- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- This is a typical day for Brad,
this is usually what he does most of the day,
takes his naps.
What we're doing here is
we're actually gonna talk about
proper positioning for a person
after they've had a stroke and when they're in bed.
And we're first gonna start off with,
if they're sleeping on basically the non-involved side,
Brad had a stroke.
We're gonna simulate that he had a stroke
on the left side, affecting the left side.
So that's what this red band is here for
on the leg and the arm.
So what you're gonna wanna do,
this is just if the person wants to lay
on their good side or on their non-involved side.
You're gonna have a pillow under the head.
You're gonna have one pillow behind in their back here,
kind of a lot of times bunched up
to try to help hold them from rolling over backwards
like this, especially if they have some trouble
with their balance.
You're gonna have a pillow underneath their arm
and what we like to do quite often
is maybe even have it like this.
We're running outta bed here.
If there was a bed that, you know, went further on here,
I'd like to have the arm as straight as possible,
cause the arm is gonna want to tend to curl up
and we want to get out of that position.
Now, I like to see palm down, like that.
So you got the pillow under there, and then
you're gonna have a pillow under the leg
between the knees and you're gonna have this leg
forward a little bit and slightly bent,
cause what legs in strokes tend to like to do,
they like to come back and straight
and the hip tends to retract on them.
So we're getting a little bend at the hip
a little bend at the knee
and this is the position that you wanna be in
if you're gonna sleep on your non-involved side.
We're gonna cut away
and we're gonna show you how
you're gonna have a person sleep on the involved side.
All right, we're back now.
In this case, you have a patient or a person
that really wants to sleep on their involved side,
the side that had the stroke
and a lot of times we prefer,
Brad and I were just talking,
that you don't sleep on that side.
It'd be better if you slept down the other side.
But if you're a person that's been sleeping that way
for years and would like to give yourself
a little variance and maybe
reduce some of the pressures on the body,
even them out,
you go ahead and sleep on this side.
The big thing is that I don't want you sleeping
on the point of the shoulder.
I don't want you way over
on the point like that.
We're gonna have you kind of halfway
off the shoulder, kind of partly onto the back,
partly onto the side.
- Sure.
- And what you're gonna do is
you can use a pillow to help do that.
You can use a pillow behind him again
to help and a pillow under the head.
So you can see again, he's not on the point of the shoulder.
He's taking pressure
right on the back of the shoulder
and on the back.
So then again, we're gonna use a pillow
between the legs
and I'd like to have both legs bent a little bit,
is what I like to see.
This one's forward a little more front of that one
and this one's slightly bent
and this one's slightly bent and there you go.
That's the position.
The next one we're gonna show you
is a person sleeping on their back.
- Shoes would be off though
- Having someone lay on their back
after they've had a stroke.
This is the involved side.
Again, we got the red stripe here
and the red stripe on the pants.
You can't see that, I guess,
but we're gonna put,
now we're gonna have one pillow under the head,
we're gonna have one pillow underneath the arm.
Again, trying to keep the arm
straight as possible,
the elbow straight as possible.
Don't want it up like this all night long.
So you're gonna have palm down.
You're gonna have the elbow straight as possible.
And then I usually like to put a pillow
under the leg too.
A lot of times, if you put one
kind of under the calf and under the knee,
you raise the heel up a little bit
so that you don't get pressure on the heel
all night long and you get that skin breakdown.
- Sure.
- Especially if you're prone to it.
So you can have variations with that,
but find out whatever is the most comfortable.
But this is probably the most simple one
and works out real well
and it's another option for you to roll onto.
- And I think, you know, the other leg
may need a pillow under there
but usually the person's gonna move that leg around
and it may not need it.
- Yeah, you can,
you know, there's some personal preferences
to these,
- Sure
- but this is a good starting point.
So all right, good luck.
And if you haven't already
make sure you subscribe to us
- You better believe it.
Take care.