Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 438 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Tuesday, September 28, 2010

Analysis to riding a two-wheeled bike

This is one of my goals. In order to accomplish this there are numerous items to work on. I have to do a lot of analysis to determine what individual pieces I need to work on. This is completely different than how I started on a trike, I just got on and started pedalling.
My balance is pretty good, I can ride my tricycle for hours with no problems, I can stand on a bosu ball for 15 minutes at a time.
1. The up and down motion of the left leg is in a straight plane on my trike, much better than when I first started riding when the knee would swing out quite a bit.
2. Getting the left foot flat when pedaling. Spasticity in my leg causes my toe to point downward when pedalling. The toe occasionally scapes the ground. So far it has not caught anything, but this needs to be corrected prior to the two wheel test. I use the pool at the 'Y' for some of this. standing on the lowest step with my right foot on it. I put my left leg/foot go thru a pedalling motion, also useful for mimicing the walking motion. At the 'Y' I also use the exercise bikes because it is much easier to concentrate on good pedalling form when you do not have to balance the bike. The toe clip is essential to keeping my foot on the pedal.
3. Getting the left foot onto the pedal. This is only possible right now on my trike when I am completely stopped. My hamstring doesn't have enough power to counteract the spasticity extension of the lower leg. Some exercise to counter this; Stand in the pool and lift the left leg to the surface facing the wall so the foot can't swing out. Lying on a mat face down and lifting my left foot up so it forms a 90 degree angle to my body. Sitting in my chair at work and pulling my left leg underneath me.
4.Signalling turns with my left arm. I am passing on this because I know I do not have enough brainpower to tackle this. Also I will only be starting out on paved dedicated bike trails.
5. holding the left arm straight to be able to put weight thru the arm to the handlebars. I do have a city bike so my riding posture is fairly upright but I used to ride with the dropped handlebars all the time and was very comfortable doing that.
I can't use the flat hands and straight arm against the wall because I can't get anywhere close to a flat hand. So I use a shoulder height branch from our apple tree to lean into and push away from.
6. grasping and releasing the left hand from the handlebars. On my trike this is not really a problem. Once I get it clamped on it will stay there. But for a bike I will need to be able to release it. Or I might have to ride the bike into the ground if I fall or try to stop suddenly. I extensively work on passively flexxing/unflexing those fingers. But I plan on wearing my SaeboFlex, it will at least allow me to let go of the handlebars. I will look stupid but that comes with the territory.
7. braking with the left hand. I don't plan on using this because I will be on a flat dedicated bike path. Maybe if I am lucky the Saebo will allow my hand to open enough to reach the brake lever.
8. Getting my left hand onto the handlebar. This will probably have to be done while stopped. I barely can control my whole arm while standing still.
Left foot toe clips. I have this on my trike and will have to install one on my bike. Without this I doubt I could keep my foot on the pedal for any length of time.
This ought to be interesting since the first time I rode a three-wheeler I crashed on a perfectly straight/level path. Obviously this will be a goal for next summer, I can work on the pieces this winter.

This pretty much is not how therapists are taught to work with stroke survivors, they are taught to work on complete functional movements. But since I am nowhere close to the movement needed I decided that the only way to recover was to break down the movements into doable small pieces and then eventually put them together. Since this is not one of the ADLs I shouldn't even attempt this.

You know the routine, Do not take any of this as medical advice.
2 updates, read these before trying this.
http://oc1dean.blogspot.com/2011/07/testing-bicycle-riding.html
http://oc1dean.blogspot.com/2011/08/epic-failure-at-bike-stroke-therapy.html

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