- Hi, I'm Bob Schrupp, physical therapist
- Brad Heineck, physical therapist.
And together we are the most famous
physical therapists on the internet.
- In our opinion, of course.
- Brad, this is a serious subject.
- Yeah, it is.
- We're talking about strokes and two days ago was what?
October 29th was
- World Stroke Day.
- World Stroke Day a campaign to fight stroke.
And just, do you wanna read those two statistics, Brad?
- Right. So in United States,
every 40 seconds, someone has a stroke,
795,000 Americans suffer from a stroke every year,
and 128,000 people die from a stroke
every year in the United States.
- Very devastating.
- Yeah.
- I mean, I just had a person that right,
he's in his fifties and had a huge, I mean,
a devastating stroke.
- Yeah.
- I mean, obviously very disabled.
So we thought we'd go over three exercises.
Now these are not advanced exercises by any means.
I mean, these are very simple exercises.
They aren't taken into account, you know
D one or D two patterns these are the kind
of therapists speak here, right?
- This is something you could do independently.
- You can try it home.
And maybe with a little help of somebody
in case you're that weak that you can't even.
So let's get right to it, Brad.
- And we're gonna talk about just the leg.
- Just the leg. That's right.
These are just what we call the lower extremities.
- Sure. And on a stroke, almost always,
always one side is affected the other side is right.
- Right. Exactly.
Usually it's the opposite
of the side of where the assault occurred.
You know, usually the, the blood clot
or the blood bleed, you know, occurred on this side
then we have weakness on this side.
- Sure.
- All right, so I'm laying down flat on my back.
And one of the first things you want to do is a lot
of people have spasticity or tone and tightness
and they also have weakness.
So this helps break up the tone
- And tone is one of those things.
I always have a hard time, really getting understanding
for that until you start working with people.
But like you mentioned, it's tightness
the muscles have a tendency to tighten up
and they have certain patterns
that they tighten up with with a stroke.
And that's the key is to do an exercise that tries to
break that pattern of tightness
- Even from the beginning.
When you still, if you don't even have the tone
you wanna start doing these exercises
before the tone develops.
- Sure. Right.
So anyway, this is a very simple one.
Anybody can do.
Well, I shouldn't say that if your leg is so weak
and it might actually flop over like this.
- Yes, exactly.
And that's where you might need somebody to
help guide you to start.
And you're just gonna rotate back and forth this way.
Now this breaks up the tone in the trunk
but it's also making your leg, you know
work this way and this way.
So you, you're starting to strengthen some
of the muscles that need some strengthening.
- Correct.
- And you can actually go a little bit further down
or you go a little further up.
And if you get to the point where you actually
can do it, you know, without support of the other one
you can do a little bit of this.
- Sure. And if you're real weak
you may have a family member like on the bed.
This is, this is what therapists do.
This is a real common pitted position.
- Yeah.
- And they may start like this holding the knees together
so that one might want to flop out.
- Yeah. And then you could even put 'em little resistance.
- Sure. Push.
(loud grunt)
Go the other way.
And then as he gets stronger
then you go to that independent mode.
- Right, and then we go right into the next exercise
which is doing a little bridging.
- Sure.
- And, and this helps bring the pelvis forward
which with a lot of stroke patients
the pelvis wants to go stay back.
- Right. So this starts working on trunk muscles
and getting a little bit of work
on the knee and hip extensors.
- You bet.
- And this is another one you can have someone hold the leg.
- Yep.
- Like that, hold it down, whatever needs.
- And, and then I can push up like this.
And start that with, with a little assistance.
- And, and I oftentimes you'll find if you kind of put
sit on those feet and I'll go ahead
and I'm gonna pull back on the knees.
- Yeah.
- Right here, I'm pulling back and pushing in the knees
that helps a little bit too.
And as the person gets stronger, if they don't need you
you definitely don't want to help
if they can do it independently.
- Now this last one is probably
a little more advanced spread.
As you moved along
and you started getting some of the strength back
this is just a good general exercise to
help a closed kinetic chain, I guess, as you'd call it.
Get to the end of the chair
and you're gonna bring your arms out, which stretches
let's say again, this is the stroke side.
And a lot of times the arms tend to go like this
helps stretch the arm out.
- Right.
- And you get to the
you wanna scoot to the edge of the chair.
And actually a lot of times we have people do this.
Scoot forward if they have trouble.
- Yep, segmental.
- Yep, and then you're gonna lean forward
like this, and you're just gonna work
on getting up like this
this is forcing weight through the air.
- Right.
- The involved leg.
And obviously you're taking involved spring.
And if you can't get up right away
just do a few of these.
- Right.
- And if you're feel tippy by all means
you gotta have someone there to help you through the fall.
- Right. Exactly.
In case you're gonna feel like you're gonna fall forward.
But to be honest with you, you know
it takes a good heave to get forward.
- Yeah
- The trouble is probably not getting enough weight
so you can work like this and start doing some of these.
- One key thing that all therapists
always say is go back to here, Bob
If your feet are out this way too far.
Now try it.
- Yeah. You'll never get out of the chair.
- So, you really have to.
- You have to have him back.
- Yep. And then we say nose over.
- Over the toes.
- Yep. If you line it up.
- Yep and that gives you that extra leverage to help get up.
- And in my case it's really hard
to find the nose, even Brad.
(sarcastic laugh)
- All right.
Thanks. Good luck with it.
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