Hands are the chief organs for physically manipulating the environment, and each hand is dominantly controlled by the opposing brain hemisphere. After a stroke with partially damaged brain, grasping a block, gripping a glass, pinching to pick up a small ball or simply opening hands … These tasks may suddenly seem to be too difficult to reach. Indeed, impaired hand function is one of the most frequently persisting consequences of stroke.
The essential of the hand movements is controlled by specific part in our brain (within the motor cortex), and accomplished by two sets of muscles and tendons.
After a stroke, if the controlling brain area is damaged, it will also result in the shortening of soft tissue, skin, tendons and muscles. These will further become one of the most limiting factors to regaining hand function later. If the tissues are not stretched, it will result in spasticity which will further limit use of hand and arm and diminish the recovery potential.
The loss of hand functions results from the combination of two factors : a loss of brain activity due to the stroke and the physical changes in muscle and tendons that occur as a consequence. The less active the motor cortex and the more severe the spasticity , the less one can use his/her hand muscles.
Both problems need to be addressed as part of rehabilitation: stimulating the building of new circuits of information in the brain and releasing the spasticity in the hands, to allow these circuits of information to activate the hands.
Usual interventions include muscle vibration and electrical nerve stimulation in the limbs enhance the motor cortical output to target muscles; mental practice (patient’s concentrating on moving the muscle). NeuroAid, which supports neurological functions, can also help patients to regain hand function more rapidly. With time, the cells in that part of the brain affected by the stroke progressively become more easily activated. The changes in the strength of the connections between the brain and muscles lead to improvements in the ability to use the muscles.
Further intervention are under exploratory development, for example a team of Canadian doctors has developed a test to evaluate hand muscle control: tapping a single keyboard key with the index finger; picking up pegs, one at a time and placing them into holes on a pegboard; and pushing with index finger against a metal bar that measures force. Performance on this test was linked to the ease with which brain cells that control muscle functions can be activated; how active the brain cells are at the time of testing; and the strength of the neural connections between the brain and the muscle. Such test supports then the development of new clinical treatment strategies which will better match each patient situation at the different stages of the recovery process. This may open in the future a route way for more effective individualized optimized treatment protocol for stroke survivors based by adjusting the treatment to the individual’s exact situation and recovery dynamics.
There are specific books or tools such, which may help you find out the exercise which are most suited to your situation – by researching on the internet we came across several books written by stroke survivors who are more than happy to share their experiences. To benefit from these ex stroke patients’ genius creations, you can visit Amazon.
I thought we could use this newsletter to share which books you found to be most useful for your recovery, do write us a short email on which was your favourite book during your recovery journey and why it helped you . We will publish the list of the best ranking books in the upcoming newsletter.
Sources:
Medical News Today
Blue Bridge Healthcare, USA
April 13th, 2009 at 11:41 pm |
I had to read numerous books to try to piece together what would work for rehabilitation.
Here are the books I’ve read on neuroplasticity.
The mind and the Brain : neuroplasticity and the power of mental
force / Jeffrey M. Schwartz and Sharon Begley.
Train Your Mind, Change
Your Brain: How a New Science Reveals Our Extraordinary Potential to
Transform Ourselves by Sharon Begley
The brain that changes itself : stories of personal triumph from the frontiers of brain science / Norman Doidge.
Neurological rehabilitation Carr, Janet H.
Stronger After Stroke by Peter Levine The best book by far. This one is worth buying
Other books at least partially about stroke that I found useful;
Stretching / Bob Anderson ; illustrated by Jean Anderson.
While I can’t do most of these I try to adapt these to loosen my spastic muscles.
The Whartons’ stretch book : featuring the breakthrough method of active-isolated stretching / Jim and Phil Wharton with Bev Browning. This is the better of the two stretching books.
Anatomy of Movement by Blandine Calais-Germain This one came recommended from my OT. It helps me visualize what muscles are being used for what movements and has some excellent diagrams
of walking.
A motor relearning programme for stroke by Carr, Janet H.
clinical science of neurological rehabilitation,Bruce H. Dobkin
Willard and Spackman’s occupational therapy.
9th ed. / [edited by] Maureen E. Neistadt, Elizabeth Blesedell Crepeau
Got some additional inhibition techniques for spasticity from here. Rood technique
Gait Analysis: Normal and Pathological Function
by Jacquelin Perry, Bill Schoneberger
The body has a mind of its own : how body maps in your brain help you do (almost) everything better / Sandra Blakeslee and Matthew Blakeslee
Sensory re-education of the hand after stroke by Yekeutiel, Margaret
Hand and brain by Wing, Alan M. not very useful
The healing art of qi gong : ancient wisdom from a modern master / Hong Liu, with Paul Perry.
Sensory Re-Education of the Hand after Stroke by Yekutiel Margar
The survivors club : the secrets and science that could save your life / Ben Sherwood.
Faster, better, stronger : 10 proven secrets to a healthier body in 12 weeks / Eric Heiden, Massimo Testa, and DeAnne Musolf.
One-Handed in a Two-Handed World (Second Edition) (Spiral-bound) by Tommye-K. Mayer
Still Here : embracing aging, changing, and dying / Ram Dass ; edited by Mark Matousek and Marlene Roeder.
Change in the weather : life after stroke / Mark McEwen with Daniel Paisner ; [foreword by Bill Cosby].
The luck factor : changing your luck, changing your life, the four essential principles / Dr. Richar
And the ones I would like to read
Peeling the Onion: Reversing the Ravages of Stroke
Striking Back at Stroke: A Doctor-Patient Journal
Stroke Rehabilitation – Guidelines for Exercise and Training to Optimize Motor Skill by Janet H. Carr and Roberta B. Shepherd
Acupuncture for Stroke Rehabilitation: Three Decades of Information from China
Rehabilitation of Paralysis Due to Apoplexy by Pan Chang
Clinical Science of Neurologic Rehabilitation
by Bruce H. Dobkin
Stroke Rehabilitation: Guidelines for Exercise and Training to Optimize …
Clinical Neuromythology and Other Arguments and Essays, Pertinent and Impertinent
Second Edition ( this one I will never buy, I will not support him )
By: William Landau
Stroke Rehabilitation: Guidelines for Exercise and Training to Optimize Motor Skill Carr J, Shepherd R. Edinburgh: Butterworth-Heinemann; 2003, softcover, 301 pp. illus, ISBN: 0-7506-4712-4,
Textbook of Neural Repair and Rehabilitation
Acupuncture for Stroke Rehabilitation- Three Decades of Information from China by Hoy Ping Yee Chan
Upper Motor Neurone Syndrome and Spasticity, Clinical Management and Neurophysiology
Michael P. Barnes & Garth R. Johnson Eds
May 2nd, 2009 at 11:20 pm |
I read a book called “Stroke – The Facts For Rehabilitation” – covered some very useful exercises for regaining movement in hands, arms and legs, and to some extent in your face too. It helped my dad a lot in the early days after his stroke.