♪ 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.
- Remember Johnny Carson, when he used to have that staff,
and he'd go like, nevermind.
Today, we're gonna talk about hand weakness after stroke.
This is the single most important thing
to do to regain motion.
So we'll reveal this in the video, Brad.
- Okay.
- By the way, if you're new to our channel,
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'cause we're always givin' something away.
What are we givin' away this week,
we're givin' away the FitGlide.
- There you go.
- This actually would be very helpful after a stroke too,
especially if you had your legs affected.
- Right, yeah, you don't use it on the table.
- Right, right, it's on the floor.
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So after a stroke, many experience weakness,
especially in the hand.
Hand and wrist.
- Right, mhmm.
- Brad and I aren't real experts on that,
because if you understand physical therapy
and occupational therapy,
a lot of times the occupational therapists
spend more time on the wrist and hand.
- Right.
- But I have worked with patients who've had stroke
long enough that I know very well the common pattern.
- Exactly.
- You're trying to regain motion and strength
in the wrist and hand through two means generally.
One, after a stroke, there's swelling in the brain.
- Mhmm.
- And as that starts to go down,
some of your function returns.
- Right.
- Some of the connections, you know, are remade.
- Yep, they call 'em the pathways,
and as that improves, they improve,
and boy, it's fun to see the gains, however...
- Well, the other way that you can make a gain
is actually the brain forms new connections.
- Mhmm.
- And the ability to do this is called neuroplasticity.
And to be honest, it's just like a lot of things,
with a younger brain, you see the connections form easier.
- Sure, right.
- I remember having a person, this was really quite tragic,
he was only in his 40s and he had a stroke.
- Sure.
- But he recovered so well, because
he was younger. - He was young, right.
That's just the nature of the human body.
- When you get to be our age,
you can call someone 40 years old, young.
So neuroplasticity helps reestablish the communication
between the injured parts of the brain and the body.
You're reestablishing connections.
The process, it's the process that enables stroke survivors
to regain motor function in the hands
and other parts of the body.
So for this to happen, for this to work the best,
I'm gonna give you three words:
repetition, repetition, repetition.
- In other words, repetition.
- Yeah, in other words, repetition.
If you do that, that's what's gonna help
reestablish those connections the best.
- Right, you just gotta keep on goin',
and that's where it's nice to have support at home,
or the therapist is the cheerleader, let's keep doin' it,
and then once you see things to gain, it's worth it.
- Right. - You know it's really a--
- Well, for me, I think if you make it
a part of your routine. - Sure.
- That's where it becomes repetition,
you know what I mean? - Yep.
- So that's why, I don't know if you ever heard
of constraint induced movement therapy,
that's the type of therapy where they actually
constrain your good arm, your non-involved arm,
and they make you use the involved arm,
involved limb. - Right.
Particularly with a stroke, what can happen
is the mind will actually ignore that side.
- Yes.
- Without the person being aware of it,
so they just start using the good side,
so you have to actually force it by, you know,
constraining or however you may do it,
to use the injured leg or the injured hand.
- Exactly, so that's not what this video's about.
I'm gonna, at the end of this video,
and this is gonna be a fairly long video by the way, Brad.
- Sure.
- I'm gonna warn everybody up-front.
I'm gonna show you some exercises
you can do for a hand and wrist
that actually have virtually no movement.
- Okay.
- What I wanna talk about now is if you have some movement,
say you have, typically this is what I've seen Brad, again,
working with a lot of patients who have had a stroke,
you see some finger flexion,
that's one of the first things that come back,
and a lot of times wrist flexion too.
But what tends to lag is extending the fingers,
and extending the wrist.
- And this is just the way the body's connected,
they got synergies, it's called,
and you don't really need to know all that,
it's complicated.
- Right, it's very complicated.
- We'll make it easy for you.
- What I'm gonna talk about now works really well for you
if you have just a slight amount of spasticity or tone.
If you have a lot, say really your hand
is really curling up, then this,
we're gonna be talking about this product by the way,
this product is not for you.
This is called the SaeboGlove,
and we'll have a link below so you can see it.
We have no connection to these people at all,
I've seen their stuff, they make good stuff,
I wanted our subscribers to be able to see these products.
- Right, so if you've go a hand that's not opening,
you have that, but there's some motion in there,
and you're wondering, is there anything out there for it,
this may be an answer for you.
- This may be an answer.
Again, the SaeboGlove.
If you have real tightness, then you would use
what is called the SaeboFlex.
And again, we'll have their website linked below so you can,
they have lot's of information on the website.
I think you can even contact them.
- Sure.
- They're very good, very good service.
So again, we're not paid by them,
I wanna make sure that's clear.
So this is the SaeboGlove.
They have a couple videos on their channel,
when they showed a before and after,
they show two patients, and the patient before
was like this, and they had no wrist extension,
and they had no finger extension,
and they were trying to pick up an object,
and it was very difficult.
- Mhmm.
- They put the glove on, and they could then pick up objects
quite easily, to be honest with you.
It's got nice rubber grips in here too, you notice that?
- Yeah, it does, yep, little grippy things on there.
You probably cannot see it from this distance,
'cause it's black on black, but there are rubber...
- They're called tensioners.
- Tensioners that help extend the fingers at each joint,
as well as at the primary knuckle joint.
So you can vary each finger or thumb the resistance needed,
'cause sometimes it's very common
that some fingers are stronger than the others,
so you can custom it per that patient, for that hand.
- If you had even a nerve injury, Brad.
- Sure.
- That affected maybe the ulnar side more.
- Yep.
- You could hook those up,
and you could leave these unhooked up.
- Yeah, say those are normal,
and you just wanna work the fourth and fifth digit.
- So it's very clever, and what this,
goes back to our title again,
now with this in place, you can use it throughout the day.
- Mhmm.
- Repetition, repetition, repetition.
- Yep.
- As it gets stronger, you can go ahead
and take some of the bands, the tensioners, off.
- Right.
- Now if you have no strength at all,
sometimes they use electrical stimulation with this.
- Sure.
- They actually do that right along with it.
- And that's something the therapist
will need to help you with.
- They've got measurements, to fit your hand.
- Sure.
- Fairly easy to put on, but I would say
you might need help, maybe.
- It all depends on the level of weakness
that you have with your hand.
- Right.
- But I've been wearing this here
for probably 10 or 15 minutes now,
it's very comfortable, I'm impressed with it.
- So are you the Terminator?
Or if we wanna go really old school,
we'll go the Six Million Dollar Man, right?
- Oh, yeah.
Lee Majors.
- Lee Majors. - Yeah.
- And we were talkin' about it,
he was married to Farrah Fawcett I think?
Or dating her at least.
But we wanted to get something for everybody,
we got the Terminator, which is you're a little bit older,
but if you're with the Six Million Dollar Man...
- We better get back to treatment, Bob.
- All right, so, I think that's all
I need to say about the glove.
I mean, if you're interested in that, fairly expensive,
but I think it's worthwhile if you've had a stroke
or some other neurological injury.
- Right, and that's what you're having difficulty opening,
but you still have some close.
And you know, it's one of those things
that you could ask your therapist,
hopefully if you have a therapist
maybe you could refer back to.
So yeah, we don't promote products
unless we really think they're good quality.
- Yep, exactly.
So now I'm gonna show five exercises, Brad--
- Oh, you bet. - That you can do
without any product, that you can start these right away.
So we're gonna start with,
let's say this is my involved hand.
I'm gonna put that hand flat on the table,
or, if you have a slippery table, or a towel.
Now this is just simple, I'm doing ulnar deviation
is all I'm doing.
- Yep, side to side.
- Yep, now let's say you have no strength.
- Okay.
- You can use the other one to help you.
- Okay, yep. - You know what I mean?
- A little assistance. - But the key is,
you use this as least as possible.
- Sure.
- So you wanna try to do it on your own.
I actually think I'd slide better on the table, Brad.
- And that may be the case depending on your surface.
- Sure, but if there's nothing there, I'm gonna go ahead,
and there might even be a little bit of flexion like this,
I'm gonna go ahead and push it down.
- Yep, stretch it out. - And I'm gonna start
working back and forth.
- And just the contact of the other hand sometimes will,
and the help will help turn those muscles on.
- Yeah, or make that connection.
- Right.
I've found it very useful just to make contact,
particularly with the muscles that are going.
- So now we're gonna work on wrist flexion and extension.
Again, we put it on the towel or on the table,
again, I find the table is much better,
this is a very slippery table.
- Oh, yeah.
- Thumb up, like this,
and you're gonna just go back and forth.
Now you can clasp your hands like this too.
- Sure, yeah.
- And just go back and forth like this.
- Could you do it not on the table too?
- Yep, absolutely, you can do it without the table.
If you are able to tolerate a little bit of gravity,
you got some strength goin' on,
you can actually go this way.
- Sure.
- And you can actually go this way.
- Can you see that pretty good, Liz?
- All right, same thing, next one now, thumb up,
again, I'd do at least 10 repetitions on each one of these.
Now we're gonna do supination and pronation.
- Sure.
- And again, you can use the other arm,
try to help move it along.
- This is where you wanna keep this elbow, you know,
to the table if you can, so that it isolates that motion.
- Yeah, you're not goin' like this.
- Right, exactly.
- You're just actually rolling it back and forth like that.
- Yep, really focuses on that elbow and forearm.
- With all these, you're not forcing, you know.
But again, using this arm as little as possible.
The last one, very simple, you're actually,
this one is one where you do need a washcloth.
Well, maybe it can just work.
You're just gonna grip closed, and open.
- Yep. - Like that.
And as you open, again, that's one that tends to be
the most difficult for people,
you might have to push down a little bit like that.
- This is one of those things that you could use this,
just for a visual, you can...
- Yeah, you can see it curling up.
- Yep, you get it there, and...
So the goal would get the whole towel into that fist,
and then you would have that repetition done.
- And then you try to extend back out again.
- Yep, it just gives you something to look at,
a visual, a goal, and that can be helpful sometimes.
- These seem fairly simple, there's only five to do.
This is something, again, we're talking about repetition.
- Right.
- So you wanna do it multiple times a day.
When you're watching TV or whatever,
you can just even start, you know,
just doing it absentmindedly almost.
- Sure, yeah, once you get good enough at it.
- Once you know all the exercises.
- Right.
- All right, again, we'll put the link below for Saebo,
good company, and Brad and I can fix just about anything.
- Except for...
- A broken heart.
- There ya go, Bob.
- But we're workin' on it.
- We will continue to work on it.
Oh, yes.
(upbeat tones)