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schuang74

when is it "too late for rehab?"

55 posts in this topic

Hello I am new to the boards but I was wondering how late is "too late to begin rehabilitating my affected side ( upper left extremity)?

I am about 8 month past my stroke.  I can walk fine and I am back to work.Fortunately I am right handed.  I have read many conflicting opinions on this question and cant seem to get a definitive answer.  I am currently working with a traditional hand PT but progress is slow.  Maybe I am being impatient.  But I would love some real world examples on what methods people in this community have had.  to summarize, i cant raise my left arm over my head without assistance from my non effected side.  I cant make a fist or any other fine motor movement with my fingers.  but I can slightly curl my fingers and in a relaxed position my hand stays relatively open.  I would welcome suggestions on exercises or therapy recommendations.  Thank You!

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There is no reason why you should not continue to improve your muscle tone. Carry on exercising the way you do now and find extra means of exercising. Don't expect results to come fast, improvement is diabolically slow. 8 months is nothing. I am working my hand continually and have been doing so for the 19 months since my stroke. I expect to continue improving my flexibility and even strength. 

Deigh

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Ditto what deigh said.

 

Never say never.

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Unfortunately exercise does not always seem to be the answer to recovery after a stroke. I did not belive the consultant when when he said the numbness in the left hand would not go away. I am a bass player and although I practise every day after six years there has not been any improvement. I was advised not to try clenching of the hand to strenght it as this could cause further damage.

 

The same situation applies with my walking, most days of the week I walk at least a mile, recently on holiday I was managing up to four miles a day but still I drag my left foot and ruin my shoes. I suppose part of the failure to recover could be age related, I am now 82 and bits of me are wearing out, probably a younger person may  have more chance of recovery.

 

I did find getting off medication a help, statins semed to cause muscle pain, blood pressure reducing tablets did not help with my balance With a change of dietand excercise and the help of my doctor the only medication in the last  four years has been aspirin.

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In my 12 year experience with stroke and my recovery process thus far along my opinion on When is it too late for some kind of Rehab is it's never too late???........ It does take lots of time when your body was hit so hard with one stroke while some folks had more than one stroke.....It just takes work on your body much as possible because your brain was affected as well in some way....

 

I just started back taking therapy at their facility after many years with just at home therapy...... The thing with going to the facility is you get many therapist assisting you with different parts of your body and using several types of machines for different parts of your body..... Your age plays a big part in your ability to recover and how much you can do all the time.... You must keep working your body to get movement back especially after several years with the stroke..... Every little bit you can do is a help for your recovery...... Don't ever give up the battle and let stroke win...... :D  :roflmao:

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I agree with Fred, Don't give up and let stroke win. Keep on trucking, keep on beleving, and Keep on thinking postive.

 

God bless

 

Yvonne

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Hello I am new to the boards but I was wondering how late is "too late to begin rehabilitating my affected side ( upper left extremity)?

I am about 8 month past my stroke.  I can walk fine and I am back to work.Fortunately I am right handed.  I have read many conflicting opinions on this question and cant seem to get a definitive answer.  I am currently working with a traditional hand PT but progress is slow.      Maybe I am being impatient.  

It does sound a little like impatient but you are not alone in your frustration. 8 months from stroke and working in itself is a HUGE milestone. Congratulations. I feel anything that you can learn to do going forward is going to help. Good luck .  

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Hello I am new to the boards but I was wondering how late is "too late to begin rehabilitating my affected side ( upper left extremity)?

I am about 8 month past my stroke.  I can walk fine and I am back to work.Fortunately I am right handed.  I have read many conflicting opinions on this question and cant seem to get a definitive answer.  I am currently working with a traditional hand PT but progress is slow.  Maybe I am being impatient.  But I would love some real world examples on what methods people in this community have had.  to summarize, i cant raise my left arm over my head without assistance from my non effected side.  I cant make a fist or any other fine motor movement with my fingers.  but I can slightly curl my fingers and in a relaxed position my hand stays relatively open.  I would welcome suggestions on exercises or therapy recommendations.  Thank You!

The majority of recovery happens 3 - 4 months after your stroke.  Here is an excerpt from a website that I wrote about stroke:

 

Rehabilitation should begin as soon as possible after a stroke. The first priority is to stabilize your medical condition and get life-threatening conditions under control. Doctors also take measures to prevent another stroke and limit any stroke-related complications. However, once these steps have been taken, it's common for stroke rehabilitation to start during your acute hospital stay.

The sooner you begin stroke rehabilitation, the more likely you are to regain lost abilities and skills. Rehabilitation is imperative following a stroke.  Rehabilitation therapy must start immediately and continue, to some degree, for however long as possible.  New brain connections, neural pathways, must be developed around the damaged area.  The only way to expedite these connections is through therapy.  The benefits come from helping the brain to reorganize itself with physical therapy, which in turn helps the stroke survivor to recover functions lost after a stroke.

 

Recovery NEVER stops!  It slows but continues forever.  The degree of recovery depends on how much effort is put into it.  Example: exercising 3x/week compared to a leisurely lifestyle. 

 

Still, there are many factors that can affect recovery. 

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I say go for it! Studies have shown thta some stroke patients see improvements years after their stroke. I say thta any that you do now will only help it all depends on how hard you work is my theory.

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Granted, all strokes are different, therefore,  all recoveries are different, but they do have some similarities. All recoveries, for instance, seem to be a lot of hard work, slow, and unpredictable. All therapists are different,too. I am now in PT for the 8th time, and each of my therapists has contributed something different to my recovery. But, I've been blessed, too, by having excellent therapists. In a lot of ways, my recovery/rehab has been a bit unusual, but that's a long story. Let me just say this: I'm 9 yrs. post-stroke, just turned 60 last month. I had PT yesterday, and did several things that I've not been able to do before. So, the answer to your question is , Yes, it's worthwhile to work on your hand now. My whole left side used to be totally numb. Now, the numbness persists mainly in my left hand and foot.The rest of my lt side is still numb but it's to a lesser degree, if that makes sense. I'm continually amazed at how much I can do with a numb appendage. 4 months before my stroke, I dislocated a bone in my wrist. After the cast came off, I was sent to a "hand specialist" for rehab. She worked wonders with my hand. She worked in a sports rehab clinic that served injured athletes. Maybe you can find someone like that to help you with your hand. Good luck, Becky 

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I think we have to accept the fact that after a stroke no matter how much therapy we have certain parts of our body damaged by a stroke are never going to improve after the initial recovery. I went straight back to playing the bass as soon as possible but my original speed has never improved, the left hand is in continual use but remains numb. With daily exercise in walking I must have covered well over 2,000 miles, but I still have the limp and a tendency to trip. I concentrate when walking to improve my gait but it stays the same. Last year on a beach in Florida I was stopped by a person who saw my wobble when walking and concerned about my health equired if I was okay.

 

What I do find disturbing is people who are put on medication just accept the fact that they will take it for the rest of their lives and make no effort to alter the life style or queuery their doctors decision.  We have a drug industry that is fueld by profit and seems to do most of the research proving how good their drugs are for us. I have several friends in the medical profession who say they would not touch some of the drugs that are doled out to their patients.

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There are no guarantees, but I too have heard many stories - and, as Tracy mentioned, seen multiple studies - that indicate that significant progress is possible for years post-stroke. My husband has determined that he'd rather put in a couple of years of frustrating work every day for unknowable results than not do so and wonder "what if?" Different people have different circumstances and priorities, so only you can decide how long you want to continue with rehab, but improvement is possible at any time.

 

Regarding therapy recommendations, not sure exactly what you had in mind, but my husband used the GRASP manual as a guide for his UE home exercise program. Loads of exercises here for multiple levels: http://strokerecoverybc.ca/wp-content/uploads/2011/11/GRASP_All_3_levels11490.pdf 

 

Also agree with another recent thread that stressed the importance of trying to use your affected hand/arm for everyday tasks. When my husband's hand was non-functional, he still would have it tag along on tasks (attempt to put both hands on/near cups and dishes when he was picking them up, attempt to turn on lights or the faucet with affected hand, etc.) so his brain didn't forget about his arm's existence.

 

If you're looking for therapy methods or devices, there are tons, all with uneven track records: e-stim, Saeboflex, Bioness, Neuromove, acupuncture, pool therapy, etc. Good luck with everything, and keep us posted with your progress if you can!

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My only other advice is that you know your threshold. Your body will tell you like I'm sure it already has time and time again. It also depends on how much affect the stroke had on your body. I had to accept that some things were not ever going to be the same. It's so difficult to feel like you are working so hard to get all better when some things may be getting to their new better. It is sad for me to remember not struggling like I do now. For the first year I was telling myself "OK Tracy go through this therapy and listen to your doctors and soon enough you'll be back to the same old Tracy". For me it was a real awakening when I realized that was not going to happen. I'm not saying it won't happen for you but really learn your body and be aware of your functions and deficits. A lot of things can get better with a lot of hard work. I wish I could say you will be your old you but I couldn't say that and be honest. I wish you the very best and yes get on the therapy train. I don't think it's ever too late.

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It is never too late for therapy. Any exercise will help. Remember to practice patience. Progress can be verrrrrrrrrrrrrrry slow but that doesn't mean it is nonexistent. Keep up the good work.

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Unfortunately for reasons I will not go in to but Mr Trump has the right idea the UK health system after care is non existant due to lack of money. It must be more than four years since I had any follow up on my actual condition realating to my stroke. Best I get is a yearly blood test but never get the results so I asssume I am fit to continue living. I did voluntary work with the Stroke Association but that folded after six months due to lack of funding. We do have mobile units run by our health service who will do checks on general fitneness, blood pressure and cholesterol but these are not available to persons over the age of 74. I assume this is now taken as normal expected life span and when you get past 74 you are on your own. My own medical practice is so inefficient that they have not noticed that for the last two years I have not collected my precription from them. Fearing I may self harm they will only dole out 28 75mg aspirin tablets at a time but my superstore will save me endless journeys by selling me 100. If I seriously wanted to end it all a 15 minute journey to three or four local gas station would provide with enough paracetamol to do the job properly.

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I'm sure I've replied here, but after a strenuous week of therapy, I feel that it's too late for me.

 

I'm not going to give up though. Mainly because I don't want to disappoint my husband and kids.

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Janelle, It is NOT too late for you! You're 3 yrs. out? P-S-H-A-W! At 4  yrs., the nystagmus in my right eye just disappeared one day. I may never get any better, either, but I know this: It ain't over, till it's over. And that goes for you, too, Schuang! Some of us are just "late bloomers".   Kindly, Becky

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hanks everyone for your responses.  very helpful and encouraging!

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You know when you get my age getting Medicare they pay for your therapy or some of it anyway and also a scooter when you need one.... They sent me the one that will go through the doors of a bathroom where as the ones I got from the VA was too wide for the bathroom door..... Hope this bit of info is helpful I been around now for a long time..... :roflmao:  I'm still kicking.....

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:welcome:   As you've read in the previous posts, improvement is slow and takes an indeterminate amount of time.....hope you keep up with the therapy!!  

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Lin is right I might have said before that studies show there are improvements beyond the first year. It's just slow and steady like the turtle. Please don't give up.

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As most have stated, it's never too late.  As a PT working with stroke for 20 years, everyone has untapped potential & has the ability to improve.  It's never too late to take advantage of neuroplasticity (the brain's ability to learn new tasks).  In regards to the upper extremity, it's usually very slow, and takes many, many repetitions.  Once or twice a week is not enough. It requires daily dedication.  With that said, there are no guarantees of anything.  However, I've seen amazing things from people that have put their mind to it & not accepted the status quo.

 

All the best, Brian

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I spoke to my physio during the week about this topic.

 

Because they don't really know what is going on in my brain, all the work I'm doing is to retain what use I have.

 

Any progress will be a bonus.

 

Therefore it is never too late.

 

Like georgebass, from my point of view, some things I don't think will improve. As long as they don't get worse!

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Is not a persons recovery from a stroke also obscured by the onset of old age and you body is starting to fall to pieces? My second stroke when aged 76 damaged the left side of my body leaving me with a numb left hand and dragging my left foot when walking. At almost 83 I still have both these problems despite the fact I am an active bass player and normally try and walk at least a mile every day.

I now have the siutation that when standing up after sitting down for more than five minutes my left leg no longer functions properly and my first few strides are very painful but then go away, also rather strange that I do not get problem after lying down all night, the leg stays normal

So my point is, have I gone as far as I can with rehab and are my current problems just old age? apart from aspirin I am not any medication so can't blame that for side effects.

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George, The only thing that I can think of is to ask your neuro if your stroke occurred in the area of the brain that controls the parts of the body, and/or functions that you're having trouble with.  Since you already  know that your stroke affected your leg, I doubt he's going to say that your stroke would have nothing to do with your current difficulties. Ask your neuro anyway.  If there's another way to tell, I'm sure he'd know before I would, as I'm not a doc. As for your walking, rehab, and exercises, I would keep on doing them as they're good for your overall health, and they will help you maintain your present abilities whether or not you see progress from the stroke.   Becky

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