Brain and Spine Rehab Cyprus

These videos were taken 5-6 years post stroke

Building up my “drinking from a cup muscles” (without the elbow sticking out). 

As you can see in the left part of the video, I go from sitting down, having a weight in my hand and my elbow on a table, to standing without elbow support. The most important point of attention is the elbow, it wants to move out because the muscles are stronger if I move the elbow out. 

In this exercise I am isolating muscles (among which the brachialis, also called workhorse of elbow flexion) that flex the elbow while rotating the underarm, which is necessary for example to bring a cup to your mouth. 

The brace I use (the right video) is used to keep my finger straight and it gives some weight as well. I used an elastic band to keep my elbow in place during the exercises. I could go to 1/3 and 2/3 of the movement as you can see.

Why am I doing this?

To isolate my weakest muscles and train them so I can eventually  have my left arm move accurately again without compensating! The big gain through this exercise is that I have more control and stability during the movement and that my arm is not flaring out anymore!

The weight is important too. That gives me a “feeling that the arm is there” (gravity).

 

 

Building up my “raise my arm and bring something towards me”  

For a long time I was not able to lift my arm purposefully, let alone make any directed movement in that position, like raising my arm and drawing a clothing piece towards me. 

During this movement muscles like the mid and posterior deltoid, teres minor and infraspinatus, are used to lift the arm and together with the biceps and triceps make the drawing movement ( more muscles are involved in this process but I like to keep it simple by mentioning the important ones)

Why am I doing this?

To re-learn reach out and bring something towards me with an elevated arm.

 

 

Building up my “rotators muscles” from scratch  

In this video, I am able to isolate shoulder rotators like the teres minor, infraspinatus. 

In the left part of the video, I use a pillow to rest my arm on and make small movements. They have to be strong in that particular position to be able to do what I am doing in the right part of the video.

Why am I doing this?

In order to make movements where my arm is used, for example, to remove a stain from a window or to lift something out of a sink

 

 

Stability around the shoulder while fighting gravity   

The whole purpose of this exercise is to have the muscle strength, stamina and stability around the shoulder to keep the arm and shoulder in place while putting pressure on an object while fighting gravity.

 

 

Building up my "push  muscle"  

The same thing as in the video above. While pushing and moving an object.

 

Pure external rotation   

This is one of the most important isolated movements for the arm and shoulder. No elevation, just pure external rotation. The big gain with this exercise is to stabilize the upper arm without the arm flaring out when attempting to rotate the arm outwards. In this exercise you are using both muscles to keep the arm from flaring out ( such as the pectoralis and coracobrachialis muscles) as well as the rotator cuff muscles to make isolated external rotation possible

Why am I doing this?

This exercise will make reaching out to the side, in a purposeful way, much easier

 

 

Strengthening my grip and  improved wrist extension 

Wilfully extending my wrist has been very difficult. By using the upper body exerciser(UBE)on the affected side or bi-manually has not only strengthened my grip but also improved wrist extension a lot. The UBE has improved wrist stamina as well as forearm manipulation, especially extension strength.

 

Cross movement

I do this exercise to improve trunk and leg stability. In addition it trains my capacity to multitask while moving around. The crossed movement of the leg and arm combine with stepping up has an important neurological effect through cross cord and inter hemispheric activation. Thus strengthening normal movement patterns at cord, brain stem and brain level. This simulates day to day activities way better then just training in isolation thereby also reducing the risk of falls. The vibration plate that I do this on actually accentuates the muscle and Proprioceptive  feedback. It vibrates at 10Hz simulating normal muscle feedback (-:

 

 

 

Walking, getting up and going, walking stairs

I do this to further strengthen hip stability by doing squats and hip extension exercises. Note that I have a suit on that electrically amplifies my glutes and transverse abdominal muscle activity. Although these exercises are used a lot, do them only after you have trained these muscles enough in isolation. For example using so called iso clam exercises. Note that I am using the vibration plate to enhance the signal back to the spinal cord and brain. 

Why am I doing this?

These exercises will make walking, getting up and going, walking stairs and protecting your back from injury a lot easier.

 

 

Upper front leg

Here I am activating the whole anterior movement chain in my leg. From toes to hip. This exercise should only be done after you have accomplished a strong posture and have sufficient glute and deep abdominal strength ( iso clam exercises). I do this exercise to be able to have more ease in getting my leg out of a seated position, such as moving my leg out of a car. Note that I am sitting supported, which is important because it prevents back injury.

Why am I doing this?

These exercises will make walking, getting up and going, walking stairs and protecting your back from injury a lot easier.

 

 

Foot  

Here I have gone from training the foot extensors, which I was not able to do for 1 year post-stoke, since I had a foot drop and I was wearing a brace  (which I was told that I would wear for the rest of my life ) to using my weak foot in a position where I have an extended to neutral foot and training toe-off, which is important for propulsion strength and speed while walking. Having trained the foot extensors first makes this movement much more stable and robust.

Why am I doing this?

To be able to walk properly

 

 

Standing up on one leg

Ok, this is a tough one. Even for people who do not have a stroke. Even I was surprised that I could do it!

Really important though. It is all about the ability to get up and having more endurance while walking stairs and regular walking. Only do this when enough progression has been made in postural, hip stability ( gluteal and transverse abdominal) and foot extension strength plus endurance.

 

after 6 years , I could finally make a side bridge 

Please notice that the EMS ( electro muscular stimulation, more on the weakest side of my body) suit helps the muscle activity required to do the side and supine bridges, which makes progression a lot quicker. Also without the suit! The side bridge and bridge exercise are hard ones to master. As with the other exercises do not even try before you have mastered hip shoulder and postural strength. Otherwise the exercise is unstable and will lead to injuries. These exercises will make getting up from a lying position in any way a lot easier and more safe. In addition it will train the hamstrings, which are very important for walking stability and strength in the posterior movement chain. In fact most people are quad dominant which leads to weakness of the hamstrings and glutes, thus making them more vulnerable to back and leg injury. 

 

Result:

walking February 2022

 

 

Result:

my fingers february 2022