The most commonly asked question I get from stroke survivors is what equipment or strategies most improve hand function. This week I decided to make a video in addition to this article.
This won’t be news to you, but losing hand function is a big deal. We don’t realize how much we rely on our hands until we can’t use them anymore.
And there’s a spectrum of hand functioning in survivors. It depends on several different things; where the stroke occurred in your brain, what your specific recovery journey looks like, and the amount of rehab you received after your stroke.
It’s also necessary to understand that hand function relies on the strength of your trunk, pelvis, shoulder, and shoulder blade (scapula). You’ve likely heard the saying, “Proximal stability for distal mobility,” at least once in your rehab. The stability of muscles closest to your body allows for freer movement of the muscles further away from the body.
For example, if your trunk muscles are weak, you may find it difficult to maintain sitting balance. If you’re having to concentrate on sitting balance, it will be much more difficult to focus on small finger movements.
A Combination Approach
All that said, combining exercises with activities using a task-specific training approach is an effective way to improve hand function post-stroke. This is based on both scientific and real-life evidence. I’ve linked some studies in the resources section if you’re a research nerd, like me ?
In addition to being effective, they can also be done without any added cost or special equipment.
It’s no surprise that exercise would be a part of stroke recovery. But what the heck is task-specific training?
It’s a technique used in neurorehabilitation. Task-specific training is based on motor-learning principles and the neuropsychology of learning and experience. It aids in cortical reorganization, which is a principle of neuroplasticity. This means that the more you do a specific activity after a stroke, the brain pathways will attempt to reorganize and rewire to get the desired outcome.
Let’s take a more in-depth look at task-specific training principles applied to activities.
The 5 Rs of Task-Specific Training:
- Relevant: Whatever activity you decide to practice, it should be purposeful and meaningful to you! Research shows that neuroplastic changes happen more often when an activity is relevant.
- Random: Switch between different activities. This helps you develop generalization. When you perform similar movements and activate the same movements, it’s easier to translate those movements across tasks. For example, reaching for milk in the refrigerator can help you reach up into a cabinet to get down plates, bowls, etc
- Repetitive: Practice, practice, practice! By practicing aspects of an activity over and over, the better you’ll get. This is something called massed practice and can help your brain rewire more quickly. No surprises there!
- Reconstruction: Once you’ve got the pieces of an activity down, put them all together and practice the whole activity.
- Reinforce: If you’re in therapy or have someone helping you with this, ask them for feedback on how it’s going. Regardless if you have help, give yourself feedback when you know a task went well or didn’t quite hit the mark!
Don’t get me wrong, e-stim and robotics have their place in stroke recovery. But man, they can be expensive! And you need special training plus a doctor’s approval to use them.
Why not try something that science has proven to be effective and is free?
Try alternating exercise and activity days to reduce burnout or boredom with your home recovery program. Keep practicing both exercises and activities even if you don’t see changes quickly. It takes time and a lot of repetition for the brain to rewire!