I don't care how great a therapist is, if they see a patient a half hour 3 times a week, they're not going to elicit robust enough neuroplastic change to provide better and lasting movement. That's what all the research says. Survivors (families, pipe up!) should demand the “home exercise program” (HEP) during the first week of therapy. Why? Because they will get much greater gains if they work 4 hours every day than if they work a half hour 3 times a week, or 2 hours a day, 5 days a week or whatever. Too often the HEP reflects nothing more than a watered-down version of the very exercises that precipitated the plateau.
HEP does not stand for "hand 'em photocopies". A HEP should start from day one. And the “H” part of should be defined as wherever the survivor is staying; skilled nursing, the hospital, wherever, they should be given tons of homework and survivors should be encouraged, threatened, cajoled, coached and convinced to follow through on the home work. And families should be involved in this effort as much as possible.
3 comments:
Survivors I met disagree because I think most of them are too lazy and happy not doing anything but facebook all the time
Peter-
Do you have any data on using Trigger Point Therapy to increase movement several years post-stroke? I was doing a lot of exercises to strengthen my leg, but my knee just felt "stuck" - it didn't want to bend. I have been doing Trigger Point Therapy on myself and it is releasing a lot of tight muscles - hopefully my brain will get the idea and keep them lose - resulting in easier movement.
sorry Nancy, I see nothing on Medline that discusses this treatment option with regard to stroke recovery.
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