1. Daily Stroke Rehab Strategy
John Van Deun
1/12/2019

2. Vision Statement
Layout a way to perform rehabilitation exercises on a daily basis with focus
1/12/2019

3. Goal and Objective
Layout a path to follow to accomplish a daily regimen of exercises
Complete multiple daily rehab exercises with multiple repetitions and sets
Feel relatively good about doing them
1/12/2019

4. Today’s Situation Getting started is difficult
Once started, exercises are boring and frustrating
Knowing how much to do is hard to decide
1/12/2019

5. How Did We Get Here?
In the past I found it very difficult to do my exercises consistently and eventually stopped doing them altogether
I hoped there would be a silver bullet to reduce my spasticity
1/12/2019

6. Available Options
Stop doing rehab - advantage - NONE disadvantage - the stroke has taken over your life. With possibly no recovery
Do rehab incrementally - advantages - low impact on the body - recovery slow but sure disadvantages - NONE
Do rehab consistently and with focus advantage - optimal recovery for each survivor disadvantages - NONE
1/12/2019

7. Recommendations OPTION 1 - Stop Rehab
OPTION 2 - Do Rehab Incrementally
OPTION 3 - Consistency and Focus
1/12/2019

8. OPTION Stop Rehab
If you decide to stop your rehab, it’s not the end of the world, you may be able to live one-handed in a two-handed world. There is information and books on the internet about this. The next thing to do is to make the decision to take this route and apply yourself to become proficient using one hand.
1/12/2019

9. OPTION cont’d
You can also get tools to aid you in ADL (activities of daily living). And then you will have to practice using these tools to become proficient. So you’re doing rehab anyway. And if you decide to forego the aids, you will probably practice a bilateral form of induced movement therapy. Again you’re doing rehab!
1/12/2019

10. OPTION Incremental
If you decide to do rehab incrementally, this is a good thing. I would simply look at this as a stepping-stone to Option 3. You can start off slow and work your way “up” ( the only way to go).
So get some exercises and start the journey.You could start an exercise with say, 5 repetitions and 1 set, then work up to 10 reps and 2 sets then 15 reps and 3 sets ( you get the idea) always concentrating on consistency and focus.
This in my mind is the best way to go! And it’s the journey I am taking.
1/12/2019

11. OPTION - 3 - Consistency and Focus!
If you decide to start from option 2 and have increased incrementally, you should be able to continue from where you are with ‘extreme” consistency and focus.
GO FOR IT!
1/12/2019

12. What to do next
The next step will be to choose an option that you are comfortable with
Option 1 - get information on living one-handed. Start using one hand and look into aids to use.
Option 2 - get exercises from your OT.
Option 3 - continue the journey.
1/12/2019

13. Action items -
Download the Excel spreadsheet that’s on the same blog page as this slide show
Fill in the spreadsheet with your sets starting times, exercises, goals and starting repetitions.
Adapt the spreadsheet to your needs
More than 3 sets? Recheck each set
1/12/2019

14. FINALLY START YOUR JOURNEY CONCENTRATING ON CONSISTENCY AND FOCUS!
GOOD LUCK AND REMEMBER THE MORE YOU DO THE BETTER YOU’LL FEEL AND YOU’LL BE GETTING BETTER!
1/12/2019

15. P. S. There are two items I mentioned, but haven’t addressed yet:
How many exercises to do.
Feeling good about doing your exercises.
1/12/2019

16. How many exercises to do:
Unfortunately, in my experience, there is no set answer to this question. If anyone tells you there is, they don’t know rehab. Suffice it to say that to get “lasting” results the more you can do the better and I’m talking thousands! ( they are cumulative, however ) I don’t say this to scare you; just being realistic! I will give you a personal example on the next page.
1/12/2019

17. Cont’d
One summer about four years ago I really got into using my Saeboflex glove. And for 90 days straight ( after 21 days it becomes a habit, they say )I started moving Saebo balls at a rate of 335 per day (this took hours, yes)! So at the end of 90 days I moved over 30,000 balls and guess what! My hand was getting better. I could start typing two-handed again (very slow, but type I did ). Now it’s not my intent to scare people by the numbers I did, I just want you to know that each person is different . I was a 63 year old at the time and that’s what it took me. I would think that other the progress of other people would be governed by age and brain chemistry combined with dedication.I just want to point out that in most cases more is better as long as your doctor says you can tolerate it. So the answer to the question, finally, is the number of reps to do is whatever it takes to get better. And that’s all I can tell you! I hope other people especially those who got better can give us information about their age and what it took them to finish their journey.
1/12/2019

18. Cont’d
Unfortunately, I fell into a deep depression and I’ve taken a pit stop! All that work lost! So now I’m starting over. (“Giving up is not an option!”). It will take some time but I’ll get there! And that’s the good thing about rehab you can stop, but don’t stop as long as me because all the benefit will deteriorate. I now have the depression under control and can begin anew.
1/12/2019

19. Felling good about exercises
This is a relatively short answer for me. I find the more I do (common theme for me) the better I feel. Once I get into the habit phase, after 21 days I think, I start feeling good because I know little by little I’m getting closer to my goal. Keep a journal and prove it to yourself but remember even small gains are big!
1/12/2019