or decrease in muscle stiffness. When the muscle stiffness is increased, it is known as increased ‘tone’. Increases in tone can make it harder to stretch and move. For example, as you walk, you might find your arm gradually starts to bend. This is likely the result of increased tone.
It is likely that you will have been assessed for these changes while you were in hospital. Your physiotherapist or occupational therapist might have given you exercises, stretches and a splint to manage the changes in ‘tone’ and maintain the range in your joints. It is important you follow the advice previously given as these changes often require long term management.
If you have been given a splint, you should use the splints as prescribed by your therapist. If you notice any discolouration or marks on your skin, you should contact your GP or your therapist.
Sometimes, when tone is not managed effectively, it can lead to long term changes in muscle length and movement. For example, you may find it difficult to wash your hand because you are unable to straighten your fingers to get to your palm.
If you have difficulty managing the changes in your tone, you should seek further advice and support from your physiotherapist, occupational therapist or GP.
As a result of tightness or increased tone you may be required to wear a splint to help stretch your arm/hand when you are resting.
If you have been given a splint or orthotic for your arm, you should use the splints as prescribed by your therapist. If you notice any discolouration or marks on your skin, you should contact your GP or your therapist.
If your splint is wearing out, broken or not fitting well please ask your GP to refer you for review/replacement as below:
If there are changes to your needs affecting your function it may be useful to also ask for a review with an occupational therapist at this time.