Tuesday, November 22, 2011

Do it yourself!

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.


Mike said...

Survivors I met disagree because I think most of them are too lazy and happy not doing anything but facebook all the time

Nancy said...

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.

Peter G Levine said...

sorry Nancy, I see nothing on Medline that discusses this treatment option with regard to stroke recovery.

Sister Honey Bunch/Judi maloney said...

What does an fife give HEP consist of?

Unknown said...

I worked my bum off in physio and when I came home I set myself a goal to swim a kilometer to raise money for the stroke foundation, I swam 2km and swim nearly every day which has helped my fitness level no end. I now bike ride and although I cant run, I walk every day.

You have to keep working on your fitness and try as hard as you can to improve yourself.


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