Saebo, Inc.’s Post

Plateaus suck. Just like athletes and musicians, many stroke survivors will have periodic and temporary plateaus or setbacks as they continue to improve.   It is a back-and-forth process.    Improve a little, then a plateau occurs.    Modify the training and improve some more.    Then, here comes another plateau. Modify again.    You get the idea.    This “climbing up the recovery ladder” process is like improving your golf swing or learning how to play an instrument.    SIDE NOTE: Remember when Tiger completely redid his golf swing…3 TIMES?   Plateaus are real and will occur. Many will change up their practice routine to push through to climb another rung in the ladder.    So where am I going with this?   Recent advances in clinical research have shown that repetitive task training improves arm and hand function in stroke survivors suffering from MILD to MODERATE impairment. Unfortunately, Individuals with more SEVERE weakness are unable to benefit from similar powerful treatment principles due to lack of movement.    This inevitably leads to a term called “learned-nonuse” which means failure to use the affected limb. Without movement, there is no chance for recovery. Basically, here comes a plateau.    So, how can we help stroke survivors take advantage of what the research wants us to do?   Occupational therapists received orthotic training in school and should understand the rationale behind selecting appropriate dynamic orthoses based on the client's condition. Most clinicians also have been introduced to electrical stimulation and other movement-assistive devices.   ⚡ A dynamic hand orthosis (or glove) will allow severely impaired hemiparetic patients to take part in purposeful task training. Simply put, it’s taking a non-functioning hand and allowing it to grasp and release again. ⚡ FES allows the client to generate purposeful movements during appropriately timed tasks. ⚡ Unweighting devices like, mobile arm supports, can properly position the severely impaired arm in preparation for occupational performance.   With solutions commercially available (and taught in OT/PT schools), there is no excuse for patients to leave “empty-handed”.     Patients:    If spasticity is preventing you from using your arm or hand, get with a therapist who is knowledgeable with the above solutions. Your recovery depends on it.   You will be engaging your hand and your brain will thank you for it.  Therapists:    If you are currently not providing neuro-based solutions in your tool bag, ask yourself why?    Treating clients with mild to moderate hemiparesis is hard. Treating severely impaired hemiparetic clients is even harder.    Now is NOT the time to say, “Sorry Mrs. Jones, there is nothing more I can do for you as no further progress can be made”.    There is no expiration date on neuroplasticity, so let's keep driving changes and help your clients climb one more rung! #noplateauinsight