Monday, September 30, 2013

Are you frail and elderly?

(The following is a paraphrasing of writing by Janet Carr and Roberta Sheppard in their stellar book "Stroke Rehabilitation.")











"Frail elderly." This is the way most stroke survivors are treated, and it's not good. It is important for stroke survivors to engage in strengthening and cardiovascular training. It is also important to do a lot of intensive and repetitive practice. The problem with both training and a lot of practice is that they cause fatigue. And when the survivor is perceived as being fatigued they'll be asked to rest. But exercise is safe after stroke. Intensive rehabilitation improves not only muscle and heart/lung strength, it also improves movement.

To promote intensity in rehabilitation goals should be set. Goals can include increasing the speed of a task, increasing number of repetitions of the task is done, and improving the performance of the task. The stroke survivor can benefit from these parameters being graphed. Graphing of improvements in performance can provide type of feedback to the clinician, and can be motivating the survivor.

                                                                          ©Stronger After Stroke Blog

5 comments:

Scott Gallagher said...

I never made more progress than when I used the weight-lifting technique of “lifting to muscle failure” (it's where you see the guy screaming in bodybuilding pictures). The mental effort is enormous, but that effort gave me two-thirds of my arm strength back in one month. For stroke impaired bodies, it's important to ensure that all muscles are exercised, and that progress is somewhat evenly distributed among them. I got “winged scapula” (shoulder blade sticks out like a dorsal fin) when I failed to exercise the anterior serratus muscle. Didn't even know what that was. Also, take it easy on full body and core exercises like squats when lifting heavy, at least at first. I got seriously light-headed and dizzy going too strong here.

Ben Rutstein said...

Just go along with Medicare and you will probably be alright :/ eating lots of nutritious foods also help...

Ben Rutstein said...

Just go along with Medicare and you will probably be alright :/ eating lots of nutritious foods also help...

Peter G Levine said...

Scott: agree. The lifting is not just muscular though. It effects the nervous system as well.

Scott Gallagher said...

Absolutely. In fact,I believe it affects the brain first, which then acts on the muscles. I saw the same increases in arm size in both arms, even though total weight lifted was very significantly less on the stroke side. My guess is that the brain interpreted my mental effort as meaning I was lifting the same weight with both arms, and "grew" the arms as if I were.

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