Stroke Rehabilitation – Improving Arm Function Using Electrical Stimulation

Therapist – I’m just going to stretch your shoulder
back here it’s very tight behind your wing bone. That kind of gets these muscles to
kind of relax out and then stretch them out before we do the stimulation
Britta – Whats my wing bone? Therapist – Your scapula. Britta – Ok. Therapist – So trying to get to loosen out cause this is very
stiff. Before we do the stimulation I want the muscles and the joint as loose as
possible. Little better. Britta – I cheated, right, I mean I
used more of my elbow, yes, yes. Therapist – Yeah I want really more of these guys here. Try pulling back again.
I’m going to put the electrodes on your muscles in between your shoulder blades
back here, okay, to try and get that muscle to fire more. I am just programming your stim right now. Ok, ready? I am going to increase the stim back here. So, what I’m looking for this is gonna pull
your shoulder blade back like this with me. Britta – Where do you want it to start? Therapist – Start your
arm here so I can feel these muscles kick in. Usually the first time we do some stim on
you we don’t get much of a contraction, but with practice you do tend to get a
better contraction. So let me know as I’m going up I’m feeling for a contraction, but
if it gets too painful tell me, ok? Are you feeling it ? Britta – I am feeling
it. Feeling it in the, can you like put yeah feeling it in the top more than
the bottom but feeling it in both top and bottom. Therapist – Come forward a little bit I’m gonna
have your arm come forward to as it comes back you’re really feeling that
muscle come in with the stim ok. Ok then work with me, pull it back, pull that arm back pull that wing bone,
shoulder blade down and back. Good. You’re comfortable, its not hurting? Britta – Yes I’m comfortable, no it’s not hurting.
You can definitely crank it up. Therapist – Pull back, good. Pull it, work with the stim. That’s it, even more, pull that muscle all the way down
the back. Britta – I feel like I’m not doing anything. Therapist – You are, you are firing that muscle, its weak, that’s your weakest muscle
right now the ones that are stabilizing your shoulder which is why when you’re
doing a lot of activities and you’re sitting your shoulders very forward in
your joint, the ones that are all back here are you’re weak ones. Now what
we’re going to do, now that I have your placement good, I am going to have to get on your
stomach, I’m gonna come around in front and I’m
gonna have you do the exercises like you did last week with the arm dangling over
the edge we’re having to really fire this muscle.
Alright what we’re going to do is you’re going to start with the arm in
this position here. When you feel the stim I wanted you to pull your shoulder
blade up and back and bring your arm up to your body. When the stim turns off
we’re gonna let your arms come back down. I’m looking for you to access these
muscles right here where the electrodes are. I’m gonna wait for your cue I’m
going to guide you through it too, so when you feel stim I want you to
initiate the movement. Good, down & back. Britta – Just hold it up there till the stim stops?
Therapist – Yep and then when it stops you are going to let it come back down, you get a couple second
break, and then do it again. Than release all the way down. I don’t want to pull from here I don’t want
the shoulder coming hiking toward your ear I want everything pulling down and
back which is why I’m kind of guiding you down this way. Keep reaching, reach, reach, reach, shoulders
ok, pain at all? Britta – No. Therapist -Do you feel a the stretch in the front? Britta – Stretch in the whole front
of my arm like from my elbow down to my pinky, stretch but not a painful stretch.
The stim is on and now its off. On. Therapist – Work with me on up. Pull that shoulder
blade down and back. Ok, there? Stretch out this muscle back here. You ok?
Good, pull them back. Nice and tall get that good posture and a curve in your lower back. What was your neck, cause I’m gonna start doing
some stuff with your hand. I’m gonna leave this stim on cause it’s getting a good
retraction going on back here but we’re going to switch to do stuff with your
hands. Good, open all the way good. Make a fist. squeeze hard again, I am going to give you a little stretch of that
end range. Sorry, better which fingers are you feeling it worst in? Are they all the same?
Britta – The middle finger. Therapist – Open all the way. Good make a fist.

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