Making connections

My stroke clients’ learning is coming along in leaps and bounds. We have been exploring movement of the affected side. When we started he had little active movement in his arms and little to none in his fingers. The first time I asked him to move his arm, he tried so hard that it looked like his head nearly popped into a million pieces, but there was no real movement in his arm.

From there we worked on me holding his arm where he could actively move it (this helps to show progress and create motivation to try) while trying to breath and relax in between. He could move it more and more. A couple of weeks later he told me about this jerking movement his arm does. He was not sure what it was. It turned out to be real active movements of his arm that he could control. This movement in his arm did not look like his movements used to but that didn’t make them less real. It made it a start of a learning curve because now we can be working on controlling this movement so it becomes smoother and more controlled.

We also worked on him regaining some movements in his fingers. He said that he had some movements during his intensive rehabilitation after the stroke but that after a while he lost it and so they worked on different aims. His fingers are naturally open and he has a hard time trying to squeeze them together to hold onto things. We worked on holding onto a piece of doweling and to lift it using the strength of both arms. While doing this I could observe that when he extended his arms that his fingers would squeeze more together. But when trying to consciously squeezing his fingers it wouldn’t work. Through my observation I knew it was possible, now my client had to figure out how to access this movement.

We elevated his arm in this position he can relax (not using any muscle) so his fingers would stay open to grab objects. I then ask him to squeeze his fingers and he tried. He kept staring at his fingers but nothing happened. I could see him getting frustrated. I told him that the movement in his fingers most likely wont come from there and he should try to squeeze with something else like his shoulder or bicep. And then it happened. His fingers close. He repeated that movement a couple of times and later his wife would tell me it was like magic.

No magic – it’s more likely he made connections. With riding the brainwave I could say that his brain created some new pathways, but realistically I don’t know what exactly went on in his brain. What I do know is that my client is learning more and more that he still has active movements on his effective side, however they do not feel or being controlled the same way. It will time to learn how to control that but the important part is that he learned it’s possible.