- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heinick, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Brad, Brad, we haven't done this for a while.
- No, we took a little sabbatical
for a couple, three weeks.
So
let's get going. - Let's get rolling.
- We want to talk about strokes.
Okay. - Yeah.
- And one of the problems with strokes,
after the stroke, is balance.
And I'm gonna show you some balance exercises
you can do at home,
after you've recovered.
And this is for people
who are already to the point,
they're lucky enough where they've recovered,
where they can walk,
- Okay
- but they're walking is unsafe.
- All right.
Are they fairly safe? - Okay
- Pardon?
- Are they fairly safe?
- Fairly safe.
Probably using a cane,
and may not even be using a cane.
- Okay. - They're higher level.
- All right. - And you can do this
for balance, even if you haven't had a stroke. Okay.
- Okay.
- And you'll understand.
It all makes sense as we get into this.
So you remember from school,
the three things that hold your balance, Bob.
- Sure. - What?
- Vision? - Yes.
- Proprioception. - Yes.
- Vestibular.
- You've got it. Okay.
- We're gonna tax that.
- We're gonna tax all those.
And we do have a volunteer,
volunteer from the audience today.
And
- Callie
- Cal, Callie
- Callie. We are gonna call her Karen?
- No, Kayla,
- Callie.
- Callie, come on in.
Sorry. Sorry.
Sorry. Well
- Callie's a student,
a junior undergrad for physical therapy.
- Yeah, face the camera there.
Okay. Why don't you stand here.
Now, what I want you to do,
this is first phase.
You're gonna bring your feet together.
So your ankles are touching.
Now, some people may not get that 'cause of your knees
and your anatomy, but just bring your feet
as close as you can.
You're gonna look straight ahead
and you're gonna cross your arms, just like this.
Okay. And then now if someone has poor balance
you may have to have someone on both sides.
So Bob, you can stand there.
- Sure.
- And this is how you would be if someone's
off and they're a little shaky.
- I would say maybe have a belt around them.
- Yeah. We could even go with the belt.
- Want grab a belt?
- You better believe it.
So if it is someone that's come phone from the hospital
you probably have a belt.
Okay.
- And this way you can do it one person then.
'Cause you're not always gonna have two people at home.
- Yeah. - So,
- Okay. So here we go.
And you're gonna do this for 30 seconds.
The, the time isn't necessary, but we're gonna
use a standard 30 seconds.
And when you getting this from the foam pad test
and the sensory organizational test,
which is too scientific,
but these are good quality balance tests
and rehab, the devices used.
So now 30 seconds no swaying, everything looks good.
Then you go to the next higher phase
and we're gonna close your eyes.
So that takes the vision out of the picture.
- Right.
- And a lot of times, and I know Bob and I have
seen this a lot where all of a sudden people start swaying.
- Actually Kayla has been swaying a lot right there.
- Yeah, yeah.
You out last night?
- No
- Okay. All right.
And you're gonna look at your watch.
You're maybe have your clock on the wall
and hold that for 30 seconds
if they're doing well with that.
Okay. The next thing is
the proprioception.
This is a knee pad I got from home.
They recommend a three inch foam pad for the official test.
- Okay.
- But anything that's soft and squishy
and it's gonna throw off their balance.
So you're gonna stand on this.
Okay?
And you feel that's squishy?
- Mm-hmm.
Makes things work a little bit harder.
- Mm-hmm.
- Okay?
And if they're standing with their eyes open,
then their eyes closed.
Okay.
- Now she's trying a little harder too.
You can see this.
- Yep. You can see the ankles working down here.
- Yeah, exactly.
- Okay. Now, if you really wanna get more official
the dome is what they use.
So you don't close your eyes.
So your eyes are open and they're accepting information.
- I see.
- But the dome for me makes, too hard to make.
So the next best thing is take a pair of sunglasses
put some tape over 'em
and here, can you put those on?
I don't wanna,
and now she can keep her eyes open.
So it's more relaxed and a normal sensation there
especially with someone with a stroke,
may have problems maintaining eye closure,
and this makes it easier.
- What do they use for a dome?
Do you know?
- Yeah. They make this kind of a papier-mache thing.
It was way
- Like a bag?
- I thought about putting a paper bag over.
Okay. Very good.
So
the next step,
if they're doing really well with that.
Okay. Off here,
feet together again, we're gonna start all over.
Eyes open, close here.
If she's steady here and they probably are at this point
now you're gonna let's let's go down here.
You're gonna take your right foot and you're gonna touch
with your toe right there.
Now touch straight out to the side,
bring it back to the starting point.
And now see if you can touch across
and back to the starting point
and then straight behind you,
back to the starting point.
Okay.
So it's 1, 2, 3, 4,
kind of like dancing.
Okay.
But this is gonna be harder.
So you may have to hold onto that belt
the first time they're doing it.
If you have a cane, they might wanna hold a cane.
Okay. Go ahead and do it.
1
2
3
4
You passed it. Okay.
- Three looks the hardest.
- Yeah.
Now we're gonna go to this.
Put these on
the next step up.
Yeah. Three going across.
- Yeah. - Yeah.
Okay. Go ahead. Not quite. There you go.
Two, three.
And she's still doing very good.
Now let's make it a little bit more difficult
in the same setup.
I want you to reach out as far as you possibly can.
You're gonna bend this knee a little bit
and reach out really far
and just touch your toe.
Go ahead.
Touch. Way over.
Wow. She's got great balance and back.
Okay. - Wow. You know what?
Make her do with the other side.
- Ah, good idea, Bob.
Let's tax, let's tax her balance.
- Yeah. See, she's already having more trouble.
People tend to go to their dominant foot first.
- Yeah. See, she's coming there you go
- On a normal individual, you'll see
that they have a one side that's better than the other.
- And this is where therapist really start to have fun.
Let's go with this Bob.
All right, here we go.
This is the ultimate on the foam.
We got the dome, the eyes covered
and now let's do the same thing.
Reach out with the right foot.
There you go.
Look at this left ankle work.
- And this is where you're definitely gonna have someone
holding on to you.
- Yeah. Whoa.
And you do have to be careful on the foam
if they have a weak ankle. - Right.
- You won't want to do it 'cause you could roll it.
- They'll turn it.
- Yep. Okay.
Now do the other leg.
We might as well be complete.
- She's getting smarter on that one.
- How old are you?
- Nine or 20.
- She's 20 years old.
Healthy, young 20-year-old.
- Yeah.
- And that gives you a baseline for that.
But if you have someone after a stroke
you probably won't even get to the foam.
- Get to the foam.
- Yeah. So you go by the individual's potential.
Be safe, have a belt on them.
Two people if needed and it's a great exercise.
Okay. You wanna sit down?
You can sit down with us to finish off.
- All right.
- All right. Thanks a lot folks.
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Just keep subscribing.
- Yeah. Yeah. Look at this though.