Best Stroke Rehab for Learning How To Perform Transfers. (Training)

Aug 26, 2023

Best Stroke Rehab for Learning How To Perform Transfers. (Training)

Famous Physical Therapists Bob Schrupp and Brad Heienck present the best stroke rehabilitation for learning how to perform a transfer. They will instruct you step by step as to how one can learn to safely perform transfers again after experiencing a stroke or cerebral vascular accident.

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Content

0.439 -> hi I'm Bob Shrum physical therapist

3.06 -> Brad Hynek physical therapist together

4.589 -> beyond the most famous physical

5.85 -> therapist on the internet and now

7.109 -> opinion of course I've got a weapon

8.429 -> today

8.97 -> okay today we're going to do another

10.62 -> video for Clement I believe he's from

13.559 -> Russia his dad had a stroke and we're

16.199 -> gonna show them another thing to work on

17.76 -> here which is going to help with

19.41 -> performing transfers since to stand up

22.74 -> sit to stand and again this falls in the

25.05 -> type of rehab which is called functional

27.66 -> training you're training the body to

30.06 -> perform a specific task and they have

32.55 -> found research has found that this has

34.35 -> been the most successful type of stroke

36.059 -> training because it's practical and and

39.21 -> you're reinforcing something that the

40.8 -> patient probably already knew how to do

42.3 -> at some time right so this is what you

45.39 -> need here well we would prefer that you

47.43 -> do we're gonna work on going from sit to

50.01 -> stand and this is the weak leg by the

52.739 -> way we've got to put down the red stuff

54.449 -> but that's okay this is the weak leg in

56.43 -> the weak arm what we prefer that is that

59.489 -> you're gonna have something that the

61.109 -> patient can grab on to that solid right

63.93 -> now if you have a grab bar on the wall

66.45 -> already that would work great it might

69.33 -> be worth the money to even spend you

71.34 -> know to have one attached to the wall

72.78 -> maybe in a spot where you could use it

74.79 -> because you need something for that

77.07 -> patient to really pull up on to start

79.14 -> off with so in this case we're just

81.63 -> gonna use just to represent a grab bar

83.729 -> that's mounted to a wall yeah a generic

86.49 -> wall that's your this is Brad stripper

88.619 -> pole so anyway what you don't want to do

93.39 -> if you don't have that as an option you

95.369 -> could grab on to a countertop or even

97.77 -> you know even a sink that would probably

100.38 -> work and as they get stronger a solid

103.77 -> armrest right may be enough but

106.229 -> initially you need more leverage yes you

108.54 -> do okay the first thing in as far as

111.329 -> where you're going to talk about

112.979 -> positioning in the chair itself when

115.89 -> you're gonna try to get somebody up from

117.299 -> the chair first thing you're gonna

118.56 -> realize it's very difficult to get up in

120.899 -> the chair from the back of the chair you

123.54 -> got to have the butt forward a little

125.159 -> bit when we get out of chairs what's the

127.11 -> first thing you do bad you kind of move

128.34 -> your butt forward

129.09 -> so we go out to here it's much easier to

132.66 -> stand

133.17 -> from here back right so we have two

137.67 -> people there's two ways you can have a

139.02 -> person get there but forward one is just

141.599 -> to lean back and kind of slide their

143.52 -> butt forward if they can't do it once

146.16 -> you go back again Brad I've actually

148.08 -> just gone in there sometimes and helped

149.7 -> them pull the pull forward like right

151.59 -> okay now you don't want to pull them off

154.14 -> the chair obviously right so you're

156.72 -> gonna get them forward like this and the

158.73 -> next thing is on the positioning thing

161.069 -> here is you're gonna want to make sure

162.989 -> the bar is far enough away that when he

166.08 -> grabs it that he's gonna be kind of

168.42 -> putting his nose over his toes because

171.269 -> that's the other thing is very hard to

173.16 -> get up straight up like this right

175.68 -> you need that lean forward yep and these

178.769 -> are things we all do is just don't think

180.54 -> about right but when someone's had a

182.069 -> stroke little things make a big that's a

184.08 -> cue that we're often giving people nose

185.819 -> over toes so he's gonna grab onto the

188.489 -> bar now the other the other hint here is

190.86 -> if the person's very weak that maybe has

192.81 -> virtually no strength on this side I

195.299 -> would probably take a couple pillows or

197.489 -> cushions and put them in the chair to

199.739 -> raise them up so we're starting from an

201.6 -> advantage look at that Brad you're

203.4 -> already taller right so then that's

205.41 -> gonna make a big difference if you have

207.03 -> one of those chairs that actually you

208.799 -> know is electric and it actually raises

210.69 -> up a sit to stand chair you know use

213.299 -> that bring it up to the point where he's

215.73 -> got to work a little bit or she's going

217.26 -> to work a little bit but enough that

219.359 -> they can do it without much help right

222.209 -> so all right we have a gait belt on

224.459 -> brand new bad okay he's got a belt on

226.44 -> already that that's one thing I can grab

228.329 -> onto where am I gonna be now first I'm

232.109 -> gonna do this especially if he is very

233.67 -> weak on the leg most people do have some

236.28 -> push on the leg they may not have

237.989 -> anything else but they usually have some

239.28 -> push

240.75 -> you're gonna maybe want to have two

242.16 -> people even there so what I'm going to

244.739 -> do is I'm gonna I'm gonna block this

246.9 -> weak leg by maybe putting my knees on

249.93 -> each side of his knee that's one way to

252.45 -> do it or sometimes I go like this I

255.09 -> crossover sometimes I go over like this

258.03 -> you know whatever works comfortably for

260.4 -> you I'd would go probably squeeze the

262.8 -> leg in between like that he's great he's

265.349 -> grabbed out of the bar

266.82 -> and then I can grab onto the belt and on

269.4 -> to the pelvis a little bit and this

272.22 -> often baby yang a sling or something

274.29 -> right correct breath right this hammer

276.12 -> is flaccid so the cue is okay Brad lean

278.67 -> forward and now we're gonna go ahead and

280.5 -> stand up and push pull pull pull

282.54 -> yourself up and I can help this leg and

285.15 -> I can hold up this pelvis and and he's

288.51 -> holding on on the other side so we got

290.16 -> both sides covered there you go go right

292.35 -> back down again and you're gonna try to

296.49 -> do some repeats just be careful of the

302.1 -> arm yeah if the Army is flaccid you can

304.53 -> hurt their shoulder I'm not pulling on

306.3 -> the arm here I'm just kind of steady

308.66 -> right the belt is where your your point

311.49 -> from the way you could even go like this

314.31 -> right and that might even be better a

317.01 -> better place for you so you're gonna

320.58 -> keep doing these repeats you know over

323.1 -> time until you get to be fairly decent

325.74 -> at where your strength is build up if

327.48 -> nothing else you know maybe your your

330.36 -> trunk strengthen your right leg strength

332.37 -> is enough that you can pull up fairly

333.78 -> easy and you'll see that what Bob is

336.12 -> doing with his knees against mine is

338.25 -> very helpful and all therapists yeah

340.53 -> good at that because we do it a lot

342.15 -> right and so if you haven't done this be

344.58 -> patient with yourself because your

346.83 -> technique can make a big difference so

348.39 -> you know it might take a few better over

350.34 -> time with exactly so after you've become

353.19 -> good at become good at that what then

355.56 -> you know the next thing is gonna try to

356.82 -> get good at is just actually pushing up

358.98 -> from the chair itself and that way

361.08 -> eventually gonna be able to perform

362.73 -> transfers no matter where you're at you

364.68 -> know if you're in the wheelchair so now

366.51 -> you know now he's going down come down

368.79 -> again if I'm still in here and now we're

371.49 -> gonna go ahead I'm gonna grab here okay

373.53 -> Brad going stand up goes over the toes

375.89 -> you know and we're working on that

378.15 -> so we're gonna repeats on that we can do

380.58 -> again you can do three sets of ten of

382.5 -> these you can do ten if it now by then

385.14 -> at that point we get them up and now

389.4 -> we're gonna want to start working on

391.05 -> standing bounce and one of the things

393.84 -> we're gonna work on is weight shifting

396.12 -> because he's gonna want to take most of

398.16 -> the weight on his right

400.789 -> probably have his arm on something to

402.87 -> steady himself maybe a walker or we'll

405.03 -> use the back of the chair here and now

407.43 -> we're just gonna work on shifting the

409.02 -> weight back and forth so he's putting

410.43 -> some weight on that involve leg and

413.759 -> people often come to glut that you're

415.62 -> gonna have to give verbal cues and maybe

417.96 -> even pull over yep and make the person

420.87 -> give you they're just just be careful

424.169 -> for this right yep that's why I got both

427.8 -> hands out about this knee might have to

430.02 -> cross some front of there or you can go

432.389 -> like this yep something to you know

434.669 -> you'll get a feel for that if that needs

436.8 -> wobbly if they're that weak probably to

439.919 -> people I've had one person to stand

441.419 -> there just to make sure just hold on and

443.16 -> yeah get down on their knees and a hold

444.9 -> and make sure it's supported and if

447.15 -> you're starting to get some strength in

449.22 -> that leg then you at some point you even

450.93 -> want to let go with the arm and maybe

452.31 -> reach for things sure you're trying to

454.289 -> work on the balance here

456 -> once the bounce has improved to the

458.25 -> point where you're feeling pretty solid

459.599 -> about this then we can work on that next

463.11 -> step which is you know he reaches

465.09 -> actually I'd like to have a chair with

466.229 -> an arm on it probably yeah arm chairs

471.449 -> are much better so now when he gets up

474.33 -> he's gonna go ahead and reach for that

475.62 -> arm he's got something solid and again I

478.919 -> can support that you can take this step

480.509 -> and you can just turn and pivot right

481.8 -> into the chair but the key here is even

486 -> if there's no strength in that leg at

487.53 -> all is to do those repeats so you can

490.409 -> get you know if nothing else the right

492.36 -> leg is going to get stronger the the

494.43 -> trunk in here the muscles of your core

497.28 -> are gonna get stronger so that you can

499.259 -> stand up and you can stand and and and

501.78 -> work on balancing and get better on the

503.699 -> sit to stands right so again two people

507.479 -> to start with yeah if you don't feel

508.979 -> comfortable same thing comes first and I

511.169 -> don't know how big your dad is and I

512.61 -> don't know how you know it all depends

514.11 -> on if you have a little tiny patient and

516.209 -> you're big it's gonna be a lot different

518.61 -> than if you're if you're tiny and the

520.74 -> patient's big exactly so alright I'm

523.77 -> going to be a struggle too if I ever

525.149 -> have a stroke cuz we call

527.79 -> okay shake their head salt all right if

531.24 -> you haven't already please subscribe I

533.63 -> don't know get that button make it make

536.97 -> it bang alright thank you thanks

Source: https://www.youtube.com/watch?v=AqQMdz9vmnE