My wife’s post stroke recovery rests upon her persistence.  She will push herself.  She is almost completely self-sufficient.  Almost is the key phrase.

There is pain in her right shoulder area.  This has become an impediment.  Her right arm does not have a full range of motion.  Since the arm’s purpose is in service of the hand, her right hand is lagging.  We consulted with a Physical Therapist.  First things first.  Go to the Doc and have the shoulder examined.  Maybe an X-ray – maybe an MRI – but most importantly a Rx for Physical Therapy.

Her gait is off.  You’ve seen it before.  Sometimes it is a post stroke person or someone with toe-drop from a nerve impingement. Instead of lifting her right knee, pointing her toe in the air, stepping down on her heel and rolling forward on the foot from heel to toe – she hikes her right leg up by her left hip with minimal knee bend and flops the foot flat on the ground.  That is called Hip Hike.  It is starting to cause pain in the left hip.

We have been working the ankle dorsiflexor with Thera-bands.  She has been really increasing her ability to flex the ankle in all directions and increasing strength.  But the knee is not coming up.

I’ve come to realize that we have only been working on the pushing down motion of the knee and leg, not the lifting up nor for full range of motion.  Today she started on the recumbent bike with the seat adjusted relatively close to the peddles – this was step one.  I went searching for a machine that would work the leg in an upward – almost marching exaggerated movement.  Found one – but as with all such machines – there is only one plane of movement.

Then I remembered watching the guys (and gals) on the soccer field bouncing a ball into the air with their knees.  That’s the motion.

We used a smaller Swiss Ball.  She held it in front of her and then attempted to hit it to the ceiling.  It took a bit of time to get the timing right – but she got it.  There is a secondary aspect – upward movement of the right knee and balance on the left leg – all in one.  I stood a couple of feet away, caught the ball and tossed it back to her.  As this moves along – we will move from just one leg to alternating legs. The beauty of this – it is also FUN.

Form follows Function.  Look at the function and design the exercise accordingly.

The Physical Therapist was surprised at her ability to stand unassisted by her arms from a seated position.  She’s been working on this for months.  No surprise to us.  So many of our peers can’t get up without help – and they did not have a stroke – sad.