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*
When I was actively lecturing on the warning signs of stroke and the need for immediate medical attention, I would get letters from people. Lots of letters. Letters that said thank you for teaching the warning signs of stroke. It is so important to know when to call 911 – because everyday heroes are the ones that can change the outcome for a person having a stroke.
An excerpt from my book “Highs, Lows, and Plateaus: a path to recovery from stroke”
“It is very important for everyone to recognize the signs of stroke, because stroke strikes anywhere, anytime, across age, ethnicity, and socio-economic groups. I have never known anyone who planned on having a stroke. But, I know a lot of people who survived with minimal deficit because someone else recognized the signs and sought help. Unfortunately, in my field of work, I also know a lot of people whose symptoms of stroke went unrecognized. Remember, according to our national statistics, fewer that 7 percent of stroke victims get to the hospital in time for emergency intervention.
The odd thing about a stroke is that the person having a stroke often does not fully realize that anything is wrong. When asked if they are o.k. the person having the stroke quite often says they are fine or makes up a reason to explain their behavior. Remember, it is the brain that is under attack – and this is the same brain that is supposed to be identifying that something is wrong! A brain under attack is going to have to rely on someone else to identify the problem and seek help.”
The physical recovery from stroke is only part of the story. There must also be an emotional recovery: for all of the survivors of stroke – not only the one whose brain was injured. … I have found that those who survive a traumatic event, such as a stroke, must go through a grieving process that is sometimes very similar to dealing with the death or loss of a loved one. This grieving process includes: Denial, Anger, Bargaining, Depression, and Acceptance.
In my opinion, it is important to grieve the loss of life, as you once knew it. The stroke took away a lot, but you survived. It is o.k. to experience the process of grieving and to acknowledge that Acceptance is part of healing. To me, acceptance doesn’t mean giving up. It means being at peace with where you are at the time, while striving to be where you want to be. With the acceptance that life has changed, you will thrive. You will continue the journey through the highs, lows, and plateaus until life again is joyful and meaningful.
A lovely woman, C.M., once told me that her stroke had allowed her to have two lives: the one before her stroke and the one after. She said that she thought the one after her stroke was better because it was more loving, more accepting, and slower. She felt that in the second life she had been encouraged – not criticized; applauded for her accomplishments – not put-down for her failures. She accepted herself and she accepted her challenges. Because of that, she just kept trying to get a little bit better each year. And she did – just keep getting better, accomplishing more, and changing the lives of those around her. The stroke had not robbed her of life. It had given her a different one.
I have heard from a lot of people now that they would love to see some videos to accompany the Stages of Recovery that I talk about in my book. These stages were defined by a Swedish Physical Therapist, Signe Brunnstrom (1966, 1970), who described the process of recovery following stroke-induced hemiplegia. The Brunnstrom Approach, emphasizes the importance of encouraging movement within the synergistic pattern of movement that evolves post-stroke. As the stroke survivor improves, the exercises change.
I have spent quite a bit of time working out a series of exercises to help progress clients through the Stages of Recovery. Keep a look out for upcoming videos and feel free to share them!
In the past, I have been stymied at Stage 5 and not sure how to help promote individual movement of the fingers. Recently, I have had the opportunity to demo the Music Glove by Flint Rehabilitation and am very excited about the potential to rediscover finger movement: https://www.flintrehabilitation.com
Look forward to more to come. DOWNLOAD SLIDES 03-15
I had the pleasure of attending Stroke Camp last week in La Jolla California.
I went as a volunteer and also to promote my new book, “Highs, Lows, and Plateaus: a path to recovery from stroke.”
I can honestly say that I gained so much more than I gave! It was a weekend of laughter and camaraderie ~ a weekend of sharing and supporting ~ a weekend of gaining strength from each other. I met some amazing people and have so much respect for the stroke survivors and their loved ones who live each day with the struggles of stroke, and yet they turn those struggles into moments of inspiration and strength.
As anyone there can attest, I cry very easily. Sometimes I tell people that I have “dry eye” and that the lubricating tears are just a side effect of the disorder. Not true. I just cry easily. My daughter says it is because my heart sometimes brims over as tears. At stroke camp, I did not cry tears of sadness. Instead they were tears of release, of celebration for the strength of the human spirit.
Every day we hear about the pain and suffering and cruelty of our world. What I experienced was only love and respect. That is what we need to be shouting from the mountain tops. Not our differences, but our similarities ~ as people. From that we gain strength. Cheers to the Entire Team from “Stroke Camp”. You are everyday heroes !
This morning, my daughter asked me why animals begin walking shortly after they are born but it takes years for a baby to walk? The answer is not as simple as four versus two legs. If it were, then babies would begin crawling shortly after birth! Is it about size? That cannot be right since baby elephants, giraffes, and horses are far larger. Is it about survival? Perhaps. Is it about the complexity of the human nervous system? Most likely. The desire to walk it tantamount in recovery from injury! It is the driving force for much of physical rehabilitation. This complexity of the human nervous system also gives rise to the potential for neuroplasticity.
What are your thoughts on this topic? Would love to hear from you?