Stroke recovery exercises - Amber group - Week 2 Stability
This set of exercises are for the second week of our four-week stroke recovery exercise programme. It is aimed at stroke survivors who are in the amber group. This group can exercise independently but may require support. Watch the introductory video for families and carers before starting this activity.
Nicole: Hello. I'm Nicole Lavin. I'm a specialist neurological physiotherapist, and I specialise in stroke rehabilitation. I have over 20 years experience working with stroke survivors following them through their journey from the acute stages right the way through the rehabilitation process up until discharge. I feel absolutely privileged to be here today, working with A Stroke of Luck in collaboration with the Stroke Association to bring you these activity videos. I hope you enjoy.
Nicole: Okay. Amber Group, this is your stability warm up. So for this activity, you need to be seated in your chair or wheelchair. And again if you can possibly try to sit away from the back of the chair so that you're making your trunk and core work a little bit harder. And for this activity, if you could get somebody to place a pillow underneath your feet. Causes a little bit of an instability in your feet and ankles, so it makes you work a little bit harder. All we're going to do for the warmup, we're going to push your feet down into the pillows. I'll demonstrate that now. So you're pushing downwards into the floor. Okay, so there's not an awful lot of movement there, but you will feel it tightening up in and around your bottom and your upper part of your legs. So you're going to push down and relax. And what I'd like you to try and do at the same time is to try and bring your nose forwards. And if you can bring your nose forward over your toes, keep your arms supported on your lap. Okay. So we're going to do that for 10 repetitions. Are we ready? So pushed down. Lean forwards. Come back and relax. That's one. Push down, lean forwards. Come back and relax. Keep that going, so down. Forwards, back and relax. Down, lean forwards, back and relax. Down, forwards, back and relax. So we're halfway through keep going. So push your feet down into the pillow, lean your nose forward over your toes if you come. Back and release, keep going. Doing really well, last few to go. Last one. Push down. Really get your nose forwards, back and relax. Well done. Okay, so take a short pause there to go through the coaching points of the activity we've just shown you.
Craig: Sit in a chair or wheelchair and try to sit away from the back rest. Place a pillow under your feet. Support your arms on your lap. Push your feet down into the pillow whilst moving your nose forward over your toes. Return to start position and repeat 10 times.
Nicole: Hi Amber group, this is the first activity in the stability series, and for this activity you need to be seated facing a wall but far enough away from the wall to do some reaching and challenging of your stability. So sit in your chair or wheelchair. Okay? With your weaker am supported. Now for the purpose of this activity, we've actually put some post it notes on the wall, but you can just reach to any sort of target in front of you. So for the first part of the activity you're going to be using your stronger arm, okay, to reach for the targets and come back to the middle and get your alignment back. So making sure you're in the middle with the weight on your right side of your bottom and your left side of your bottom and trying to get that equal. So I'll demonstrate that now for you. So you're going to face your target. You're going to reach forwards with your stronger arm, touch the target, come back, to the middle and keep your alignment. So you're not actually going all the way back to the back of the chair. Okay, you're keeping away from the back of the chair. So we're going to do some repetitions with your stronger arm first, and then we're going to repeat it with the weaker arm. When we do the weaker arm, you will need to support it with your stronger arm. So we'll go through stronger side first. Are we ready? Off we go. Reach. Come back to the middle. Make sure you're in the middle. Reach, back. Reach, back. Reach, back. So you can see for the purpose of the demonstration here, we've put the post-it notes on the wall in a clock shape. So we're getting some across body reaching going on there, and that's important for stability. Vary it. So some high and some low. High. High across body, back to the middle. And low, back to the middle. So we're going to repeat some of this now, using your weaker arm And for this activity. As I said before, you need to support it with your stronger arm. I take the pillow out, okay. And when we do this, you might, you're only working within the pain free range, so you might not actually be able to do some of the high ones. So we'll start low okay? So reach forwards. Just go within the pain free range and do not pull your arm. Okay? You are supporting the arm. Come back to the middle. Okay. And again, out. Back to the middle. Out, back to the middle. Try some across body movement. So we're getting, challenging stability a little bit more. Out. And back to the middle, but it's important not to pull the arm and just support the arm. Keep that going and relax. We'll take a short pause now to go through some of the coaching points for the activity you have just watched.
Craig: Place some targets onto the wall in front of you. This could be pictures, photos or post-it notes. Sit in a chair a little away from a wall whilst facing it. Do not sit too far away, just enough to challenge yourself whilst reaching. Initially, have your weaker arm supported with a pillow. Use your stronger arm to reach for the targets and then come back to the start position, ensuring that you have weight equally through both bottom cheeks. Try to reach to both left and right and high and low. Now try to reach with your weaker arm supporting it with your stronger hand. Do not pull your arm and do not push past any pain or resistance. You may not be able to reach some of the higher targets, but that's okay, do what you can.
Nicole: Hello, Amber Group. This is stability exercise number two. So for this activity, you need to be seated on the chair. Try and sit forward on the chair so that you're not taking up the back support. Okay? And you need a water bottle. Now you can determine how much water you put in the bottle. And the more water that's in it, the harder it will be. So, for your weaker arm, you might want a bottle that's just half full, for example. And this is working on core stability, so I will demonstrate the activity first. You're going to sit up tall, tighten up your muscles like what we've done in the warm up. You're going to reach down. Reach right down to your water bottle. Bring it back up towards your mouth, align yourself cross over, hand to hand, and then lower it at the opposite side. Okay, let go, come back to the middle. Okay, so we're going to do 10 repetitions, so it's five on each side. Are we ready? Off we go. Okay. So reach. Lift up to the middle. That's one, cross over. Lower control it down. Let go, back to the middle. That's two. Reach. Bring it up. Cross over, lower. Keep that control as you're lowering. Down back to the middle. Okay, Keep going. You're doing really well. That's it. Excellent. To the middle, cross over. And down. Okay, back to middle. Okay, we've got four more to go. Let's go, down, across, and down, back to the middle. Okay. Last two. Really keep that control. Keep that tummy tightened and down, come back to the middle. Okay, Straighten up. Tighten up. Keep your breathing nice and relaxed. And pause. So we'll take a short pause there to go over the coaching points for the activity that we've just shown you.
Craig: Sit forwards in your chair, trying to sit away from the back rest. Tighten your tummy muscles. And reached down to the side to pick up a bottle, return to sitting in the middle, bring the bottle up to your mouth. Take the bottle with your other hand and reach down to place it by your foot. Repeat this five times on each side. Remember to sit up tall when returning to the middle and control the movement when reaching to the side.
Nicole: Okay, Amber Group. This is your final activity in the stability series. We're going to combine some of the activities that you've already done in this series so far. So you need to be sitting forwards in your chair, again not taking up the support, and a pillow underneath your feet. And this is to provide a little bit of instability. Your feet need to be positioned on the pillow back behind your knees. So if you're looking down at the pillow, your feet are behind your knees. Okay? We're going to combine the activity that you've done earlier with the targets on the wall, with some reaching, with some side reaching, okay. And what we're looking for with this is a nice controlled movement coming back to the middle after every repetition. Okay, so we're going to clasp hands so that you can support your weaker throughout the activity. And remember, do not pull the arm. Okay, off we go. So we're going to reach forward, take your nose over your toes and come back nice and slow and controlled, coming back to the middle. Now we're going to reach towards our stronger side and come back to the middle. And across to our weaker side, back to the middle. And it's this midline that we're looking for each time. Reach forward, back to the middle. Over to your stronger side, if you can go a little bit higher and there's no pain and you have the movement, take it a bit further. And to the weaker side. We're going to take it a little bit further by side bending to a target. So really reach down, see if you can tap the target. Push yourself back up, back to the middle. Now to the opposite side. So side bend, you're coming forwards and side. Tap the target. Push down through your feet on the pillow, back to the middle. Let's repeat. Down, to the target. Push through your feet. Come back to the middle. Down to the target again, back to the middle. Let's do one more repetition either side. Down, to the target, back to the middle. And final repetition, down, to the target, back to the middle. Let's take a short pause there so you can go through the coaching points for the activity we have just shown you.
Craig: Sit facing the wall, as you did in the first exercise, but with a pillow under your feet. Place your feet behind your knees. Place targets on the wall and have water bottles each side on the floor. Clasp your hands or support your weaker arm throughout this activity. Reach in front of you to the wall, towards your stronger and then weaker side, returning to the middle each time. Repeat the sequence three times. Then reached down to the target on the floor to your stronger and then weaker side, coming back to the middle each time. Repeat three times each side.