Stroke recovery exercises - Red group - Week 4 Flexibility

This set of exercises are for the fourth week of our four-week stroke recovery exercise programme. This week we are focusing on improving your flexibility. The video is aimed at stroke survivors in the red group. This group have limited mobility and need a carer or family member to support them with the exercises. 


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: In this set of activities, you will need a pillow, your chair or wheelchair and your carer or family member. 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.


Mark: Okay, Red Group, this is your flexibility exercise, which will be your warm up to start you off. You will need a carer or a family member with you throughout this exercise. So we do suggest that you look back at the advice and guidance videos for carers before you begin. So for this warm up, you need to be seated in a chair. If you can, you need to be unsupported, sitting up tall, engaging your trunk and core. If you struggle with that, that's perfectly fine. Use the support of the chair throughout. However, do as much as you can stay unsupported, even if it's just a few seconds. So with the arm already supported in a pillow, you're gonna keep up there to ensure that the shoulder is in a nice, stable position. Okay, carers or family members, you're gonna get yourself down. You're going to support the weaker leg. Okay, by placing your hands underneath the knee and you're going to straighten out the weaker leg just to the point where they feel comfortable, they shouldn't feel stretch already. Don't force it into pain again, at a position and at a range where they're comfortable. Then what you're gonna do. You gonna ask your stroke survivor to hold on to her weaker hand with her stronger hand, and you're just gonna slowly slide forward to a comfortable position where the just about feel the stretch underneath their leg in the hamstring. This may be a small movement. That's totally fine. Go within your limit where you're pain free, you will feel slight discomfort because this will be a stretch. And what you want to do is hold it there. So if you bring yourself back, we'll go for a 15 second stretch now. Away we go. So bring yourself forward. Just hold the where you can feel it. but you're comfortable. Carers, don't try and force this leg out. Just keep it there. Okay. Well done. Carers, you're going to put the leg back down on the floor. Then you're gonna ask your stroke survivor to keep hold of your hand. Extend your stronger leg in the air and same again, you're gonna lean forward until you feel the stretch. What we'll do is we'll hold that now for 15 seconds. Again, you may find you have a bit more range of movement with the stronger side. That's perfectly normal. Just go towards that limit where you can feel it working. And well done. Put the leg down. Moving up into your trunk now. You're going to remove the support of the pillow from the weaker arm. Carers, family members, we're going to keep the arms supported and you're going to support at the forearm, like so. You're gonna drop your arms over the edge and you're gonna tilt side to side, stretching out your trunk to your limit, and we come back. Then going to come over to this side, ensuring that the arm is supported throughout, especially as she comes back up. You're not pulling the arm, you're not dragging it. You're lifting it up with her to get that full stretch down the sides. We're going to do that now for 30 seconds. Away we go. Try not to go too far. Just a nice comfortable limit. Again carers, make sure you are not pulling this arm. It is snug right up in that shoulder. Make sure you're safe and feel comfortable, pain free. And relax there. Gonna to place the arm back on, and gonna to ask your stroke survivor to support the arm again. And we're gonna do one more set of each. So carers, back on the floor, hands underneath the leg. Lift it up to the point of the stretch and ask your stroke survivor stretch forward. 15 seconds. One more time. You might find you have a bit more range of movement now. After your first stretch. And relax. Back you go. And same again now with a stronger leg. Lift it up, and lean yourself forward. If your stroke survivor feels a bit uncomfortable leaning forward, you can always support them like so. So they feel a bit more stable. And back you go. And then carers, we're going to return to the weaker arm. Support it behind the arm, at the forearm, hands over the side. We're gonna tilt for 30 seconds. Away we go. Keep that arm supported nice and snug in that shoulder joint. Lift it up. As she goes over to her stronger side. Carers, make sure you're in a nice, stable position, not bending your back, keeping it nice and [indecipherable]. There you go. Give yourself a few moments now to go through the coaching points from this exercise we've just shown you.


Craig: Sit in your chair and support your weaker arm with a pillow. Try to sit away from the back of the chair. However, if this is difficult, rest back. Straighten your weaker knee. Your carer will help you to do this. Only straighten as far as your leg will allow. Slide your hands forwards so that you bend slightly in the middle until you can feel a stretch in the back of your leg. Use your stronger hand to assist your weaker hand, but do not pull your arm. You may feel slight discomfort when performing this stretch, which is normal. Hold for 15 seconds. And then repeat with your stronger leg. Now reach down to the side towards the floor or wheels of your chair. Start towards your stronger side and then to your weaker side. Your carer will support your weaker arm as you do this and also help you to return to the middle. Your carer must not pull or push your arm. Do not move too far, just as far as is comfortable. Repeat for 30 seconds. Rest and then repeat the whole warm up again.


Mark: Okay, Red group. This is your first exercise for your flexibility. So you will be seated in your wheelchair or a chair, and you will need a carer or family member with you to help you with this exercise. So what you wanna do, you want to have your weaker arm supported by a pillow, and what we're trying to do is try to straighten out that weaker wrist and hand and trying to get some nice extension so you can increase the movement and release some of that tone down your weaker arm. So to do this, you can ask your carer to come in, handle the weaker hand, try and lift the thumb up slightly and get your hand into your fingers. So you bring about that wrist extension then as the stroke survivor to place their hand, their stronger hand, palms together like so. So the fingers are nice and flat against each other. From there, you're gonna block the wrist of the weaker arm and you're gonna support the weaker elbow to prevent the arm from moving. And, you're then, from here, we're going to go back and forward like so. And we're gonna hold it for two seconds, and then we're gonna go in the opposite direction, to which you may need a bit of support as you bring it across. And back into the middle to finish off. We're gonna do five reps on each side. Away we go. OK, one. Two. Well done and bring it across. One two, well done. Block the wrist, bring it back over. One, two, well done. Assist with the movement. One, two. Well done. Carry on with the blocking. Well done and assist with the movement. Don't force it. Don't pull it, just enough where we're slowly stretching out the wrist and increasing that range of movement. There you go and back again. One, two. Well done. One, two. Well done. One more, each side. And one, two, well done. Place the arm back down on the bed, supported by the pillow. Give yourself a few moments now to go through the exercises and the coaching points that we've just shown you.


Craig: Sit in your chair or wheelchair with your weaker arm supported on a pillow. Your carer will help you to open up your weaker hand. Bring your stronger hand over to your weaker hand and try to place palms together. Try to get your fingers as straight as possible, but don't worry if you are unable to do this fully. Move your hands backwards and forwards assisting your movement with your stronger hand. Do not push past any pain or resistance. Repeat five times in each direction.


Mark: Red group. This is your second exercise now for flexibility. Once again, you're gonna be in your chair or your wheelchair, and you will need to carer or family member to support you throughout this exercise. Once again, feel free to look back at the guidance for carers exercise video that we did before. So what you gonna do? You gonna have your weaker arm supported on a pillow. Okay. And you're gonna ask your carer to support just above the elbow, ensuring that the shoulder is supported and not dragging down. You're gonna ask your stroke survivor to grab hold of their weaker hand, like so. You're gonna bring that up to your mouth, okay? And you're gonna bring your arm outwards palm up until you feel the stretch or your limit. Once you feel your limit, don't force it into pain. Don't try and extend into a position where it's uncomfortable. Just relax there and bring it back up to your mouth. Carers are supporting at the, just above the elbow the whole time as the stroke survivor goes through the movement. Also for carers, once they've reached their limit, and regarding there's no pain, you can just provide a little bit more extension just for the greater stretch in that bicep. And if they need to, you can assist them up. But they should be OK with that. We're gonna do five reps of them, but we're gonna hold it for 10 seconds at the very end. So here we go. We're going to support, stretch it to the limit, a little bit extra and hold. And there's 10. Let's bring it back up. And nice and slow, let's extend the wrist and the elbow and hold. And again bring it back up and back down. Each time you might find you've got a bit more range of movement and it's less uncomfortable. 10 seconds again. And for your fourth rep, here we go, 10 seconds. And last one. Well done. Big stretch. Final 10 seconds. 10, nine, eight, seven, six, five, four, three, two and relax. Give yourself a few moments now to go back through the coaching points for this exercise you just watched.


Craig: Sitting in your chair or wheelchair with your weaker arm supported on a pillow. Hold your weaker wrist with your stronger hand. Bring your weaker hand towards your mouth, try to get your fingers to touch your mouth. Slowly take your hand back towards the pillow, trying to get the back of your hand to touch it. Only move as far as your arm allows and do not push past any pain or resistance. Hold for 10 seconds. Your carer will support your weaker arm throughout and assist you if needed. Repeat five times.


Mark: Red Group. This is your third exercise now for flexibility. Once again, you're gonna be sitting in your chair and you will need a carer or family member with you. If carers feel like they do need a bit of guidance with handling for this exercise, you can look back at the exercise and guides videos already provided. So you're already sitting in your chair. If you can, you want to sit yourself unsupported. If you struggle with that, that's fine. Get your carer or a family member to place a pillow length ways behind your lower back so you feel like you are away from the back support of the chair. What you're gonna ask your stroke survivors to do is move your stronger arm and support your weaker arm underneath the elbow, so it's protected like so. The elbow is supporting the shoulder. What you're gonna do from here is you're going to tilt to the side, bring yourself back. And almost like a circle to work on the flexibility of your trunk. So what, you're want, bring yourself back around nice and slow and forward in this sort of movement. Carers or family member, to make your stroke survivor feel a bit more safe or secure. You can place your hand just on the chest and on the lower back, and you can just guide them. And just make them secure specifically when we come forward to get that stretch into their lower back. You're not doing the movement for them. You just guiding them. And what we want to do is five reps one way, then five reps the other. So we'll do that now. Here we go. And here there is one. And two, nice stretch. And what you want to try and imagine is increasing those circles each time. There we go. And we're gonna go five the other way. That's one. And two, three, four, last one. And five. Give yourself a moment there to look back at the coaching points for this exercise we've just shown you.


Craig: Sitting tall in your chair and, if possible, away from the back of the chair. Use a pillow at your lower back to help with this. Hold your weaker arm and support it under your elbow. Try to move your body in a circular motion. Your carer can support your body to make you feel more confident whilst you do this. Do five circles in one direction and then five in the other.