♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Yes and we are the most famous physical therapists
on the internet.
- In our own opinion, of course Bob.
- Today we're going to go over the best hand exercises
for stroke patients, at home, using a mirror.
This is something that they can do themselves,
or with a spouse, or with a loved one.
- This is really a neat concept.
When I saw it, it's really exciting.
I can't wait to do this.
This is going to be fun.
- It's kind of a neat concept,
that they not only use for stroke patients,
but they also use it for pain patients
who are having intractable pain in their arm.
They convince the arm that it no longer has pain.
- It, that, well...
- We'll talk about it.
By the way, - Oh yeah.
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There you go Brad.
- [Brad] Yeah!
- [Bob] Because we're always giving something away.
In fact, we're giving away the iReliev TENS unit,
or EMS unit.
They're both combined in one unit.
- Right
- And this is great for pain control,
- Right
- And also for strengthening.
They also, for some of the runner-ups,
they're going to get some of the pain gel.
It's just a roll on gel.
You've been using it on your back.
- Right.
It's one of those things that's a topical pain relief.
It works really well.
I like it because it's a roll on type thing.
- Yeah, so go to bobandbrad.com,
go to our giveaway section,
or go to Facebook, Bob and Brad,
it's pinned to the top of the page.
So this is research backed,
it's not something we're not pulling out of our butts.
- Oh Bob, come on.
- Out of our brain, okay, is that better?
- Yes, much better.
- And they call it mirror box therapy,
or mirror therapy.
It's just a simple, cost effective way
to work on recovery of the hands, wrist, and arm function.
So what you do is you're going to get a mirror.
They have expensive ones you can buy,
but I just bought a cheap one,
I mean, are these things?
What are these Liz?
Do you think five bucks?
Ten bucks?
- Right
- Yeah, they're hardly anything at all.
And you just have it hooked up somehow on your table,
so it doesn't fall over.
- Right, you could have someone like I'm doing.
Just have someone help you out and hold it.
- Right, cause they can help tell me
how things are going on the other side.
- Right.
- So this is my side that had the stroke.
The involved side.
- Right.
- So it's on this side, it's affected this side, so.
You put the involved side on the other side of the mirror.
You put your non-involved arm
on the side of the mirror that you can see.
So what you you're doing here, in essence,
is tricking your brain.
So right now when I move this arm,
I'm thinking that my left arm is moving too.
- [Brad] Is that clear in the camera?
- That's clear?
Okay.
- [Brad] So he's not even going
to look up and look at the stroke arm.
- No I'm not going to look at the stroke arm at all.
It's funny, I do feel like it's moving.
- [Bob] Yeah.
- It's a weird, weird concept.
So they actually use this for pain control too.
If this arm's having pain,
you look at it.
You do things, and say "this one doesn't hurt
when I'm moving it".
And so it tricks the brain, so.
The brains an amazing thing, isn't it?
So I'm going to go through a series of exercise
that you can try.
- [Brad] Sure.
- And as a start.
You know, everything is about repetition with stroke.
- [Brad] Right.
- You want to start forming those pathways again.
And this is helping form that pathway
to remind the arm how it used to work,
and try to recreate new ones.
- [Brad] Right.
- All right, so first one,
you're going to start, now you can put your hand on,
I have a slippery table here
so I'm not going to worry about it.
But you can put it on a towel,
even a sheet of paper.
I'm going to do it palm down, flat down.
And I'm going to look at, I'm watching both,
and I'm just going to go back and forth, like this.
Brad, do you want to kind of show what I'm doing?
- [Brad] Oh, so, yeah.
- Yeah. I' just going ulnar and radial deviation.
And try to do it with this side too.
- [Brad] Right.
- Certainly think about, that's how you're starting
to establish those pathways.
- [Brad] Right.
- Second one.
Hand on your side, okay?
And now you're going to do wrist flexion and extension.
So yeah Brad, if you want to show it that way.
- So again, he's thinking about both hands doing it.
- Yeah both hands doing this.
- But we're only getting feedback from the mirror
and looking at the good side.
- Yeah, and the person that's helping you
can look and see how much you're doing.
- [Brad] Sure.
- You know, so.
Then we're going to go palm up.
Now, it's not unusual after a stroke to have a spastic hand
that wants to close on you.
- Right.
- So a good one to start of with
is to try and open the fingers, and hold it open.
You know, you may not, you may not be able to
bend and flex and extend it here.
But if you can hold it
- [Brad] Right
- just hold it.
- And this is something where if you've got a partner,
you know, they can offer some assistance.
- They can go like that yeah.
- And say hold it there, keep your fingers out.
- And then let go, and yep.
Exactly.
That's a good point.
That's why it's nice to have an assistant with you.
And then if you're able to,
yes, you can do flexion and extension.
- [Brad] Right.
- And as I look over here,
I feel like my left arm is doing it.
- Right, yeah it is really an interesting concept.
- It's a weird, weird thing, so, right?
And then we're going to go ahead,
palm down on the paper,
and we're going to go ahead and,
and this is actually one of the ones
sometimes it's a great one to start off with,
because some times you don't have much
for hand movement yet.
- [Brad] Sure.
- But you might have shoulder.
So you're going to do shoulder protraction
and retraction.
So you're moving the shoulder forward.
This is one where you're probably want a towel.
- Yeah, you don't want resistance on the table
or whatever you have your hand on.
- I'm going to grab a towel real quick here.
- Again, this is not so much the arm moving,
but it's the shoulder.
- Shoulder, right.
- Look at Bob's shoulder.
- I'm going forward, and then I'm retracting.
- Forward, and I'm not trying to use my body,
I'm just using my shoulder to drag.
- This is where that shoulder over the scapula
is moving across the rib cage.
And it's really important to get that motion moving,
sooner than later.
- And often, that's the one that comes back first.
- [Brad] Sure.
- You know, generally a lot of times
it comes back proximal to distal.
- [Brad] Yeah.
- So that's one of the things you're going to see.
And the last one, you know, in reference to the Karate Kid,
we want to do wax on, wax off.
- [Brad] Oh yes.
- So we're just gonna go back and forth like this.
You're going to go internal, external rotation
like this, basically.
Well you're doing flexion and extension of the elbow.
- [Brad] Well Bob, I can't turn 90 degrees sideways
like that.
Don't play games with me now.
But again the key here is repetition.
You know, they talked about doing this
for a good amount of time.
20 to 30 minutes.
- Sure.
You're going to get fatigued,
physically as well as mentally.
You're going to need to take your break.
I imagine you could do circles as well.
- You can do circles, yeah.
I just gave some examples - Right.
you can, whatever you can work on.
Whatever motion you can get - Right
if you can just get like a little bit of finger flexion,
just work on that, you know.
Just start, try to get some movement going at all.
- Right.
- Any movement at all is excellent.
- Right.
- And you could actually do this with the leg, too.
- Sure.
- You could, especially
with ankle dorsiflexion and plantarflexion.
- Right.
Yeah, I could see that with the person sitting down.
Or even possibly, well, not so much laying in bed
because it would be hard to see the mirror.
- And it's nice, you can always make sure you look good
while you're doing it.
Alright, thanks for watching! - There's no hope for you Bob.
There's no hope.