Best Stroke Rehab Approach-Getting out of Bed and Sitting Balance.
Best Stroke Rehab Approach-Getting out of Bed and Sitting Balance.
Famous Physical Therapists Bob Schrupp and Brad Heineck describe how to use functional training to treat someone who has had a stroke.
They demonstrate the progression to perform bed mobility, getting out of bed, and improve sitting balance. Special hi to Kliment and his Father. Also hi to Aaron Avilia of Second Chance Stroke Survivors (On facebook)
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Content
0.17 -> hi I'm Bob Shrum physical therapist
2.61 -> brand I'm a physical therapist again we
4.47 -> have the most famous physical therapist
5.79 -> on the internet long our opinion of
7.589 -> course Bob
8.189 -> credit as proof that we always listen to
10.139 -> our viewers we have a viewer out there
12.269 -> who unfortunately his father just had a
14.58 -> stroke this is for Clement KL I am ENT
17.58 -> and his father the stroke sounds like it
20.039 -> was a fairly bad one he doesn't have
22.41 -> much movement as our more leg at this
24.269 -> point and I promised him we'd show some
26.88 -> exercise that he could start off with
29.189 -> and we're going to do this in a series
31.349 -> of three videos this is going to be the
32.7 -> first one the other ones aren't going to
34.41 -> be up for another week or two but I will
36.54 -> start off with this one this is the most
38.25 -> basic stuff and Brad you're going to be
41.01 -> the person that had the stroke shirt and
43.17 -> this this red tape indicates that the
46.41 -> arm here is the arm affected and yeah
49.5 -> this leg is the leg affected sure so you
51.57 -> can start off by have the person already
54.149 -> laying down in what we call the supine
57.03 -> position in bed now one thing that I
59.34 -> found with nearly everybody who has had
62.67 -> a stroke even with those who are very
66.18 -> weak and have no movement on leg fact I
68.159 -> have a patient this week that just came
70.02 -> in very same thing no movement at all
72.72 -> and anything but they almost always
74.58 -> still have this if you bring the leg up
77.159 -> like this and even push it a little bit
79.2 -> this way it can usually push a little
81.36 -> bit they almost always have that and by
84.72 -> the fact that they can push a little bit
87.06 -> means that they can probably do a
89.189 -> bridging what we call bridging so and
92.43 -> I'll show you what that is we're going
93.42 -> to put the leg in this position here but
95.79 -> what you're going to do is bring the
96.75 -> other leg up also and you're going to
99.03 -> hold both legs together and you're going
101.07 -> to have the person lift their butt up
103.159 -> yeah and now if this leg has no strength
106.95 -> at all that still can use the good leg
109.71 -> to help the bad leg and this is called
112.59 -> overflow when you start any one leg help
115.86 -> the other one eventually
117.27 -> the brain starts overflowing to the part
119.85 -> that needs doing it let's start helping
121.469 -> that sometimes called crossovers Ross
123.96 -> over right by the way this this whole
126.509 -> technique by the way is called
128.069 -> functional training what you're trying
130.259 -> to do is train the body to do something
132.15 -> that they're going to
132.72 -> you in their activity of daily life you
135.84 -> know like so right now we're trying to
137.82 -> Train Brad how to move his body and bend
140.7 -> a little bit like if you lift your butt
142.2 -> up Brad you can actually move it over a
143.94 -> little bit and reposition himself but
146.58 -> we're also trying to Train Brad how to
148.35 -> get out of it so this is functional
150.66 -> training this is research-based that
153.03 -> it's found out that this probably works
155.16 -> better than most other techniques so
157.41 -> anyway so we're going to start off with
158.58 -> the bridging eventually if you get some
161.58 -> decent strength in here you could
162.9 -> actually even just do the one leg in and
165.33 -> see I'm pull up something around it like
167.67 -> this you know and start getting a little
170.55 -> bit of bridging we start get a little
171.84 -> bit of trunk control
172.65 -> alright that's section one basically of
175.65 -> getting out of bed all right the other
177.81 -> part we're going to work on you can put
179.58 -> these down now is the arm because to get
183.03 -> out of bed Brad's going to need to have
186.03 -> to turn his body this way we're gonna
187.62 -> get out of bed this way yeah so what
190.68 -> he's going to do he's going to take the
192.36 -> arm that's affected he's going to grab
194.85 -> it with the good arm around by the wrist
198.39 -> like this and he's going to bring it
200.7 -> over this way and work on this pattern
203.94 -> right here so he starts down here palm
206.37 -> down palm up palm down palm up now we're
212.97 -> getting some rotation of the body he's
214.769 -> crossing midline these are things that
216.66 -> don't mean anything to you but this all
218.1 -> helps and then yeah eventually we can
220.83 -> start working on putting the two
222.78 -> together where you you could bring the
225.72 -> one leg up or you home legs up and yeah
229.17 -> and you can work on going like this so
232.799 -> eventually you can work on the factories
234.36 -> to do phase one of getting out of bed
236.1 -> now this of course you're going to want
240.299 -> to be in front of him because safety
242.4 -> first year the last thing you want is
243.84 -> for your father to fall out of bed so
246.269 -> you might even need two people here when
248.76 -> you're doing this when you finally do
250.799 -> the act
251.39 -> getting them out of bed so so now we're
255.08 -> going to put the two together
256.34 -> if this leg doesn't stay up you can go
258.739 -> ahead and put it down you can put it
260.87 -> down like that and now you're going to
262.52 -> have again grab the wrist and he's going
265.7 -> to go over like this and you can push
268.31 -> with this leg and now you can be right
270.65 -> here to make sure he's not going to fall
272.24 -> out of bed and then when we get to this
274.22 -> phase what he's going to be doing with
276.29 -> this arm you can do one of two things
278.15 -> you can push up from the bed with the
280.82 -> good arm and which is going to help him
282.41 -> lift up or you can actually push up the
285.35 -> other arm and take some weight through
286.52 -> it okay but before he does that you're
290.419 -> going to have to bring this leg lock
291.74 -> where he's going to use this leg to
293.12 -> slide that leg off that's there that's
297.86 -> there and then you can push up now when
300.62 -> you're doing this when it actually helps
302.99 -> I'm going to do it on the other side I
304.19 -> would do it normally on this side you
306.59 -> can actually put a hand on his pelvis
308.87 -> here and put one underneath under his
311.54 -> shoulders like this and then he pulls up
313.1 -> like this and they Rock it's kind of
315.14 -> looks like he's rocking right Brad this
317.24 -> is almost a fulcrum I want to emphasize
320.21 -> this hand is much more important than
323.12 -> what he's doing up Ryder you can
324.89 -> actually help somewhat just by putting
326.75 -> your hand there it makes a trunk
328.46 -> contract a little bit yeah so I got a
330.83 -> good hand right here and I'm pushing
332.419 -> like that it is amazing how much then
335.06 -> yeah how much how much leverage it gives
337.79 -> but again I if you do have and here also
340.91 -> case they have trouble so the leg comes
342.74 -> off they're pushing up with this and
345.05 -> we're going like that okay I know this
347.72 -> looks easy because Brad obviously didn't
350.15 -> have a stroke but it does work if you
352.58 -> start getting down the technically it's
354.56 -> really hard to pretend you have a stroke
356.36 -> but when you work with someone these
359.3 -> techniques it takes the practice your
361.37 -> first time you may have to do this a
363.71 -> dozen times before it all fits together
365.63 -> and then it starts to be fun because you
368.18 -> see progress the person is starting to
370.25 -> work on their own
371.09 -> and the person your dad is going to see
373.669 -> that he's going to see we're working
374.99 -> towards something we're not just moving
376.79 -> my arm and light we're working towards
378.53 -> getting out of bed and then what's up in
380.6 -> this position I have no idea what his
382.49 -> sitting balance is like but that's the
384.29 -> time to work on this step and that's
386.18 -> where you take the arm and again you
388.16 -> want to wait there and through these
389.419 -> these services as much or these limbs as
392.09 -> much as possible leg and the arm and
394.31 -> we'll work on the leg next next time but
396.74 -> you know weight-bearing through this and
398.48 -> if he needs help you're going to maybe
400.31 -> have a belt around them or even adding
402.65 -> the up he might be going like this but
404.93 -> this is where you want to work on where
406.639 -> he can even reach for things with this
408.41 -> arm you know reach up here reach down
410.45 -> here trying to keep his balance while
412.55 -> he's doing that don't you grab down
414.229 -> there because by I can I can even holy
416.51 -> assets for like that there so this is
418.94 -> literally what you're going to have to
420.29 -> do yeah and then I can reach over here
422.389 -> and a lot of times they don't look like
424.79 -> that side so you have to say reach all
426.95 -> right and then I'm putting weight
429.05 -> through this arm which will make those
430.97 -> muscles contract I've already even
432.5 -> talked and what I'd like to see too is
434.389 -> that you're on a bed so your feet are
436.669 -> hit the ground we're just going to help
438.47 -> obviously a lot to what is balance and
440.96 -> stuff so these are just a few hints on
443.39 -> how to start and how to get things
445.039 -> rolling and hopefully that's helpful and
448.49 -> well like I said we'll get a couple more
450.38 -> videos up in a few weeks new bed so now
452.72 -> I'm going up will stride
Source: https://www.youtube.com/watch?v=rbUmG8c5YM8