♪Bob and Brad, the two most famous♪
♪ physical therapists on the internet.♪
- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapist
on the internet.
- Well in our opinion, of course, Bob.
- Today Brad, we're gonna talk about leg strengthening
for someone who's had a stroke using the exercise ball.
- Right, one of my favorite tools and it's really nice
cause this is something,
this particular exercise protocol is for someone who's
had a stroke and their leg is not flaccid.
They have active range of motion,
they can move.
- Flaccid, he means there's no movement at all in it.
- Right, just limp.
- So there's a little bit of movement is what you're saying.
- Right, but it's not strong enough where they can stand
and really walk on it.
Maybe with a lot of assistance of one person.
- And this is a lot of people
after they've had a first had a stroke.
They've got just a little bit of movement there
but they can't stand on it.
So this, this would be a good exercise protocol these.
- Exactly. So you're gonna take a ball about this size
because we have 65, 55 centimeter ball
and you're not gonna make it real hard.
It's gotta be a little soft, actually.
- So let a little air out.
- Right.
- Or don't put all air in.
- Exactly. Can you move, Bob?
- All right.
- So this, you're probably gonna have to have two people
because to get the ball, if you've had a stroke under here
you probably one arm may be affected.
- So this is a family member or someone trying to help.
I want to get my family member better.
- Exactly.
- I might even have to lift their leg up on it.
This is the weak leg.
- Right? This is the weak leg.
The one closer to the camera.
And the first thing is simply range of motion.
And let's say don't don't.
- Okay.
- Let's say, if you're strong enough to do this,
you can do it.
But if that leg is not strong enough or the ball
is all wobbly, take the good leg and then you do
single double knee to chest.
The good leg is gonna help and assist the weak one.
- Okay.
- And you're just gonna go back and forth, back and forth
- What if this one's floppy, like this?
- Yeah, if that one.
- Then I can maybe just put my hand there and help it?
- Exactly. And sometimes I've done it where
I've taken straps and strapped the two legs together.
So you don't have to hold it.
Yeah, if you got another person to help you, they can just
hold it so that a lot of times that knee will go like this.
You may have to come over
- And hold it like this.
- Yep, exactly.
And once it starts to get stronger where you don't
need that, Bob will take one hand off, and then the other,
and then as it strengthens, you're gonna take the good leg
and just do this all by itself.
And that so it works at control.
Yeah. This is let the range of motion
- Works a lot of control to do this.
- Now the next phase is to strengthen the hamstrings
while you're here is convenient.
You can go to here. Now, watch what I do to the ball.
Keep your eye on the foot.
I'm gonna squeeze down.
- Okay. And this is why you want one
of the reasons why you want a soft ball
not so soft that it's flat, but it's cushy.
And so you're gonna push down
and all the way through the range of motion
you're gonna squish that ball, squish, squish, squish.
And move squish, squish, squish, and move.
And that's gonna strength a lot
of hamstring as well as some of the hip for control.
- Brad, could you,
let's say you start off initially and you
don't have much strength, could the person hold it here.
- Yep.
- And you push down a little bit with that.
Just starting a little isometric.
- You, you bet
- Or isotonic too.
- Yep.
- So you're just pushing down here, pushing
down here then maybe I'll move it here.
Now. Push down again, Brad.
- Good point, Bob.
- Okay. I'm over here.
Push down again, Brad.
- Great.
- Okay.
- Yeah, and there's gonna be other things
- Or you can keep the leg straight and push down.
- Bob, you interrupted me.
- Oh!
(both laughing)
I'm his wife now.
Okay, push down.
- No. So the point was is that each individual
you might find something new that we haven't came up with
but it's gonna work for that person.
So don't be afraid to do that as long as
- Experiment.
- Yep. So yeah, that's a great idea, Bob.
Okay, now the next thing is in the wheelchair.
- Okay.
- You can do a real nice exercise.
- Wheelchair or could you do this one in a recliner, Brad?
- Yep. Any kind of a chair actually.
- Okay.
- But it needs to be stable, is what you're saying.
- Exactly.
Cause you'll see why you can.
Why don't you grab that stool, Bob.
When you walk, you're putting pressure through your legs
and the muscles co-contract and they contract differently
than they do when you're laying down like that.
It's called open chain.
This is a closed chain exercise.
- Okay.
- So if this is my weak leg, I'm gonna put it up.
Bob's gonna hold the ball stationary.
I'm gonna put up, get a little closer, Bob.
There we go.
- And I might even hold the leg for you
if you can't get up there.
- Exactly.
- I might be over on the side.
- Right,
if the knees flopping out.
In this case, the armrest is helpful.
- Sure.
- Because it holds it and it's gonna do that.
The whole point of this is I'm gonna try and push
into the ball.
And this is another reason why you want a soft ball.
So you get some motion with this pressure, as opposed
to an isometric, you got some motion.
You can do two legs at once.
Get some crossover effect, which is a neurological benefit.
When you use two limbs at once.
- Some overflow.
- Yeah.
- You're actually pushing me, Brad.
- Yeah.
- He's actually getting some good push.
- Now, the reason why, if you have a wheelchair or a chair
you wanna put it up against the wall.
- Yeah.
- Is because this can happen.
And this is where you really have to be careful.
- Yeah. You don't want this to have, I mean
you'll go right over.
- Exactly.
- And we don't want to be responsible for that.
- Right. You need to get..
- So if you're in a recliner or if you're
in a solid chair, that's not gonna flip over
- Right.
- This, this would work well.
- Exactly right. So again, the other person's
gonna hold the ball
and Bob's on a rolling stool, which doesn't work so well.
- Right. Cause it's, he's just pushing me.
- Exactly.
- Plus you're getting a lot of push, Brad.
- Yeah, yeah, exactly.
Someone that's had a stroke probably, you know
won't be that stronger, they'd be walking,
doing more exercises. And repetitions
on all these 10 to 15.
I like to do once you get past 15, usually take a rest.
- Sure.
- You know, you could go up to 20, if your things
are going well and you're having fun,
but these are great exercises, I think.
- Great Exercise.
Great way to start getting some weight bearing
like you said, cause you're not able to stand yet.
- Exactly.
Yep. So it's safe.
You can do it at home with a family member
but the helper really needs to pay attention
to what we talked about with the safety cues.
- Yep. Excellent.
- All right, very good.
Good luck on your rehab.
And we hope it goes well.
- Make comments below.
We like to hear from you.
- Sure!