Wednesday, February 9, 2011

Hand recovery and stroke rehab

My left hand is still pretty worthless I have looked all over for what to do about it and only came up with a few items.
What are the various options for rehabilitation of the hand? Neither my therapists or my doctors seem to have a good understanding of what the research points to as being the best way to accomplish this.
1.Saeboflex this looks like an outrigger on your hand with the springs pulling your fingers into extension.
Because the Saebo takes me 20 minutes to get on I don't use it very much. In the original Yahoo Saebo forum I complained about the bead chains being very hard to adjust one-handed and the Saebo representative said that they were not meant to be adjusted by patients, only trained therapists. This is poor planning on their part. They could easily change from bead chains to open chains with a hook to attach. The original research on this was for FTM(functional tone management) http://www.allied-services.org/files/PRSaeboFlex.pdf
I actually changed the velcro straps from the side they were on to the opposite side because tightening them was much easier for myself, it seems they were positioned that way for the therapist/caegiver to use rather than a one-handed patient. I also had to get a new outrigger for my thumb, still not quite positioned right.
2. Theraband makes progressive hand trainer sheets with prepunched holes for your fingers. You put the sheet into an embroidery hoop, the one that comes with the kit doesn't work, so buy a 7 or 9 inch embroidery hoop. none of the individual sheets were strong enough to keep my fingers open, so I used all six that came in the red refill pack and put them into one hoop. Once I get the flexors tired out I work on various finger movements. A lot cheaper than the SaeboFlex and probably just as good, except for maybe needing to anchor your thumb on the ring. This probably has no clinical support or research, just something I came up with myself. But I can get it on in less than a minute.
http://www.thera-band.com/store/products.php?ProductID=22
I personally think the Theraband hand-trainer sheets put into a crochet ring are at least as good and they also allow intrinsic muscle workouts. Actually tone is not triggered by exercising spastic muscles, therapists who say this have not been following the latest research. You should actually exercise those muscles to tell your brain that they are being controlled.
3.I got my own eStim machine, works great when I get around to using it. My hand will eventually come around but I'm focusing on arm and walking first. Allegro Medical #77715
4.Passive flexing and unflexing the fingers with my right hand. Right now I use the passive movement theory of flexing/unflexing my fingers hundreds of times each day. This is because I am into the hard neuroplasticity part, moving functions around rather than the easy neuroplasticity of just getting the penumbra to work better.
http://www.ncbi.nlm.nih.gov/pubmed/15003755
5. Hand Mentor for Stroke Patientshttp://www.kineticmuscles.com/hand-physical-therapy-hand-mentor.html
I have no idea if this is any good, I have never heard of any survivor talking about it.
6. Hand Helper I received one of these from my OT and would spend minutes willing my hand to relax. Getting the rubber bands on requires a two-handed person. At one time I saw on the internet a version of this that had it spaced out for individual fingers, but I didn't bookmark it. If someone sees this send me a link
http://www.amazon.com/Med-Dev-Ultimate-Hand-Helper/dp/B000SOLDJ0/ref=wl_it_dp_o?ie=UTF8&coliid=I3A77PN6KHG76B&colid=3Q7JDNQZ8LB7Z
7. Gripmaster I bought a couple of light resistance ones but they don't work for me because I can't separate my fingers enough to use them.
http://www.amazon.com/Gripmaster-Exerciser-Medium-Tension-7-Pounds/dp/B0006GC5D8
8. the ADL way, which is since you can do everything you need singlehandedly you do not need therapy for your hand.
And thats all folks.

My OT mentioned one of her patients that got his hand back after 5 years. No explanation of what he did.
Most patients that have motor deficits in the hand do not seem to have any guidance about the way to recover. I can go to all the stroke forums and see that lots of persons are complaining about not being able to get hand function back
I have heard about SaeboFlex, Mental imagery, Mirror box therapy, Bioness, Biomove and just waiting, hoping it will improve which seems to be the preferred method for the insurance companies and HMOs.

But then this is all just an uninformed opinion of mine. You need to go back to your doctors and therapists and say you are going to ask how to recover the hand every day you see them. Start putting the pressure on, they are supposed to be working for you.

1 comment:

  1. I just passed the 6 month marker since my stroke left my left side partially paralyzed. I've been pleased withe the progress my leg has made (still a long way to go though) but my hand is more difficult. I have had weak, un-precise grasping capabilities for several months now. Wrist ext. seeems to be slowly improving but not enough to be functional. I use EMG e-stim (biomove 5k) to try to gain a little finger extension. I dont have an issue with my hand being closed tight all the time, I just can't get finger extension. Sometimes when it feels like I'll get extension the finger(s) will start to close instead.

    Hopefully by increasing the time spent on the estim along with the mirror box i just ordered I will start to see some progress. Even just a tad would elate me.

    Best of luck, and thanks for the site - very helpful info.

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