Stroke recovery exercises - Red group - Week 2 Stability

This is the second set of exercises in our four-week stroke recovery exercise programme for the red group. These three exercises focus on stability. This group is for stroke survivors with limited mobility. 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.


Mark: Hi, my name is Mark Watterson. I'm also a physiotherapist who specialises in musculoskeletal injuries and neurological rehabilitation. My main passion in life is helping those recover from their stroke. I'm proud to bring you these activities in the videos you're about to watch.


Craig: For these activities you will need a bed, a pillow or towel. Before starting the warm up to this activity. It is very important that carers and family members watched the advice and exercises for carers video.


Nicole: Hi, red group. This is your warm up for your stability section of activities. For this activity your stroke survivor needs to be lying down, preferably on the bed, with their weaker arm supported by a pillow or rolled towel. And we're gonna work through three exercises within this warm up. So the first one is quite simple just taking up the support of the bed and just literally asking your stroke survivor to squeeze their bottom cheeks. So trying to squeeze the bottom cheeks together. So if you want to do that for me. You might see a little bit of movement like that and release. So that's the first one. The second one, you're going to bend the knees up, so you're stronger side first, and then carer, you might need to come in to support the weaker leg. Okay, so because you are handling the leg and supporting and stabilising, we do recommend that you watch the advice and guidance exercise video for carers that we've done previously. From that position, you will be stabilizing the weaker leg, and you are redoing that bottom squeeze. Okay, so squeeze again in that position and release, and we're aiming to try to squeeze the right bottom cheek and the left bottom cheek together at the same time. The third part of the warm up is staying in this position. Okay. And you need something for some feedback. Okay, So you might use a rolled up towel. I've got a beanbag here. Anything just small to place under the lower back of your stroke survivor. So we're going to squeeze that underneath. You might do this with the legs straight, if you haven't got the stability, we're gonna pop that underneath, okay? And then legs back up. Um, legs back up. So now your stroke survivor has a point of contact in their lower back. And with the third part of the warm up, you're going to ask them to squash that the piece that you put under the lower back and tighten up their abdominals, keeping their neck in contact with the pillow at all times. So we're going to go through the whole warm up. We're going to do 10 repetitions of each activity. So let's go back to the start, now that you've seen the examples. Lower down, take that out. Okay, so are we ready? Activity one. Squeeze and release. So tighten up and release, one. And again two. And again Three. You might want to put your hands onto the bottom of your strokes survivor, just to provide a little bit of feedback and just ask them. Are they squeezing at the same time and same rate. Keep that going. Do it at your own pace. One more and relax. Well done. Okay, so the second part of warm up, knee up facilitate the weaker leg. So underneath the knee, bending up, trying to make sure the knees and feet are in line and you might be stabilising that leg. Okay. Same activity again. Squeeze and release. Ready. Off you go. Squeeze and release. Squeeze and release. Keep that going for 10. Good. And your role of as a carer family member is to stabilise this leg. Well done. Okay. Keep going for 10 and relax. Well done. Straighten out your leg down and then facilitate the weaker side down. And now onto your final component for this section. So get your piece of material, rolled up towel, Slide it underneath the lower back. Okay. To provide the feedback and then from that position, legs up again, taking the weight of the weaker leg and stabilising. Are we ready? So you're going to squash the item under your lower back with your tummy trying to pull your tummy bottom back down into the item. Off we go. So tighten up and relax. And again, make sure you don't lift your head up off the pillow. And you're just looking for that tilting motion at the pelvis there. Keep going for 10. Well done, keep this leg stabilised in line with the other leg throughout and just go at your own pace. Okay, well done. Let's relax the legs, okay? And take a short pause there to go through the coaching points for the activity we have just shown you


Craig: Lie on your bed with a pillow or rolled towel under your weaker arm. Squeeze your bottom cheeks together. And repeat 10 times. Now bend your knees so that your feet are flat on the bed. Your carer will assist your weaker leg to do this, to keep it in position. Squeeze both cheeks equally. And repeat 10 times. Now place a rolled towel under your lower back. Your carer again will help you to do this. Tighten your tummy and squash the towel with your lower back. Repeat 10 times. Try to keep your head and neck in contact with your pillow as you do this exercise.


Nicole: Okay, Red Group. This is the first activity in the stability series. Your stroke survivor needs to be laying down, preferably on the bed with their heads supported with a pillow. And their weaker arm supported with pillow or rolled up towel. Ideally, you need to be stood at the head end of your stroke survivor, and we're going to be looking at tightening up the abdominal muscles, the lower abdominal muscles in this activity. It's a lot of control, okay? And we're looking at a small movement, where you're going to facilitate to try and get some symmetry. So carer or family member, your hands need to be on the shoulder blades of your stroke survivor. So you will be sliding your hands underneath, like so. And for this activity, bend your knees. Okay. And you're going to ask your stroke survivor to lift their head up off the pillow, tighten the lower apps and back down. Okay, so that is the activity that we're going to do. And your role is to keep hands on shoulder blades. Okay? And you're not pulling. You're not pushing. You're just giving some feedback and trying to get some stability there. Okay. Are we ready? Off we go. Up we go. Breathe out and breathe in and lower. That's one. And again, out. Just go as far as is comfortable. And you just feel it in your lower abdominal muscles and last one, out and breathe in. Rest. Okay? And we're going to do another two sets of those when you're ready. Okay. Ready? So off we go. Up. And down. Up. And down. Final one. Up and down. Okay, take another short rest. We'll do one more set. It's important that you as a carer or family member keep your hands in this position and don't move them around the head or neck or shoulders. So you're keeping them over the shoulder blades. Okay, We're gonna go now for the last set. Ready? Off we go. Up and down. And up. And down. Final one. And down. And relax and take a short pause. Now to go through the coaching points for the activity we have just shown you.


Craig: Lie down on your bed and ensure your head and weaker arm are supported with a pillow or towel. Your carer should stand at the head end of your bed and place their hands on your shoulder blades to support you. Lift your head as much as you can off the pillow, as you breathe out. Only lift as far as you are able to. And then return your head to the pillow. You may only be able to lift your head a little, which is great. Just do as much as you can. Your carer should not move their hands from your shoulder blades. Repeat this three times. Then rest and repeat the whole thing another two times.


Nicole: Okay, Red Group, this is stability exercise two. And for this activity, your stroke survivor needs to be lying on the bed with weaker arm supported and a pillow supporting the head. And for this activity, we're going to go into what's called a bridge position. So you'll ask your stroke survivor to bend the stronger leg up, put the foot flat on the bed, and you're going to support like you did in the warm up under the knee. Bend, Okay, to try and get them in line. You may then need to support the weaker leg there. Okay to stop it falling out. If there's any instability there around the hip. So you're going to keep the leg in that position in alignment and you're going to ask your stroke survivor to lift the bottom, tightening up up off the bed. So we're going to lift as high as they can. And what you should be looking for is symmetry. So making sure one side doesn't lift more than the other, hold it and then slowly, lower back down. So the downward movement on this activity is as important as the upward movement. So we're going to go for three repetitions. Okay, so we're ready. We're going to tighten up and lift. Try to keep it symmetrical. One, two, and three and lower. Slowly lowering, trying to get some control. Okay. If your stroke survivor is struggling with this and there is some obliquity in the pelvis, you can actually come in and support the leg with your shoulder to give them a little bit of feedback with your hand here. So, for the last two repetitions, I'll do it this way for you. You ready? Lift and lower. Good. And again, lift and lower. Well done. Okay. And relax. We're now going to take a little pause, and then we're going to do another set of three. Okay. Are we ready? So support the leg and lift and lower. That's one. And again. Lift and lower. Two and last one and lower. Okay, well done. We'll take a short pause now so you can go through the coaching points of the activity we have just shown you.


Craig: Lie down on your bed and ensure your head and weaker arm are supported with a pillow or towel. Bend both legs up so that your feet are flat on the bed. Your carer will support and assist your weaker leg. Throughout this activity, your carer will attempt to keep your weaker leg in position and your knees in line with one another. Lift your bottom up off the bed. Try to keep both sides in line with one another, making both sides work equally. If this is difficult, your carer can assist your weaker hip by giving it some feedback with a hand underneath your bottom. Repeat this three times. And then rest and repeat again.


Nicole: Okay, Red Group. This is the final activity of this series. So your stroke survivor will be in lying still and we're going to take some of the elements of the other activities that we've done and combine them together in this one. So what we're going to do for this one is we're going to bend the knees up, so you get your stroke survivor to bend a stronger leg up into that position, foot flat on the bed. And again carer or family member, you're going to help support this leg. Bring it up so that it's actually in line with the other one and keep it there. So it's nice and stable. Now we're going to do a head lifting movement like what we did in the warm up. But with this you're going to include the upper body so you can ask your stroke survivor to support the weaker arm okay across the body like that and we're going to ask them to slide the hands up towards the knees. OK, so we'll demonstrate the activity. So it's a sliding movement, and as you slide your head should lift away from the pillow and slowly lower down. It is important to stress that you are not pulling the arm at this point. You're trying to slide towards your knees. Okay. So carer family member you're supporting the leg. Are we ready? Off we go. So slide up as far as you can go just within your comfortable range and slowly down. Remember to breathe as you raise. Ready? Breathe out, reach forward and slowly lower. And one more. Okay, so sliding, not pulling and slowly lower and rest. And you should feel that in your lower part of your tummy, your lower abdominal muscles. Okay, if you're feeling it in your neck, don't go as high. Are we ready? Last set of three. Off we go. Slide, just to where it's comfortable. And down, that's one. And again, that's two. And final one that's three and relax. And with this activity, it doesn't actually matter if you don't get as high as what our model did there. As long as your neck is lifting from the pillar when you're doing the activity. Okay, so we'll take a short pause so we can go through the coaching points for the activity you have just seen.


Craig: Lie in the same position as in the previous exercise. Support your weaker arm across your body with your stronger arm. Slide your hands up towards your knees. As you slide your hands, your head may lift off the pillow. Slowly return back to the start position. Remember to breathe out as you slide your hands towards your knees. Breathe in as you return to the start position. And do not pull your weaker arm throughout this activity. Repeat three times. And then rest and repeat again.