- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heinek, physical therapist.
- And again, we are the most famous physical therapists
on the internet.
- Well, in our opinion, of course, Bob.
- Brad, as proof that we always listen to our viewers.
We have a, a viewer out there who, unfortunately
his father just had a stroke.
This is for Kliment. K L I M E N T.
- Okay. - And his father had a stroke.
Sounds like it was a fairly bad one.
He doesn't have much movement
in his arm or leg at this point.
And I, I promised him
we'd show some exercise that he could start off with
and we're gonna do this in a series of three videos.
This is gonna be the first one,
the other one's aren't gonna be up for another week or two.
- Sure. - But we'll start off with this one.
This is the most basic stuff.
And Brad, you're gonna be the person that had the stroke.
- Sure. - And this, this red tape indicates
that the arm here is the arm affected and, yeah,
this leg is the leg affected.
- Sure. - So you're gonna start off
by having the person already laying down in a, in a
what we call the supine position in bed.
Now, one thing that I found
with nearly everybody who's had a stroke, even
with those who are very weak and have no movement at all.
Like in fact, I had a patient this week that just came in,
very same thing, no movement at all and anything
but they almost always still have this.
If you bring the leg up like this
and even push it a little bit, this way
they can usually push a little bit.
- Uh-huh, yeah. - They almost always have that.
And by they, the fact that they can push a little bit means
that they can probably do bridging, what we call bridging.
- Sure. - So, and I'll show you what that is.
We're gonna put the leg in this position here
but what you're gonna do is bring the other leg up also,
and you're gonna hold both legs together,
and you're gonna have the person lift their butt up.
Yep. And now if this leg has no strength at all
they still can use the good leg to help the, the bad leg.
- Sure. - And this is called overflow.
When you start having one leg help the other one
eventually the brain starts overflowing
to the part that needs to, and it it'll start helping that.
- Sometimes it's called crossover.
- Crossover, right.
By the way, this, this whole technique, by the way
is called functional training.
What you're trying to do is train the body to
do something that they're gonna do
in their activity of daily life.
You know, like, so right now we're trying to
train Brad how to move his body in bed a little bit.
- Sure. - Like if you lift your butt up, Brad,
you can actually move it over a little bit
and, and reposition himself.
But we're also trying to train Brad how to get out of bed.
So this is functional training.
This is research based that it it's found out
that this probably works better than most other techniques.
So anyway, so we're gonna start off with the bridging.
Eventually, if you get some decent strength in here
you could actually even just do the one leg and then see
I even pull up sometimes on it like this.
- Yeah. That helps a lot. - You know, and
and start getting a little bit of bridging.
We start getting a little bit of trunk control.
All right, that's section one
basically of getting out of bed. All right?
The other part we're gonna work on,
we can put these down now, is the arm, 'cause to get out bed
Brad's gonna need to have to turn his body this way.
We're gonna get outta bed this way.
Yeah. So what he is gonna do
he's gonna take the arm that's affected.
He's gonna grab it with the, the
the good arm around by the wrist like this.
And he's gonna bring it
over this way and work on this pattern right here.
So he starts down here.
Palm down, palm up.
Now we're getting some rotation of the body.
He's crossing midline.
These are things that don't mean anything to you
but this all helps.
And then yeah, eventually we can start working
on putting the two together where he, he,
you can bring the one leg up or even both legs up,
and, and yeah. And you can work on going like this.
So eventually you can work on the fact
that he's gonna do phase one of getting out of bed.
Now this, of course you're gonna wanna be
in front of him 'cause safety first here
the last thing you want is for your father to fall out bed.
- Yeah, right. - So, you might even need two people here
when you're doing this.
When you finally do the act of getting him out of bed.
So, so now we're gonna put the two together.
If, if this leg doesn't stay up
you can go ahead and put it down.
You can put it down like that.
And now you're gonna have again, grab the wrist
and he's gonna go over like this,
and he can push with this leg and now,
and you can be right here
to make sure he's not gonna fall out of bed.
And then when we get to this phase, what he's gonna be doing
with this arm, he can do one of two things.
He can push up from the bed with the good arm
which is gonna help him lift up or he can actually push
off the other arm and take some weight through it.
Okay. But before he does that
you're gonna have to bring this leg off
where he's gonna use this leg to slide that leg off,
and that's there and that's there.
And then you can push up.
Now, when you're doing this, what actually helps
I'm gonna do it on the other side,
I would do it normally on this side.
You can actually put a hand on his pelvis here
and put one underneath under his shoulders like this.
And then he pulls up like this and they rock.
It's kinda almost like he's rocking, right Brad.
- Yeah. - This is almost a fulcrum.
- I want to emphasize.
This hand is much more important
than what he is doing up there.
- Right.
- You can actually help someone just
by putting your hand there.
It makes the trunk contract a little bit.
- Yep. So I got a good hand right here
and I'm pushing like that.
- It is amazing how much that helps.
- Yeah. How, how much, how much leverage it gives.
- Right.
- But again, I usually do have a hand here also, right?
In case they have trouble.
So the leg comes off, they're pushing
up with this and we're going like that.
Okay. I know this looks easy 'cause Brad obviously
didn't have a stroke, but it, it does work
if you start getting down the techniques.
- Right. It's really hard to pretend you had a stroke.
But when you work with someone, these techniques
and it takes to practice you're for the first time
you may have to do this a dozen times before it
all fits together.
And then it starts to be fun because you see progress.
The person's starting to work on their own.
- And the, and the person your dad is gonna see
that he's gonna see we're working towards something.
We're not just moving my arm and leg.
We're working towards getting out of bed.
- Right. - And then once up in this position
I have no idea what his sitting balance is like
but that's a time to work on this then, and that's where
you take the arm.
And again, you want weight bearing through these
these surfaces as much, or these limbs as much
as possible, leg and the arm, and we'll work on the leg next
next time.
But you know, weight bearing through this.
And if he needs help, you gonna maybe have a belt around him
or you, yeah.
He might be going like this, but this is where
you wanna work on, where he can even reach for things
with this arm, you know, reach up here, reach down here.
Trying to keep his balance while he is doing that.
- Why don't you grab down there? Cause by...
- So I can, I can even hold support like that
- There. So this is literally what you're gonna have to do.
- Yeah. - And, and then I can reach over here.
And, and a lot of times they'll neglect that side.
So you have to say reach over that way. - Right.
- And then I'm putting weight through this arm,
which will make those muscles contract
without even the thought process.
- And what I'd like to see too, is that you're on a
a bed, so your feet are hitting the ground.
Which is gonna help obviously a lot too
with his, his balance and stuff.
So, these are just a few hints on, on how to start
and how to get things rolling. And hopefully that's helpful.
And well, like I said
we'll get a couple more videos up in a few weeks.
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