Eye Exercises for Visual Field Loss

Often a stroke survivor, or survivor of traumatic brain injury, has a loss of visual field perception, often termed Hemianopsia.  They may be unable to see to one side, or they may have blind spaces in their visual field.  Many eye doctors still believe that this visual field neglect never improves after a stroke. However, in my experience, exercises that promote eye, neck and inner ear coordination do in fact help reduce the visual deficit.

Below are some exercises that I frequently use with patients in the clinic.

EXERCISES FOR VESTIBULAR-OCULAR-COLIC COORDINATION

Exercises should be completed at least 3x/day for a minimum of 10 days. It is important to have adequate water/hydration before and after each exercise set.

The GOAL OF THESE Exercises is to maintain your visual focus on the target, despite either the target or the head moving. Exercises should first be done SITTING. After all exercises are easy to complete in sitting – be sure to do the full 10 days – then you can progress to doing them in STANDING.

 Briefly close the eyes and rest between each Exercise Set. If they cause extreme dizziness (greater than 5/10 intensity) then a reassessment should be done. All exercises are initially done for 10 days with only horizontal or vertical movements. Diagonal patterns should not be added until the other directions are easy and cause no dizziness.

* IF the stroke survivor cannot hold the card(s), then another person can hold the card(s)*

EXERCISE ONE – STATIONARY HEAD / MOVING TARGET

Hold a playing card or small object arms length from your eyes, nose height. Keeping your head completely stationary, move the card/object slowly from Right -> Midline -> Left -> Midline -> Right (repeat 3x) .

While the card/object is moving keep your eyes focused on it , but your head still.

After a brief rest, keep your head completely stationary, move the card/object slowly

Up -> Midline -> Down – Midline (repeat 3 x)

 

EXERCISE TWO – STATIONARY TARGET / MOVING HEAD

Hold a playing card or small object arms length from your eyes, nose height. Keeping the card/object completely stationary, move your head slowly from Right -> Midline -> Left -> Midline -> Right (repeat 3x) .

While your head is moving keep your eyes focused on the card/object.

After a brief rest, Keep the target completely stationary, move your head slowly Up -> Midline -> Down – Midline (repeat 3 x)

 

EXERCISE THREE – TWO STATIONARY TARGETS / STATIONARY HEAD

Hold a playing card or small object in each hand, arms length, nose height with approx. 3 feet spread between hands. Keeping your head still, rapidly look from left to right focusing on the card/object on one side then the other (10x each side)

 

Advertisements

ReLearning to Walk After A Stroke

I recently presented at a Stroke Symposium for the Pacific Stroke Association and several members of the audience asked me to post my slides.  They are posted here for educational purposes only. Not all of the slides are self-explanatory, so if you have questions please feel free to contact me.

Just a reminder:  IF you are holding onto anything with your hands, or if a therapist is holding onto you during your “balance exercises”  you are NOT working on balance.  One must not have contact with anything when learning to balance on their own, therefore it is very important that you practice only in safe confine with another person guarding for safety. I recommend standing with your back very near but not touching a corner, then placing a walker or chair or person in front of you for safety. 

ReLearning to Walk 09.17

Fact or Fiction: Understanding recovery of movement after stroke

Last week, I presented a talk for stroke survivors affiliated with The Pacific Stroke Association.  Several attendees asked me to post my slides.  I am doing so, but some of the slides may not be entirely self explanatory.

Feel free to contact me with questions.

PSA 3-17

Human Standing

I see so many clients post-stroke who have poor standing balance yet have already begun to “walk”. They don’t actually walk, they “hobble”. Thing is that I have also noticed a lot of people who have never had a stroke also “hobble”, due to back pain.

I think that we have been ignoring the amazing features of the human brain and physiology that allow us to walk upright on two very small bases of support.  It is really kind of crazy that two little feet can keep us upright!  Well, we have more going for us than our feet…

Balance and upright posture is controlled by sensory interactions within our brains.  We do not “think” about balance, we simply balance. This requires that our brain be able to continuously compare input from our EYES, our INNER EAR, and SENSORY RECEPTORS in our MUSCLES.  After a stroke…or even an injury to the back… this sensory comparison is all out of whack! It is imperative to recalibrate the brain and the sensory signals it is utilizing.

A simple daily exercise will make a huge difference:

Stand against a wall with your heels touching the baseboard, hips touching the wall, shoulders touching the wall, head touching the wall.  Close your eyes.  Hold this position for 2 minutes with your eyes closed!  It will feel strange. Perhaps difficult and occasionally it may not seem possible. Stick with it.  After 2 minutes, open your eyes and then slowly turn your head to the left and then to the right, three times. Returning the head to midline each time.

Do this exercise 3 times per day every day for 2 weeks.

Once this is easy, the do the same exercise while standing in the corner of the kitchen. You will no longer be touching the wall, but instead free-standing as if you were against a wall.

*Always have supervision when doing any kind of balance training* Never try the exercise alone the first time*