♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapists
on the internet. - In our opinion,
of course, Bob.
- And you remember Johnny Carson when he used to?
No, you don't.
- Yeah. We'll skip that.
- Okay, today we're gonna talk about after stroke.
This one thing is key to rehabbing your arm and hand
and I've known this
from working with stroke patients over my entire career,
but it's also been verified now
on some studies that I just read.
- So we? - Oh, oh, I'll tell ya'.
- Oh, okay, we're gonna get to it.
- I'm building suspense, Brad. - Okay.
You're good at it, Bob.
- Yeah, by the way, if you're new to our channel,
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- Seven weeks worth. - Seven weeks worth.
And it's really gonna be cool stuff.
Stuff you're really gonna want to have.
- There is excitement within the crowd, Bob.
- Yeah, We're gonna send some positive vibes your way too.
You can become one of our good vibers.
All right, so the one thing that they have found
that the key to stroke rehab is
that you have to have repetitive practice.
- Sure.
- Repetition, repetition, repetition.
It's like practicing scales when learning
a musical instrument. - Right.
- You have do it over and over and over again.
And you can trying to reestablish those neuropath
neuro pathways, so. - Right.
They've gotten damaged, irritated, scrambled, if you will
and they need to find new ones or regenerate the old ones.
And that takes time, time and-
- It takes time and repetition.
- Yep.
- So if you are, well, we ideally
if you have some motion in the arm at all,
you may even want to do a little bit
what they call constraint induced movement therapy.
- Okay.
- That's where they actually,
you put a like a mitt on your good hand-
- Mm-hmm. - So you can't use it.
- Sure.
- And you know, you, you go through your day
and you're forced to use the affected arm.
- Right, right.
- But, for a lot of us though, you know, when you start off,
you may not have any movement or very little movement.
- Sure.
- And that's why we're gonna talk about...
There's a lot of things you can try,
but I thought we'd talk
about the CanDo wrist and forearm exerciser today.
- Sure.
- They sent this to us and I was like,
"This is a good way to start with a patient
"who's had a stroke."
You can start to get some movement.
It doesn't take very much strength at all.
- Mm-hmm. - To get it moving.
So it, what this kit comes with is
it comes with three half circles, basically.
Is that what you call these?
- Sphere?
Maybe a hemisphere?
- [Bob] Three hemisphere.
Hemispheres.
- There you go.
- And they've got three handles.
Now, the handles can go into any one of the devices.
So, you know, even though that's yellow on yellow,
you can go the green on yellow-
- Sure. - You know,
the black on yellow.
- Right.
- And they're different sizes.
- Diameters for the...
Depending on your wrist or your grip activity.
- So we're gonna start off with is generally first,
if you're having any what we call tone,
you know, tightness in the arm.
- Sure.
- You're gonna wanna stretch out the arm first.
And I know, you know, a lot of times the typical pattern
is sometimes your tone is more like this.
- Sure.
- And a lot of times we used to take the hand
and just stretch it out like this.
Stretch, the elbow, the hand
and the fingers all at the same time.
- Right, so the fingers oftentimes make that fist.
We wanna open the fingers up, work the wrist
and basically extension what a therapist would refer
to as extension, throughout the elbow,
wrist, fingers, and, and hand.
- And what, even if it's not real tight,
even if it's just starting to get a little bit tone,
it's good to do that stretch.
- Sure. Yep, get things loosened up.
- All right, so we're gonna start off with, you know,
the you're gonna go, we're gonna work a little bit
on wrist flexion and extension.
Try to get some of that going.
- Mm-hmm.
- So, you know, this one probably is the best one for that
because it's so large, but you're gonna start off.
Brad's gonna kinda show up from the side
and I'm gonna show it the straight on view.
So, you know, again, you can almost even
use your body to start getting some motion.
- Sure.
- If you have very little on your arm yourself.
If you arm is not working that well,
you can even support it like this.
- Sure.
- And try to start.
All you're trying to do is get some movement.
- And you might take the other hand and go over the top.
- Absolutely.
- And you can let it, help it out.
- You can start with that,
but try to do something without it too.
- Yep.
- And it's funny, you know,
you wanna see that visual success.
- Sure.
- 'Cause if you got kind of a dead hand or dead arm-
- Mm-hmm.
- You wanna be able to see that hey,
I can make that move a little bit.
- Right.
- Even if it's a little bit.
- Get that feedback going.
- Yeah, get that feedback loop going
and you want that encouragement.
- Sure.
So this is, as Brad's showing
that's going to the reflection and extension
and then you can also
use the handle
and you can put the handle on.
You're gonna show it with the black one, Brad?
- Yep.
And you can use it with any one of these,
depending on which one works better or what works handiest.
And- - [Bob] And a lot of times,
you know, even with you don't have much strength,
you can just set the hand on there.
- Mm-hmm.
- And now you're gonna work on flexion
and extension this way.
- So if you look at it from the top down,
if we had our aerial camera,
then you can see we're doing the same motion as this.
- Yep.
- But, from a different angle. - And with a grip.
- Right, right.
- So we're getting a little bit of finger grip there.
- Yep.
- Okay.
- This way, you know, your thumb up this way, thumb side.
It makes a big difference on how the body works.
- Right.
- So that's why we do two different motions.
- This is almost probably a little more functional.
- Right.
- And that is what they have found with after stroke.
The more functional activity you can do. the better off.
- Sure.
- It's better not to just work
on individual motion if you can do full functional moves.
- Sure. Right.
- All right, so next one is supination and pronation.
So this is working on the forearm,
but so you're gonna get on a flat surface here.
And Brad, you wanna show up from the side again?
- Yep.
- But, I'm going this way and this way.
So this is supination.
This is pronation.
You don't need to know that,
but you're just gonna go side to side like this.
- Right.
And you'll find, it's probably gonna be
much harder one way than the other.
You know, you can if you wanna hold your hand on there-
- Again, it's a starting point.
- Right.
And, but the goal is to get like Bob without the hand.
- And a lot of times again,
if you're maybe in a seated position,
you can be like this and you're just, you know.
- Sure.
- It just doesn't take very much to move these at all.
- Right. Yeah, they're very-
- Right. - Free.
- Now again, we can do it with the handles on.
These handles go in and go out very easy.
Of course, now I've made mine harder. (chuckles)
All right, so now, yeah.
Now again, we're doing the handle, we're gripping this way
and now we're going back and forth this way.
Again, very little motion it takes for this to happen.
- Yeah.
You may wanna find a little bolster.
I have a role here and that kind of evens it up.
Yeah. That's an excellent, Brad.
- That's a nice little trick if you will.
- I've got some, we got some patients who've had
a stroke that I can't wait to try these on.
- Sure.
- I just got these
so I haven't even, you know, attempted this with them.
- Right.
- But. it's gonna be a great activity with them.
- Yeah.
Again, with this, you could hold
with the other hand or if, as a, you know
someone helping a therapist.
If need to, you know, you can start there
just to get that motion going-
- And, you know, do less and less as time goes on.
- Right. - You know?
- The goal is to do it independently with one arm.
- Or if your hand is even like this, you know,
you can just go like this. - Right.
- You don't need to grasp.
- Right. - So...
- And it's amazing.
Once you start working with someone and therapist know this,
everyone's an individual, but you'll find little things
that help that particular person out
whether it's visual, a little assistance,
how you talk about it.
- So you can, you know, if they're in a wheelchair even,
you can set up a tray on their wheelchair.
- Sure.
- And they can just work on this for hours.
I mean maybe not hours,
but you can work on it for 15 minutes.
- Right, and then repeated over the day.
- Yeah, repeated.
- Every couple hours, every three hours,
you know, just get after it.
- So next one we're gonna do is we're gonna put the...
We're back to this flat one again
and we're gonna do radial deviation and ulnar deviation.
So if I'm, if you're looking at, you know, from aerial view,
I'm going like this and like this.
So we're getting the wrist moving back and forth.
So we're getting a lot of hand movements
and we we're also, when we did pronation, supination,
we're getting some of the wrist motions too.
- Right.
- So, and these are the ones that tend to come back
last, you know?
First you tend to get some shoulder motion, elbow, and-
- Right.
- And hand and wrist come out about last.
- Right, from the body down to the ulnar, you know,
we call it proximal to distal.
You don't need to understand or know that necessarily.
- And then once again, can add the handle
and this way we're actually gonna go
and you can probably get your bolster again
then Brad or something.
- Oh yeah.
- You can actually work on
going back and forth like this.
- Right.
Ringing the bell, right?
- Yep.
- Or ringing the bell, the maracas, you know?
- Maracas, yeah.
- Yep, if you had any musical background in percussion,
you know, you know exactly.
They look like a mushroom to me, Bob.
- Yeah. They do.
- Yeah, that's kinda, you know, something to think
about someday, you know?
- And then- - Bong.
- Oh Bob. Why, Bob, why?
- All right. - Here we go.
- And by the way, they had sent us this one too
which this is a good one for just does really one thing.
It works on pronation and supination.
By the way, these can be used
after you've had hand surgery or knee surgery.
- Sure, yeah.
Not just stroke.
- Really, really good for that, but yeah,
this is a very simple device, but it works really well.
You can, again, you just work on pronation and supination.
- [Brad] Here, let's put the bolster under there, Bob.
I think that might be helpful.
- Oh sure. - [Brad] Right?
It's more comfortable. - Excellent.
Wow. That's fantastic.
So I can just, you know, it's very easy to do,
but you can work on stretching it one direction.
- [Brad] You bet.
- And stretching in the other direction.
- Right, you know and then you can give
a little assistance very easily.
Be nice. Don't overstretch.
- So this is the, CanDo.
We got links down below for these.
This is the CanDo pronation and supination.
It's $50.
This is kind of low pricey if you ask me.
- Right.
- But, this one I thought was actually
a pretty good price, $75 for all these, all three of these.
So. - Oh the...
- All three different- - Sure.
- What you got 'em over here for?
- Well, I was getting 'em out of the way for this, Bob,
you know, we he's gotta make room.
- We don't make anything off of these.
We don't get an affiliate link.
We have no nothing to do with this.
We just wanted to show you these.
- Right.
- So we try to show you interesting products
that are presented to us
and that's the case today.
- You got a loss of words.
- I did. (chuckles)
- It happens.
- It happens. (Brad chuckles)
- Thanks everybody for watching.