Stroke rehabilitation exercises for the hand
A stroke is a life-changing experience and stroke patients can often experience significant problems with their hand following a stroke.
The statistics are sobering, with one study showing that six months after a stroke, about 65% of patients with hand difficulties cannot incorporate the affected hand into their usual activitiesª. Read this page to learn more about stroke rehabilitation for the hand.
The hand is extremely complex, capable of very intricate movement and with the more precise sensation than almost anywhere else in the body. Unfortunately this means that there is high potential for problems with your hand after a stroke.
The problems experienced can include weakness in the arm, shoulder or hand, decreased sensation and decreased movement.
When our physiotherapist is working with you to restore hand function, they will begin by giving you a full assessment. This assessment will look at elements such as:
- Proprioception (the knowledge of where your body is)
Some stroke patients will experience a decline in all of those areas within the affected hand, while others may experience a decline in only one or some. The physiotherapist will expertly assess the extent and severity of any problems with your hand, so that they can tailor a treatment and exercise regime just for you.
Neglect of hand
Our physiotherapist and occupational therapist will also look at whether you are neglecting your hand. When recovering from a stroke, it is common for people who are experiencing a weakness or numbness in their hand not to use it as much as usual. In more severe cases a patient sometimes may not realise their hand even exists. The therapy team can work with you to reintegrate your brain and your hand and to gain as much function as possible.
It is important to receive effective rehabilitation for any problems with your hand as a lack of treatment can cause long term damage, such as a loss of range or motion.
Your hand rehabilitation will be led by a Circle Rehabilitation physiotherapist or occupational therapist. After assessing the extent of any loss of function in your hand, a comprehensive hand rehabilitation exercise programme will be created, tailored specifically for you. This may include:
Movement: Your hand, wrist and arm will be expertly moved in certain ways to ensure range of motion is maximised even if you are unable to move them yourself.
Massage: Deep pressure can be relaxing and calming, helping the central nervous system to process sensory information. A deep massage of the hand can be useful to stimulate muscles and nerves that may not be functioning as normal.
Temperatures: A change in temperature can have a positive effect on the central nervous system, and often we will ask a patient to place their hand in cooler water then warmer water a number of times. Even in patients who have minimal feeling in their hand, this simple exercise can be of benefit.
Sensory boxes: We have a number of boxes that each contain a number of different textures. By feeling these different textures with their hand, damaged muscles and nerves can be stimulated.
Therapeutic Putty: With different consistencies, therapeutic putty can be a good way to improve strength and function in the hands and fingers
Mirror therapy: A stroke can leave weakness, partial or temporal paralysis in one side of the body. When a mirror is placed between your hands, the reflected image of a moving hand can stimulate different parts of the brain, aiding rehabilitation of the affected hand.
Constraint induced movement therapy: By artificially reducing movement in your non-affected hand, usually by use of a glove, increased use of your affected hand is encouraged.
Regaining as much function and movement as possible in the hand is crucial, as it allows you to carry out practical everyday tasks, such as brushing your teeth.
Your rehabilitation exercises will involve a lot of repetition. It is this repetition, even when you don’t feel any improvements, that can help to rebuild function in your hand. All your exercises will be facilitated and observed by a physiotherapist or occupational therapist to ensure you gain maximum benefit.