Stroke recovery exercises - Green 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 green group. This group are independently mobile.


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 stage is 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: Ok, Green Group. This is your warm up for the stability exercises. So for this warm up, you need to be sitting on the edge of a chair, try to get yourself into, like, a perch position. So you right on the edge. Pull your feet back behind your knees and to start with you going to do what's called an isometric contraction. So this means you are contracting your muscles without actually seeing a lot of movement. So for this, we're going to be working on your bottom and into your legs. So all I want you to do is to push your feet down into the floor and tighten up your tummy. Okay, so there won't be a lot of movement, but you will feel it in and around your bottom. So let's do that together, okay? So push down into the floor and relax. And again push own into the floor and relax and let's go for ten. So we've done two. Okay, push down and relax. And again, pushed down and relax. So that's four. Down and relax. You won't see a lot of movement with this, but you will feel it. Down and relax. Okay. And again, push down and relax. Three to go. Push down and relax. And final two. Push down and relax. And last one. Push down and relax. Now, for the second part of your warm up, you need to move from this position into standing, so come up into a standing position. And once you're stood, I want you to put your feet together so as close as you can get them together. Okay? Stand really tall. Tighten up your core by pulling your tummy button in, okay? And I want you to stand really still on the spot for one minute and you're going to analyse your own movement at this. For your warm up. Ready? Off you go, a one minute. Okay, One minute seems an awful long time when you stood still not moving. But for this activity, you need to make sure that you're not cheating by leaning on the chair behind you. Standing really still. Keep your breathing. Don't hold your breath. Okay. Keep nice and still. And you might notice that you've got a little bit of a sway, but this is quite normal. Okay, so if you do notice that you're swaying, try to gauge, are you swaying forwards and backwards or side to side? So your analysing what's happening when you're just in steady standing. Okay. Keep that going. You might feel twitching around your ankles and again this is normal. This is your ankle reaction to stabilise yourselves. Okay. And relax. Okay. So you might come back out into stepping back out just to get your stability back. Well done. That's the warm up complete. So we'll now go to a little pause so you can go over the coaching points for the activity in the warm up that we've just shown you.


Craig: Sit on the edge of a chair. Push down into the floor and then relax. And repeat this 10 times. Then stand and bring your feet as close as you can. Tuck in your tummy and stand for one minute. Think about how you're standing. Try not to lean on the chair with your legs that's cheating. When your minute is up, stand at ease by taking your feet apart.


Nicole: OK, Green Group. This is your first exercise of the stability um section. So for this activity you need a chair or kitchen work top because it's going to challenge your balance and stability. We're moving on from the warm up activity that we did. It's a similar activity, so you're going to be self analysing your balance mechanisms. Okay, so for this activity ideally, if you can stand barefoot, this is better. But if you do need footwear or ankle supports, that's fine. So what I want you to do is to take the support of the chair or kitchen work top whatever you've got there to support you and put your feet close together. Now because we are challenging your stability, it is important to do this with some support on your stronger side. Once you have got your feet together, Okay? What we want you to do is to close your eyes and you're going to close your eyes for one minute. So as soon as you've closed your eyes, you're starting a timer or somebody else can start a timer for you for one minute, okay? And start to analyse if there's any sway forwards backwards, side to side, just like in the warm up. So to challenge yourself further, take your hand off the support. Okay? Just hover it above the support. So you know where it is if needs be. Keep it going for one minute. You're doing really well. If you do struggle, you can pop your hand back onto the support, okay? And you are self analysing, so try to notice. Are you going forwards backwards, side to side? Is it one way more than the other? Okay, is it more than what you did in the warm up? If at any point, you do need to step to recover or to save yourself, this is fine. Step out, step back, step forward. This is normal. Okay. Try, if you can, to work towards one full minute, keep that going. You're doing really well. Well done. That was excellent. Let's take a short pause now to go through the coaching points for that activity that we've just shown you.


Craig: Ideally stand barefooted, but if you need your foot supports or shoes for ankle stability, then please do use them. Gently hold the back of a chair or work top with your stronger hand. And close your eyes and stand for one minute. Think about what your body is doing whilst you're standing as still as you can. To challenge yourself, take your hand away from the support. If you feel too wobbly, you may need to step a foot forward, backwards or from side to side to prevent you from wobbling further. Aim and work towards standing for one full minute without holding the support or stepping your feet.


Nicole: OK, Green Group, this is stability exercise two. Again in standing at kitchen work surface, the back of sofa, back of chair, something just so you've got some support on your stronger side. Okay, stand again, if you can do it barefoot, it's better. However, if you've got any foot orthosis or need foot supports, wear them that's fine. So for this exercise, we're going to go into a tandem stance which basically means one foot in front of the other. Now, ideally, you want to try and get one directly in front of the other one. But if you place it a little bit further apart, like so, that's fine. Okay. For this exercise, I'm going to show your one, one foot directly in front of the other. Okay? Standing with your hands on support until you get into position. And once you're in position, we'll want to see if you can hover your hand again above the support and time for one minute. Okay. Now, as you can see there, my leg is unstable and this is normal, and you will find that you've got one one way better than the other. We'll see that in a minute when we swap legs over. So we're going for a minute. And as the time goes on, you might feel it's a little bit more unstable, a little bit more rocking, a little bit more shaking within the ankles. But again, this is a normal ankle strategy reaction for your balance. Okay. If you feel too unstable, you can pop your hand back onto the support to give you a little bit more support. But if you can challenge yourself, try to keep it hovering above. So keep that going, you're doing really well. A minute seems a long time when you stood quite still, but keep it going. Try not to hold your breath. Breathe as normally as you can. Okay, three, two one and relax. Hand down, step back onto a comfortable stepping position. And then change your foot foot positioning. So the opposite leg is in front. Once you've got that position again, if you come directly in front of the other, take your hand off for support and off we go timing for one minute again. Okay, and like I said earlier, you will have one way that you feel more stable than the other, and that is quite normal. And you should be able to see my ankles are wiggling and wobbling all over the place. And it's really working my stability. If you feel really unstable again, you can put your hand down. Okay. For support. Try to keep challenging yourself. You can even tap it if needs be. As time goes on, it'll get harder. If your legs getting a little bit more tired, but you do really well. Keep that going. Keep it going. Five seconds. Three, two, one. Hand back down. Step back out. Find your stability again. Excellent. Now, if you have found that particularly easy, okay, you can take it a little bit further. So you can go back into that position and providing you've got surface to support. Yeah, the kitchen surface or back of two chairs like we have here, back of a sofa. You could actually take it into a walk. So one foot directly in front of the other. Okay? And you could just walk the length of your surface. Okay? But that's only if find the first exercise particularly easy. Okay, We're going to take a short pause now, so you can go over the coaching points of the stability exercise we've just shown you.


Craig: Stand barefooted, if possible, with the support on your stronger side. If you do need footwear or ankle supports, please use them. Stand with one foot directly in front of the other. Gently let go of the support and stand still for one minute. You will wobble. This is normal. So hold the support if you feel you need to. But do keep trying to challenge yourself. Switch positions of your legs. Stand for another minute, again challenging yourself throughout. If this is really easy, walk along the length of your supporting surface, placing each foot directly in front of the other.


Nicole: OK, Green Group. This is your stability exercise three. Your final exercise of this category. And for this you do need some support again, just like the previous activity. So the back of the chair, kitchen work top, anything you've got just for stability and to maintain safety through doing this exercise. So you're going to turn actually to face your your support this time, okay? And it should just be fingertip support so that you are really challenging your stability. You're going to transfer all of your weight onto your strongest leg. Okay. So into a single stance. So you just stood on one leg to begin with. Hands, fingertips are still on your support, okay? And then what you're going to do is you're going to challenge your stability further by going up onto your toes. And at that point there, you'll feel it a little unstable. Keep it there. And can you try to clap your hands three times? So, one, two, three and down. And you can see you might get a little bit of a wobble there, and that's quite normal. Okay, You're now going to do it onto the weaker leg. So again, hands onto your support for stability. Transfer all your weight onto your weaker leg. Okay. Make sure you're comfortable there and then move up on your toes. And then when you're ready, clap one, two, three and down. Again, you will find that you've got one way much better than the other. If you do find this particularly easy, okay? When you go up onto your toes, so on one leg and onto your toes, you can shut your eyes to make it more of a challenge. And for that you can keep your eyes shut and hands on and just count to three. Or, again, if you if you feel you really want to challenge, you can shut your eyes and try and do the clap. Okay, that is quite a challenge. Now let's take quite a pause there to look back at the coaching points for this activity that we've just shown you.


Craig: Turn to face your support, only allowing your fingertips to touch it. Stand on your stronger leg. Raise up onto your toes and then clap your hands three times, taking your hands back down to the support between each clap. It's normal to wobble when you do this. Now stand on your weaker leg and repeat the activity. If this is too easy, when you raise up on your toes, close your eyes and count to three. Or for an even harder challenge, clap your hands whilst your eyes are closed.