Below, we review 8 hand therapy ball exercises to improve fine motor skills after stroke.

Effective Hand Therapy Ball Exercises

The most effective way to promote hand recovery after stroke is through high-repetition practice. Consistently practicing these 8 hand therapy ball exercises will help stimulate the brain and promote its ability to rewire itself through neuroplasticity.

Start with a set of 10 repetitions of each exercise, then build up your strength to aim for 2-3 sets of 10. As long as these exercises do not cause you pain, you can do them a few times a day!

1. Power Grip

This hand therapy ball exercise will strengthen your grip to improve grasp and release of objects. Grasping the ball will develop the flexor muscles in your forearm.

It will also be important to practice releasing the ball, which will strengthen the extensor muscles on the outside of your forearm. This exercise can also help relieve joint pain, stress, and anxiety.

Squeeze the therapy ball with your fingers and thumb, as if making a fist. Squeeze, then release the ball completely, opening your fingers as wide as you can.

2. Pinch

Pinch the hand therapy ball with your fingers and thumb extended. By extended, we mean to keep all the knuckles in your fingers straight. This will help strengthen muscles different from the ones used when your fingers are curled (as in the first exercise).

To make this hand therapy ball exercise more challenging, pinch the ball for a longer period of time.

3. Thumb Flexion & Extension

The thumb plays an essential role in various hand functions including pinching and grasping, so it’s imperative to strengthen its muscles to improve control.

With your palm as flat as possible, place the therapy ball on your palm and use your thumb to keep it in place. Then, use your thumb to roll the ball up and down your palm. This movement is more challenging and requires only specific thumb muscles.

4. Table Roll

Place the hand therapy ball on a table with your hand on top of it. Then, while keeping a flat hand, roll the ball from the base of your palm up to your fingertips.

Placing too much pressure on the ball will make it difficult to maneuver. This hand therapy ball exercise will help individuals practice stabilizing their arm and hand so that only a specific amount of pressure is on the ball.

5. Finger Flexion

Unlike the Power Grip exercise, you squeeze the ball without the use of your thumb. Hold the therapy ball in your palm by pressing it with your fingers. Press and release.

Notice how much more challenging it is to squeeze the ball without using your thumb. This will help strengthen the muscles that allow you to bend your fingers.

6. Thumb Roll

This hand therapy exercise isolates your thumb and encourages you to move it through its entire range of motion. As a result, it will help prevent stiffness and improve control.

Place the therapy ball on your palm. Keep your palm as flat as possible and use your thumb to keep it in place. Then, use your thumb to roll the ball in a circle on your palm.

7. Finger Squeeze

This hand therapy ball exercise will help individuals strengthen their finger adduction muscles. These muscles allow you to bring the fingers together, which is needed to grasp objects.

Place the therapy ball between two fingers and squeeze your fingers together. Squeeze and release. You can do this with any combination between the fingers, so you are sure to exercise all your fingers!

Some fingers will be more difficult than others (like your ring and pinky finger), but your effort still has an effect on your nervous system, so don’t worry if you see little movement.

8. Thumb Opposition

This therapy ball exercise is similar to the Thumb Roll, but you will roll the ball side-to-side instead of in circles. Start by placing the therapy ball on your palm and using your thumb to keep it in place. Then, use your thumb to move the ball from left to right.

Benefits of Hand Therapy Ball Exercises

It’s important to tailor your hand therapy exercises to suit your recovery goals. Some hand therapy balls have more resistance than others. Choose ones that suit your goals. Some individuals may need to strengthen their hands, while others might use these exercises to regain mobility in their hands.

When neurological injury is involved, the focus should not be placed solely on trying to increase resistance. Instead, the focus should be placed on repetition, which provides the brain with the stimulation it needs to rewire itself.

Cater your hand therapy exercise regimen to suit your goals. You may even like adding some therapy putty exercises too! Happy exercising!

The post Hand Therapy Ball Exercises to Improve Fine Motor Skills appeared first on Flint Rehab.

Every attempt made and each movement you make, no matter how small, is a step on the road to recovery. In this article, we will discuss why “one more time” is so important in both traditional and remote stroke rehab and how it can help you or a loved one recover.

This is the final article in a 3-part blog series exploring telerehabilitation for stroke recovery. 

Be sure to check out the entire series to learn more about what telerehabilitation is and how it works: 

Jump to a Section

The Power of Repetition in Stroke Rehabilitation 
The Science of Repetition in Stroke Rehabilitation
Bringing Research Into Practice
Steve’s Story of Repetition Through Stroke Telerehabilitation
Repetition Through Telerehabilitation for Stroke Recovery
Understanding Why “One More Time” Matters in Stroke Recovery

The Power of Repetition in Stroke Rehabilitation 

Years of research have shown that one factor repeatedly stands out in stroke recovery: the power of repetition. After a stroke, the brain has the miraculous ability to reorganize itself, thanks to a process called neuroplasticity. High repetitions of task-specific movements fortify this rewiring process and form new neural connections.

By repeatedly practicing specific movements and tasks over and over again, you strengthen the new neural connections being formed in your brain. The more an exercise or activity is repeated, the more it reinforces those new pathways.

For stroke survivors, doing the same rehabilitative exercises and practice activities many, many times is key to rewiring the brain and regaining abilities. The power of repetition harnesses the brain’s neuroplasticity to maximize recovery.

Here’s what the research says about the importance of repetition in stroke recovery.

The Science of Repetition in Stroke Rehabilitation

A notable study published in the American Journal of Physical Medicine & Rehabilitation (2018) found a strong positive correlation between the frequency of upper limb exercises and motor recovery in stroke survivors. Another study in the  Journal of NeuroEngineering and Rehabilitation (2019) highlighted the effectiveness of high-intensity, repetitive task training for improving arm function.

The underlying message from this research makes it clear that doing more repetitions helps improve recovery outcomes.

Bringing Research Into Practice 

Meta-analyses and reviews from sources like the Cochrane Library and the European Journal of Physical Rehabilitation Medicine consolidate numerous studies. This research reinforces the importance of repetition, as highlighted in Steve’s story below. The research concludes that high-repetition, task-oriented therapy significantly enhances upper limb motor function.

What does this mean for stroke survivors? It emphasizes the necessity of integrating the affected side into daily activities to create a living rehabilitation environment. 

Research suggests that between 300 and 600 repetitions of challenging functional tasks per day are needed for tangible neuroplasticity. The formula for recovery is clear: Engage in intentional, repetitive movements incessantly.

Everyone has a unique stroke recovery journey. Though each experience is distinct, learning how others overcame their challenges can be inspiring and reassuring. 

Here is Steve’s stroke recovery story through telerehabilitation.

Steve’s Story of Repetition Through Stroke Telerehabilitation 

Real-life examples show the power of repetition and further validate what the research suggests. Take Steve, a stroke survivor who faced the common challenge of learned nonuse. For years, Steve had stopped using his affected hand. He primarily relied on his unaffected side to complete everyday tasks. 

But things changed when Steve decided to start using his affected hand again in daily routines. Steve’s commitment to repetition was anything but easy. 

At first, even holding a water bottle was hard for Steve. Through perseverance and regular, intentional practice, he learned to control his grip and became adept at using his once-dormant hand. 

Today, Steve has not only regained control to open a bottle smoothly but can also sign his name legibly. These were tasks he couldn’t do for 15 years after his stroke! 

This is the kind of progress that comes from doing things “one more time.”

Repetition Through Telerehabilitation for Stroke Recovery

Sometimes it can be difficult for stroke survivors to access rehabilitation services. This may be due to problems with transportation, getting around, or living far away from hospitals and clinics.

With telerehabilitation, patients can meet with a skilled therapist from their homes for assessment and therapy visits through secure videoconferencing platforms. Physical therapy, speech-language pathology, and occupational therapy can all be performed in this virtual format.

Stroke survivors can work on repetition and rebuilding skills affected by their stroke, such as:

• Motor Skills and Movement: Home-based physical and occupational therapy programs can help stroke survivors regain strength, flexibility, and motor control in their arms and legs. Therapists will guide you remotely through personalized routines that incorporate repetition into exercise and performing activities of daily living.
• Communication: If you’re struggling with aphasia or other communication disorders after a stroke, telerehab provides access to speech-language pathologists and virtual support technologies that encourage practice and high repetition of communication skills.
• Cognitive and Speech Rehabilitation: Telerehabilitation for stroke recovery can deliver interventions targeting cognitive impairments like memory loss, problem-solving difficulties, and speech disorders.

Understanding Why “One More Time” Matters in Stroke Recovery

As we have outlined, the evidence is clear that “one more time” matters in stroke recovery. Are you ready to take a step toward empowering yourself with the support, expertise, and technology you need to maximize your recovery?

Stroke rehab shouldn’t feel like an insurmountable hurdle. You will want to work together with your physical and occupational therapist to create a plan that uses repetition as your stepping stone to reclaim independence, one movement at a time.

Additional Resources for Stroke Telerehabilitation
Remote Rehabilitation for Stroke Patients: What Sets it Apart? 
Stroke Telerehabilitation: Does it Really Work? 

The post Telerehabilitation for Stroke – Why “One More Time” Matters in Stroke Rehab appeared first on Flint Rehab.

In this article, we will cover a comprehensive set of hand therapy exercises for strengthening and improving hand function. These can be incorporated into any home exercise program and offer a great way for you to stay on top of your rehab.

This hand therapy exercise guide contains exercises for all ability levels. We’ve also tried to organize it from the most simple to the most complex hand exercises.

Use the links below to jump to any section:

• Stretching Exercises
• Easy At-Home Hand Therapy Exercises
• Barbara’s Hand Therapy Exercises
• Strengthening Hand Therapy Ball Exercises
• Hand Therapy Putty Exercises
• Advanced Hand Therapy Exercises

Stretching Exercises for Extremely Stiff or Paralyzed Hands

Most therapeutic home exercise programs start with a warm-up, and your hands are no different. For those with paralyzed hands from a neurological injury like stroke, start with passive exercise. This means using your unaffected hand to help your affected hand complete the exercises.

Not only will this help prevent muscle stiffness after stroke (spasticity), but it will also keep your joints limber. Stretching your paralyzed muscles helps prepare them for voluntary movements. As your muscles strengthen due to connections from your brain to your hand, your well-stretched tissues won’t resist your weakest attempts at movement by your affected hand.

Never underestimate the importance of stretching and these passive exercises. For those who have even the slightest hand mobility, these hand therapy exercises prepare your joints for strengthening in the best way possible.

1. Wrist Extension and Flexion

Start with your forearm on a table for this gentle hand dexterity exercise. Let your hand hang off the side of the table with your palm down. Then, move your hand up and down, bending at your wrist. At the end of each movement, add some pressure from your other hand to extend the stretch at the limit of your range of motion as tolerated. This will lengthen your muscles.

Feeling tightness in your muscles as you try to lengthen them is okay, but it should not be painful. When you’re done, repeat with your palm facing up. Lengthening those forearm muscles and tendons with some added pressure is okay.

2. Thumb Extension and Flexion

For another gentle exercise, start with your palm open, as if you were signaling the number 5. Then, practice moving your thumb over to your little finger, signaling the number 4. Continue to move your thumb back and forth between these 2 positions. As mentioned above, this can be done passively by your opposite hand moving your thumb.

3. Supination/Pronation of Your Hands

Place your hands in your lap and interlace your fingers. Then, turn your affected palm to face upward. If you straighten your elbows, you will feel this stretch in your forearm and even some in the upper arm. Hold this stretch for 20 seconds and release. Then, repeat on the other side.

4. Wrist Stretch

With your fingers still interlaced, gently bend your affected wrist backward and get a nice stretch there. Hold this stretch for 20 seconds and release. Repeat on the other side.

Individuals recovering from a stroke or brain injury may find these four exercises challenging enough. Pace yourself and target the areas your therapist had you working on or the places you find stiff. You can stop here and repeat these 4 exercises with high repetition.

Repetition and movement provide stimulation to your brain that will help it to rewire (via neuroplasticity) and improve hand function.

Those looking for additional challenges see the next hand therapy exercises.

Easy At-Home Hand Therapy Exercises

For those with some hand movement, you can use common household items as part of your home exercise program. The following tasks are simple yet therapeutic ways to strengthen your fine motor skills.

5. Stacking Coins

Grab a handful of loose change and practice stacking coins on top of each other. Any stackable items in your home will work. Coins are more challenging than checkers. Coasters, bowls, or any blocks are even easier to stack.

All this will help improve coordination and fine motor skills. Find ways to make it interesting for you to do repeatedly by including a family member.

6. Pinching Clothespins with Each Finger

Clothespins provide resistance from the spring. Practice pinching them with different fingers to make the task harder or easier. Your thumb and index finger are typically the easiest to use for this. Using your thumb against a middle, ring, or pinky finger may be very challenging. Using your thumb, index finger, and middle finger together is a functional ‘tripod grip.’

7. Playing Board Games

If you want to make things more fun and interesting, play board games like checkers or chess, which require you to practice your fine motor skills as you move your pieces. Games can be very stimulating for your brain while scanning, decision making, and sequencing tasks.

8. Putting Together a Puzzle

When putting together a puzzle, you employ a number of pinches and grips while having fun. And having fun is the key to getting more repetitions, stimulating neuroplasticity. Therefore, puzzles can double as a fun activity, improving hand and finger coordination.

9. Adapted Hand Therapy Exercises with Music

Getting back to playing instruments is a great occupational therapy hand exercise because it is a functional activity. As an alternative, if you don’t have an instrument, download a virtual piano or guitar-playing app and practice on your phone.

When you resume an activity you have done prior to your stroke, the brain remembers the movement pattern and naturally activates the normal muscle motion.

Barbara’s Physical Therapy Hand Exercises

Now it’s time to meet Barbara, our favorite occupational therapy assistant. Barbara can walk you through some helpful hand exercises. Try her expert hand therapy exercises in the video below, or by reading the instructions that follow:

10. Palm Up and Down

Place your hand palm-up on a table. Then, use your non-affected hand to flip your hand palm-down. This helps improve hand and wrist mobility as the hand moves from supination to pronation. Repeat 10 times.

11. Wrist Bend Movement

Gently bend your wrist up and down while supporting your arm on the table with the hand hanging past the edge of the table. This improves flexibility in the wrist which is needed for increased hand movement and range of motion. Repeat 10 movements.

12. Wrist Side Movement

Place your affected hand palm-down on the table and use your other hand to bend your wrist side-to-side.

13. Rolling Movement

Place a water bottle or a soup can in your affected hand with your palm side up on a table. Practice curling your fingers to grasp the bottle or can, then relax. This works on strength and range of motion. Repeat 10 times.

14. Wrist Curl

Take the same water bottle and hold it in your affected hand. Then, practice bending your wrist up and down, stabilizing your elbow on the table. This will feel like a bicep curl but for your wrist. This is an excellent strength-building exercise for your forearm.

15. Grip and Release

Take a pen and place it on a table. Practice gripping the pen with your affected hand and move it across the table. Release and repeat by bringing the pen back to the other side of the table.

16. Pen Spin

Take the same pen and practice spinning it with your thumb and index finger. This helps isolate finger movements for fine motor skills.

17. Coin Drop

Place 8 coins neatly in a row in your hand. Then, practice placing them down one at a time, using your thumb and index finger while keeping the other coins in your hand with your other fingers.

18. Finger Curl

Practice touching your thumb to each of your fingertips, starting with your index finger until you reach your little finger. Open your hand wide between each touch.

This is the same movement used in MusicGlove hand therapy, which has helped many patients improve hand function after stroke or TBI.

Hand Strengthening Exercises with a Therapy Ball

For some affordable and effective hand strengthening exercises, grab a set of hand therapy balls, which are a popular and affordable physical therapy tool. They usually come in different thicknesses so that you can keep yourself consistently challenged.

Resistance builds strength in your hand by placing demand on your muscles, which helps grow the muscle and nerve fibers. Use a soft ball if you’d like to focus on hand coordination and dexterity and use a firm ball if you’re focusing on hand strengthening exercises.

19. Power Grip

For a basic hand-strengthening exercise, squeeze a therapy ball with your fingers and thumb. Focus on pressing the pads and tips of your fingers into the ball. Pick a ball with a thickness that challenges you.

20. Pinch

Pinch the ball with fingers and thumb extended, bending only at the knuckles. Press your fingers down into the top of the ball and your thumb upward on the bottom of the ball. As with all these hand-strengthening exercises, this should make you feel challenged. If not, try to use a firmer ball.

21. Thumb Extension

Roll the ball up and down your palm by using your thumb. This requires a lot of movement from your thumb.

22. Table Roll

With the ball placed on a table, roll the ball from the tip of your fingers to your palm and back. This hand therapy exercise requires more coordination than strength.

23. Finger Flexion

Hold the ball in your palm and press your fingers into the ball. This is different from the power grip above because you’re focusing on an inward movement instead of a global gripping movement. Imagine that you’re pressing your fingers straight into your palm.

24. Thumb Roll

Use your thumb to roll the ball in a circular motion on your palm. This is less about strength building and more about improving dexterity and fine motor skills.

25. Finger Squeeze

Squeeze the ball between any two fingers. This exercise builds strength in the small muscles of your hand and provides a gentle stretch between the fingers.

26. Thumb Opposition

Roll the ball side to side on your palm using your thumb. This requires strength in your thumb as well as some coordination.

27. Finger Scissors

Squeeze the putty between two fingers. This strengthens the small muscles in the hand and provides stretch to the web space between the fingers.

Hand Therapy Putty Exercises

Putty provides an alternative to the therapy balls and tools described above. Hand therapy putty exercises with putty can be similar to the exercises described above, but the putty is more pliable and, therefore, can be graded to varying ability levels. Plus, putty allows for some creative exercises, as described below.

28. Fingertip Pinch

Pinch the putty using your thumb and fingertips. This also develops strength and dexterity in the fingers and reaches the small muscles in your hand.

29. Power Grip

Squeeze all your fingers into the putty. This strengthening exercise targets the muscles of your forearm, which control the hand.

30. Flat Pinch

Pinch the putty down into your thumb with straightened fingers. Only your knuckles should be flexed while the fingers remain straight. This develops your dexterity.

31. Finger Spread

Wrap the putty around two fingers and spread your fingers apart. This helps strengthen muscles inside the hand more than the forearm muscles that power the hand.

32. Finger Extension

Wrap the putty around a hooked finger and then straighten your finger using the putty as resistance.

33. Finger Spread

Wrap the putty around your hand and then spread your fingers out to stretch the putty. This targets all the muscles in your forearm that control extension of the fingers.

34. Full Grip

Squeeze down on the putty, pressing your fingers into your palm.

Advanced Hand Therapy Exercises

Once you’ve mastered the complex hand manipulation exercise, you’ll be ready to work on advanced hand therapy exercises. Once you feel ready for a challenge, add these to your home exercise program.

These last few hand therapy exercises are very advanced hand movements. Remember to start with what is fun and build from there so that you sustain your exercise program. Because it is with repetition that you will begin to make changes in your ability.

35. Palm Down Wrist Flexion Exercise (Strengthening)

Rest your forearm on a table with your hand and wrist hanging off the edge. Keep your palm facing down. Then, lift the back of your hand up. (This is the opposite of the Wrist Curl movement.)

Try it first without any weight. Then, when you’re ready for a challenge, hold a water bottle or light dumbbell in your hand while you perform this forearm strengthening exercise.

36. Rotation Exercise (Dexterity and Fine Motor Skills)

Try rotating a pen around your middle finger, using your thumb, index, and ring finger to help you manipulate the pen. Think about twirling the pen around your fingers.

37. Shifting Exercise (Dexterity and Fine Motor Skills)

Practice a sliding movement by holding the pen in a writing position (in between your thumb, index, and middle finger) and sliding the pen forward until you’re holding the end of the pen.

Then, side the pen back until you’re holding the tip once again. Think about inching your fingers along the pen.

38. In-Hand Translation Hand Exercise (Strength and Dexterity)

Gather 10 small objects (like uncooked beans) and practice picking them up with your fingers. But instead of immediately setting them down, try holding all of the objects in your palm while you continue to pick up more of them (‘in hand manipulation’). Then, once all the objects are in your hand, practice ‘translating’ them down one by one.

39. MusicGlove (Strength, Dexterity, and Fine Motor Skills)

Flint Rehab’s MusicGlove hand therapy is an interactive, music-based device that improves hand function after neurological injury like stroke or brain injury. It works by motivating patients to make hundreds of therapeutic hand movements while following along to an interactive game.

Not only is MusicGlove fun to use, but it’s also clinically proven to help stroke patients improve hand function within 2 weeks.

Click here to learn more about MusicGlove from Flint Rehab »

The post Improve Your Hand Function and Increase Strength with These 39 Hand Therapy Exercises to Try at Home appeared first on Flint Rehab.

Before we dig into the exercises, we will discuss how to get the most from your hand therapy putty exercises.

Getting the Best Results from Hand Putty Exercises

Hand therapy putty exercises will strengthen hand function and improve finger dexterity.

Sometimes hand weakness is the result of a stroke or other neurological injury. In these instances, it’s important to realize that the goal in the exercises is to strengthen the connection between the brain and the hand.

When neurologic impairment disrupts the brain’s ability to send correct signals to your muscles, hand therapy putty exercises stimulate healing. The more you use your hand (or even try to use your hand), the more you signal to your brain a demand for that function, and the brain will adapt in response.

This phenomenon is called neuroplasticity: the brain’s ability to adapt and rewire itself based on experience. When you begin to practice hand therapy putty exercises on a daily basis, it stimulates the brain and promotes the rewiring process.

If you consistently perform these hand therapy exercises, you can expect hand function to improve due to neuroplasticity.

Now that you understand how your body benefits from hand therapy putty exercises, let’s start moving.

Hand Therapy Putty Exercises to Try at Home

The following hand therapy putty exercises were created to accompany our therapy putty pack available on Amazon.

Try to accomplish these exercises on a daily basis to stimulate neuroplasticity and create strength and coordination.

FREE PDF: Want all of these exercises in a convenient PDF? Download it for free here.

Power Grip

The power grip is the first exercise in our list of eight therapy putty exercises. This exercise is helpful for all ability levels. Grab your putty and squeeze it using all five fingers, then relax. Repeat this several times for a strengthening and therapeutic effect.

Full Grip

For this hand flexion exercise, roll the putty into a ball and hold it in your palm. Then, press all your fingers except the thumb into the putty. This exercise adds one layer of challenge to the previous exercise by removing the muscular thumb from helping.

Finger Scissors

Next in your hand therapy putty exercises, roll your putty into a ball and squeeze it between your fingers. Try doing it with all your fingers to give your hands extra therapy. Squeeze between your index finger and middle finger. Then, your middle finger and ring finger. Then, your ring finger and little finger.

You can use more or less putty to change the size of the ball and, therefore, modify the challenge and adapt to the size of your hand.

Finger Spread

Roll the therapy putty out into a cylindrical shape and then wrap it around two fingers to form a donut shape. Then, spread your fingers apart. This resistance exercise focuses on extending the muscles that were flexed in the previous exercise.

Fingertip Pinch

Roll your hand therapy putty into a ball and pinch it using your thumb and fingertips. If you have spasticity in your hand that makes it difficult to move each finger individually, press all fingers into the putty at once. As you improve, try to press each finger individually into the putty.

Flat Pinch

Straighten your fingers as best you can, and pinch the putty between your fingers and thumb. This differs from the previous exercise because the fingers remain straight instead of curled, therefore different muscles are being utilized. This is a strengthening hand therapy putty exercise.

Full Finger Spread

Roll the putty out into an even longer cylindrical shape than before and wrap it around all your fingers to form a circle. Then, spread your fingers apart. This movement targets extension of your finger joints instead of flexion.

Finger Extension

Number 8 in our list of therapy putty exercises asks you to roll the putty out and wrap it around one finger while the finger is bent. Then, extend (straighten) the finger while using the putty to provide resistance. This is an advanced hand therapy putty exercise. If you struggle with this movement, try again in a few weeks.

Hand Therapy Putty Exercises PDF

Want all of these exercises in a convenient little PDF? Download it for free here.

Also, don’t miss out on the other awesome freebie below:

The post Helpful Hand Therapy Putty Exercises + Free PDF appeared first on Flint Rehab.

Loss of hand function can be very frustrating after Stroke.  When there is little to no movement in the hand, it can seem difficult to spark recovery.  However, there are still ways to stimulate the cortex and begin recovery, even with a flaccid hand.  Using sensory stimulation in a way that references your hand can stimulate the part of the cortex that coordinates hand use.

Recovering from Hand Paralysis

After a significant stroke, hemiparesis is typical, often including hand paralysis.  In larger strokes, when there are so many deficits to focus on for rehabilitation, sometimes less time is given to the hand, especially when it initially shows little to no movement ability.  Sometimes, it is easy to assume there is no hope to regain hand movement.

Remember there is always an opportunity to stimulate your brain’s cortex and increase neuroplasticity.  Adding sensory stimulation to your exercises or daily activities is helpful to bring about that neuroplasticity.

Mirror Therapy is a way to engage your brain’s cortex by providing sensory stimulation to those parts of your brain via visual cues. Typically, mirror therapy involves using a tabletop mirror to reflect your functional hand in place of your affected hand. (See the photo at the top of this post.) This creates the illusion that both hands are moving and tricks your brain into thinking that your affected hand is working properly. Although you logically know it’s just a reflection, this still helps activate neuronal processes and begins rewiring the brain through the process of neuroplasticity.

Adding Sensory Stimulation

Music Therapy is another way to stimulate neuroplasticity by engaging the senses.  The benefits to Music in rehabilitation are extensive and varied.  Auditory stimulation used during music therapy can help prepare the brain to anticipate movement. But in addition, music has an emotional affect that can influence physiological changes in heart rate, blood pressure, and muscle tension.

In one application, we would like to share a story of how an individual applied the concepts of mirror therapy with music for powerful outcomes. Margaret, a post-rehabilitation exercise specialist tells her story of using mirror therapy in an interesting modified way to help her husband to recover some muscle activity in his hand. She initially purchased Flint Rehab’s MusicGlove for hand therapy at home. Then she used the MusicGlove to help her husband regain hand function by combining it with mirror therapy – with a twist.

Hand Paralysis Treatment, Margaret’s Way

Please note this is an anecdotal account and cannot be extrapolated to all circumstances. However, we have included links to clinical studies that support the basic principles of this hand recovery method for you to consider how to apply these principles to your unique needs.

The approach she took for her husband’s hand paralysis treatment is outlined below. We hope it inspires your recovery.

Use Mirror Therapy Differently

Margaret used the principles of mirror therapy for his hand paralysis treatment, but she substituted the visual cue of the mirror for the auditory and proprioceptive stimulation of the functional hand.

She placed the MusicGlove on her husband’s functional hand and had him exercise with MusicGlove normally. Meanwhile, she would assist his affected hand to mirror his movements.

She wouldn’t move his hand to the game; she moved his impaired hand to exactly match what his opposite hand was doing. So, if he missed a note, she missed a note.

This mirroring and passive movement, along with the music and proprioceptive inputs to his cortex, helped her husband’s brain rewire.

Because of this unique therapy, he went from being completely flaccid to experiencing twitches! Any survivor struggling with paralysis knows what a significant and noteworthy sign of recovery this amount of movement is.

Margaret’s husband saw remarkable results with MusicGlove because this device utilizes a high number of repetitions. In fact, the average user achieves hundreds of repetitions per session.

Find ways to make our free hand therapy exercise book more interesting and stimulating to your senses and you will make progress.

Don’t Get Discouraged

Your results may come slowly at first — almost painstakingly so. Try to be as patient as you can with yourself. After all, you’re rewiring your brain. It’s a complex process that involves time and hard work.

Trust the hand paralysis treatment process and know that although results aren’t showing immediately, your brain is hard at work trying to make something happen.

Signs of Recovery from Hand Paralysis

Every recovery is different, so everyone will see results at different speeds. Margaret’s husband was able to see twitches after just a few weeks of this combined sensory exercise.

While twitches are small movements, they are a big deal for someone recovering from hand paralysis.  Even when the prognosis is grim, there is always hope for recovery.

The post How to Treat Hand Paralysis After Stroke appeared first on Flint Rehab.

While the hand exercise equipment recommendations below are a great place to start, an occupational therapist can also be an excellent resource to consult regarding which hand exercise equipment may be most appropriate for an individual’s specific needs. Depending on which hand functions have been affected and the severity of impairment, certain types of hand exercise equipment for stroke patients may be more effective than others.

This article will begin with an overview of common hand impairments experienced after stroke. Next, some of the best types of hand exercise equipment for stroke patients will be introduced. The importance of practicing hand exercises will also be included.

Please use the links below to jump directly to any section of this article.

• Hand function after stroke
• The most effective hand exercise equipment
• Practical considerations
• Importance of hand exercises for stroke recovery

Hand Function After Stroke

A stroke occurs when there is a lack of blood flow to the brain, causing damage to affected areas. Depending on which areas of the brain have been affected, survivors may experience physical, cognitive, and/or emotional secondary effects.

Various areas of the brain are associated with hand functions, including:

• Primary motor cortex: directs movements
• Somatosensory cortex: receives information regarding sensation
• Cerebellum: fine-tunes movements
• Basal ganglia: assists with coordination

When these areas become damaged by a stroke, survivors may experience changes in their hand functions. Often, only one side of the body is affected, because each hemisphere (side) of the brain controls the opposite side of the body. Therefore, since a stroke is typically localized to one side of the brain, only the hand opposite the brain damage will be affected.

Common conditions that occur secondary to stroke that may affect hand function include:

• Hemiplegia: paralysis on one side of the body
• Hemiparesis: weakness on one side of the body
• Spasticity: involuntary muscle tightness
• Contractures: extreme stiffness of muscles, joints, and/or connective tissues
• Tremors: rhythmic, unintentional shaking

Since every stroke is different, each individual will experience unique secondary effects. Therefore, the best hand exercise equipment for stroke patients may vary depending on one’s specific strengths and needs.

The Best Hand Therapy Equipment for Stroke Patients

Rehabilitation is essential for regaining hand function after stroke. However, finding the best hand exercise equipment for stroke patients can be challenging. Consulting with an occupational therapist can help survivors navigate the many different types of hand therapy equipment available.

Some of the most frequently recommended types of hand exercise equipment are outlined below. This list includes some of Flint Rehab’s own products – because hand therapy is our specialty – but it also includes other tools, with unaffiliated links.

The best hand therapy equipment for stroke patients include:

1. Hand Therapy Balls – Best for Travel

Hand therapy balls offer a simple way to exercise the hands, especially for individuals with severe spasticity and clenched hands. Therapy balls have multiple resistance levels, designed to give survivors with various functional abilities an appropriate challenge.

Most hand therapy ball exercises focus on managing spasticity or increasing strength. Depending on the survivor’s needs, they may use balls of varying resistance for different exercises. For example, a harder ball may be better to roll in the hand for a finger stretch, while a softer ball may be more appropriate to squeeze between the fingers for strengthening.

Shop hand exercise balls on Amazon »

2. Therapy Putty – Most Versatile

Therapy putty is a popular, inexpensive hand therapy tool among many occupational therapists. Similar to hand therapy balls, therapy putty also comes in multiple resistances. Obtaining a putty set with multiple resistances is ideal, since survivors are often able to use a tougher putty as their strength improves.

Therapy putty is among the best hand exercise equipment for stroke patients because of its versatility. While it can be used for traditional hand strengthening exercises, some choose to use therapy putty to practice cutting or to hide pennies in. Many survivors even find themselves mindlessly working with the putty throughout their day to gradually improve their hand strength.

Shop therapy putty on Amazon »

3. Finger Exercisers – Good for Strengthening

While hand therapy balls and therapy putty can be excellent tools for strengthening the hands, finger and/or grip exercisers can often provide more resistance. In addition to being able to grip the tool with a full hand, finger exercisers also provide a great way to work on isolated strengthening of each finger.

Shop hand exercisers on Amazon »

4. Tabletop Mirror Therapy – Good for Paralysis Recovery

Mirror therapy is a rehabilitation technique that can help improve hand paralysis after stroke. It involves using a tabletop mirror to reflect the movement of one’s unaffected hand, while hiding the affected hand from view. Watching the reflection of the unaffected hand moving in the mirror can help survivors better visualize their affected hand moving, encouraging recovery.

After practicing mirror therapy in the clinic setting with an occupational therapist, survivors may choose to continue the therapy at home. While it is possible to make a mirror box using a mirror, double sided tape, and a box, professionally made mirror therapy sets are also available.

Shop mirror therapy sets on Amazon »

5. PVC Pipe Tree – Good for Coordination

Pipe trees are among the best hand exercise equipment for stroke patients because they allow survivors to practice coordinating both fine and gross motor skills. Along with addressing the ability to grasp and release objects, the pipe tree also requires fine motor precision and upper arm movement. Furthermore, following a pattern to create the “tree” can also address cognitive skills.

Shop pipe trees on Amazon »

6. MusicGlove – Good for Fast Results

MusicGlove is a premium music- and gaming-based hand therapy device made by Flint Rehab that has been clinically proven to improve hand function in two weeks. This high-tech hand exercise equipment encourages survivors to perform  numerous therapeutic hand exercises in rhythm with the music.

Unlike other hand exercise equipment, MusicGlove is something that survivors want to use daily because it is fun to use. Consistent practice is essential for recovery, making the MusicGlove an effective form of hand therapy.

Shop MusicGlove from Flint Rehab »

7. FitMi Home Therapy – Good for Paralysis Recovery

FitMi is another high-tech exercise tool from Flint Rehab that motivates survivors to exercise the entire body, including the hands. It uses a gamified approach to rehabilitation, and adapts to the survivor’s skill level to provide just the right level of challenge. FitMi is suitable for all ability levels, even for survivors without any active hand movement.

Shop FitMi from Flint Rehab »

Practical Considerations

While many different types of hand exercise equipment have been developed, it can be challenging to determine which tools are best for a specific individual. The best hand exercise equipment for stroke patients should be:

• Accessible: survivors must be able to obtain the equipment to use it
• Engaging: tools must be motivating in order to encourage frequent use
• Appropriately challenging: tools that are too easy or too difficult to use are not effective for promoting recovery

Occupational therapists can provide excellent recommendations of conventional therapy tools, such as those listed above, that meet these qualities.  However, not all individuals may be able to afford to purchase conventional therapy tools. In this case, in order to make the equipment accessible, an occupational therapist may also be able to recommend ways to use everyday objects to help improve hand function. Some examples of this include:

• Using clothespins to pick up cotton balls to address fine motor strength and precision
• Improving coordination and grasp and release skills by building a structure out of Legos
• Feeling different textured objects, such as a fleece blanket, sheet, or washcloth, as part of a sensory re-education program

With this in mind, sometimes the best hand exercise equipment for stroke patients may not be conventional therapy equipment at all. This is because the way the equipment is used is just as important, if not more so, than having a specific tool.

How to Use Hand Exercise Equipment for Recovery

In order to recover from stroke, individuals must consistently and repetitively practice exercises and activities involving affected functions. This is because massed practice stimulates adaptive brain rewiring.

When a task is practiced frequently, the brain perceives that the task is important. Using a process called neuroplasticity, the brain is able to rewire itself to create and strengthen neural pathways to make that task easier to perform. When the task involves functions that have been affected by stroke, control of the affected functions can be rewired to healthy areas of the brain.

This helps to explains why the best hand exercise equipment for stroke patients can vary person to person. The most effective tools are those that are used consistently to address affected functions. Some individuals may be more motivated to practice using high-tech devices, while others may be more likely to practice consistently with a hand therapy ball that can be used on the go.

Therefore, when considering which type of hand exercise equipment is best, it is important for survivors to think about which types of equipment will be most motivating to use on a regular basis. Consistent practice is essential to achieve an optimal recovery.

Understanding Hand Exercise Equipment for Stroke Patients

A stroke can affect one’s hand strength, movement, coordination, and sensation. Using hand exercise equipment is a great way that survivors can regain these functions.

The best hand exercise equipment for stroke patients varies by the individual and their needs. However, regardless of the type of equipment, it is essential for survivors to be consistently practicing exercises and activities involving their affected functions. This stimulates adaptive rewiring in the brain to help survivors achieve an optimal recovery.

The post The Best Hand Exercise Equipment for Stroke Patients appeared first on Flint Rehab.

Regaining effective hand function is essential for performing activities of daily living, such as grooming and feeding oneself. Repetitively practicing exercises and activities that involve using affected hand functions can help stroke survivors recover by stimulating neuroplasticity, or adaptive brain rewiring.

To help with this, the following article includes some of the best grasp and release activities for stroke recovery. An outline of how a stroke can affect hand functions and how grasp and release activities can stimulate recovery is also included. Please use the links below to jump directly to any section of this article.

• Potential hand function changes after stroke
• Grasp and release activities for stroke recovery
• How can grasp and release activities promote recovery?

How Can a Stroke Affect Hand Functions?

A stroke occurs when the blood supply to the brain becomes disrupted, depriving affected areas of the brain of oxygen and other essential nutrients. This results in damage to the brain, which in turn may impact functions controlled by the areas of the brain that have been affected.

When a stroke occurs in an area of the brain responsible for hand functions, such as the primary motor cortex or basal ganglia, individuals may have difficulties using their hands effectively. Stroke survivors often experience deficits in only one hand rather than both, typically on the side opposite of where the stroke occurred. This is because each side of the brain controls motor functions primarily on the opposite side of the body.

There are various secondary conditions of stroke that may affect the ability to use the hands effectively, including hemiplegia, tremors, and ataxia. These conditions, among others, may affect a number of hand functions, including:

• Hand strength
• Sensation
• Fine motor coordination
• Precision
• Isolated finger movements and thumb opposition
• In-hand manipulation
• Grasp and release functions

Depending on which hand functions are most impacted, the best exercises and activities for recovery may vary. However, the following list of grasp and release activities for stroke recovery is a great starting point. For more individualized recommendations for recovering hand functions, consider asking for a referral to an occupational therapist.

The Best Grasp and Release Activities for Stroke Recovery

Just as each stroke is unique, each individual also experiences different effects of stroke and severity of impairment. The following list of grasp and release activities for stroke has been loosely arranged as a progression from simple activities to more challenging activities. As hand functions begin to improve, practicing the more advanced activities on this list can promote continued improvements.

While these are all excellent activities, survivors should focus on practicing tasks that are difficult but not impossible to complete to boost recovery. One way to find this “just-right challenge” is to start at the beginning of this list and gradually progress until the activities seem appropriately difficult. Options to modify the difficulty of each activity are also included to allow survivors to find the best exercises for their specific skill level.

 With that in mind, here are some of the best grasp and release activities for stroke recovery:

1.    Grasping Cups

Practicing grasping and releasing cups is an excellent way for those with limited hand mobility after stroke to improve their grasp. Since a cup is a relatively large, light-weight object, this activity is a good starting point for recovering the ability to grasp objects.

Larger cups tend to be easier to grasp than smaller cups. For those seeking a challenge, consider moving cups or cans of food from the counter into an overhead cupboard.

2.    Towel Walks

Place an open hand at the bottom of an unfolded towel lying on the table. Then, slowly begin squeezing the fingers to maneuver the majority of the towel into the hand. Release the towel by extending the fingers, pushing it back into a flattened position.

This activity can be completed with the fingers moving simultaneously, similar to making a fist. Alternatively, those looking to increase the difficulty can work on “walking” their fingers up the towel, moving one finger at a time.

3. Picking Up Items with Tongs

Lay out an assortment of items of different sizes and textures. Then, try to pick up each item with a pair of tongs and arrange them in a row from smallest to biggest. The spring in the tongs provides some resistance, strengthening muscles of the fingers and hand. Additionally, this activity helps develop hand-eye coordination.

If picking up smaller items is difficult, focus on picking up larger items initially, as these tend to be easier. Survivors seeking a challenge can use clothespins to pick up small items, such as cotton balls, alternating which fingers are used in conjunction with the thumb for pinching.

4. MusicGlove Hand Therapy

MusicGlove combines hand therapy, music, and gaming together for the ultimate hand rehabilitation experience. This device encourages survivors to engage with music by rhythmically pinching the fingers together when prompted by specific cues on the screen. According to the research, users of the MusicGlove demonstrate “a significantly greater improvement in hand grasping ability” than those pursuing only conventional therapy.

MusicGlove has multiple difficulty levels so that individuals are challenged at all stages of recovery, and it can also track one’s progress. Through each 30-minute session, stroke survivors can perform hundreds of finger-gripping movements, stimulating recovery.  

5. Sorting Candy

Find a bag of a colorful candy (like Starbursts, Skittles or M&Ms). Pick up each piece of candy to sort them by color or arrange them in a pattern. This can improve both fine motor skills and cognitive abilities.

Larger pieces of candy, like peach rings or tootsie-pops, will be easier to grab. Therefore, survivors should consider starting off these types of candies, transitioning down to smaller pieces of candy as their grasping skills improve.

For an even further challenge, rather than picking up each candy individually, consider taking a small handful of candies in the hand. Then manipulate them one by one to the thumb and index finger to set down.

6. Alphabet Magnets

Get a set of alphabet magnets and practice spelling out words and creating sentences on the refrigerator. The attraction between the magnet and the refrigerator surface forces survivors to grip it more strongly when pulling it off. This activity can also help develop hand-eye coordination through practicing accurate spacing and placement of the letters.

If alphabet magnets are too challenging to grasp, consider using magnetic chip clips. For an added balance challenge, practice placing the magnets as low as possible.

7. Stringing Beads

Unlike the other activities, stringing beads requires both hands to work together, a skill referred to as bilateral coordination. Using the affected hand, pick up one bead at a time to place it on a string or pipe cleaner. Pull the bead to the end of the string, using both hands to ensure it gets all the way on.

If picking up tiny objects is still difficult, start with larger beads and then progress to smaller ones. To challenge one’s cognitive skills in addition to fine motor abilities, consider using a pattern when adding the beads to the string.

8. Therapy Putty

Therapy putty is an extremely versatile hand therapy product. Survivors can mold it into any shape and squeeze it between the fingers or the entire hand. Some even choose to place small objects, such as pennies, into the putty. This encourages survivors to work through the putty both when hiding the objects within the putty and when removing them.

Therapy putty comes in a variety of different resistances to help survivors improve their grasping skills at any level of recovery. Be sure to keep therapy putty off of furniture and carpet, as it can be very hard to remove.

See more hand therapy putty exercises »

Each of these activities targets slightly different hand functions, in addition to simply addressing grasp and release skills. Working through the activities in this list daily, focusing on the activities most appropriate to the survivor’s skill level, is an excellent way to improve hand functions after stroke.

How Can Grasp and Release Activities Promote Recovery?

Although the hands may be affected by a stroke, the root cause of limited hand functions is really the damage to the brain incurred during the stroke. Therefore, it is essential to address this damage for an optimal recovery.

One of the best ways to do so is to promote neuroplasticity, or the brain’s ability to adapt and rewire itself. This allows healthy areas of the brain to assume control of functions regulated by areas of the brain damaged during the stroke.

Neuroplasticity is stimulated by frequent and consistent repetition of exercises and activities involving affected functions. Therefore, consistently practicing grasp and release activities for stroke recovery can help create and strengthen new and existing neural pathways in the brain, shifting control of grasp and release skills to healthy areas of the brain. This leads to an overall functional improvement in the ability to grasp and release.

The grasp and release activities for stroke recovery listed in this article were chosen as they are more engaging than rote exercises, thus may be practiced more frequently. Finding activities that are engaging and motivating can be difficult, but is an excellent way to encourage survivors to complete the repetitive tasks necessary to promote improvement.

Understanding Grasp and Release Activities for Stroke Recovery

Following a stroke, many survivors experience changes in hand functions. Although these functions are often among the last to be recovered, the ability to use the hand effectively is essential for many daily activities. Therefore, many survivors seek to find effective techniques to recover the ability to use their hand(s) functionally.

Practicing grasp and release activities for stroke recovery, such as the examples listed in this article, is an excellent way to recover hand functions. Consistent, repetitive practice can stimulate adaptive rewiring in the brain, leading to lasting functional changes.

Survivors with impaired hand functions should consider trying the grasp and release activities outlined above to promote improvements, even if their stroke was years ago. Consult with an occupational therapist for more individualized recommendations and to discover even more ways to improve hand functions after stroke.  

The post Effective Grasp and Release Activities for Stroke Recovery appeared first on Flint Rehab.

Fortunately, there are ways to rewire the brain and restore mobility in the hand and fingers. This article will discuss the causes and treatment for severe hand spasticity and curled fingers after stroke.

Causes of a Clenched Hand & Curled Fingers After Stroke

The brain and nervous system are in constant communication with your muscles, telling your muscles when to move and when to relax. When a stroke damages areas of the brain that control hand function, such as the motor cortex, it disrupts that communication between the hand and nervous system. As a result, the hand muscles will contract involuntarily, or spasm.

This spasticity and decreased voluntary (intentional) movement prevent the wrist, hand, and fingers from moving through their full range of motion. Over time, spasticity can lead to curled fingers after stroke and, when left untreated, can contribute to the development of contractures.

Contractures are characterized by extreme stiffness or shortening in the muscles, joints, and connective tissue. When contractures develop, the range of motion of the fingers and wrist becomes restricted, causing the fingers to curl into the palm.

It’s important to manage spasticity early to prevent contractures from developing.  This will help maximize function and avoid the increased pain or discomfort that can accompany contractures. However, even if spasticity has progressed to contractures, there are still ways to relax the muscles in the hand and fingers, although this will require time and consistency.

Before exploring the different methods of hand spasticity treatment, we’d like to review prevention techniques to avoid worsening of hand spasticity and curled fingers after stroke.

How to Prevent Spasticity in the Hand from Worsening

Learned non-use is a phenomenon that occurs when a person neglects their limb and the brain begins to disengage or disassociate from that limb. Learned non-use occurs frequently following stroke and is a result of the brain trying to compensate for lost function and be more efficient. However, this learned compensation leads to decreased use of the affected limb and can make recovery slower and more difficult.

This is where the popular neurorehab phrase “use it or lose it” comes from. Following a stroke, it may feel easier to compensate for decreased function by using only the more efficient, unaffected limb. However, if you don’t use or move your hand by at least stretching it intentionally on a daily basis, then you will continue to lose hand function and the fingers will continue to curl tighter into the palm.

Fortunately, there’s another popular phrase among neurological rehab therapists: “use it to improve it!” The hand spasticity treatment options below will help you put this into practice.

How to Treat a Clenched Hand After Stroke

There are many hand spasticity treatment methods available to help relax a clenched hand and avoid curled fingers after stroke. It often works best to use a progressive approach, which means starting with basic, simple techniques and moving onto more complex methods or exercises as you improve.

Be sure to work alongside a therapist as clenched hands are a sign of severe spasticity and help from an expert is often crucial for recovery. Your occupational or physical therapist can help set you up for success by providing optimal exercises, splints, and other rehab techniques.

Here are the methods your therapist may recommend to treat hand spasticity after stroke and help relax curled fingers:

1. Hand Splints

Quick tip: Hand splints are a great starting point because they help prevent contractures from worsening. This is not a quick-fix for hand spasticity, but may be an essential first step to avoid further complications.

Daily stretching is vital for patients with clenched hands and curled fingers after stroke. This can be optimized through the use of a hand splint as these devices can provide long-duration, low-load stretching to the muscles and joints of the hand and fingers.

Stretching the hand muscles and connective tissue helps prevent spasticity from worsening into contractures. If contractures are already present, causing fingers to curl into the palm, then gentle stretching will help prevent spasticity from worsening — as long as you perform the stretch in a pain-free range.

Furthermore, stretching the affected hand and focusing your attention on your hand as you stretch will help stimulate the brain and encourage it to rewire itself. Sensory stimulation (looking at your hand while you feel the stretch) helps combat learned non-use by helping to relax the fingers and improving the brain’s awareness of the hand.

It can be especially helpful to perform active or passive stretches and exercises (which we will discuss below) and then apply your hand splint directly afterward. This can help you maintain the progress you made during your exercises. Ask your therapist to recommend a good hand splint to help keep your hand stretched or see our recommended gloves for stroke patients.

2. Hand Spasticity Exercises

Quick tip: The best way to relax clenched hands and curled fingers after stroke is to rewire the brain through exercise. There are many different forms of exercise you can incorporate into your recovery routine depending on your unique symptoms and abilities.

Exercise is arguably the most effective intervention for hand spasticity after stroke. Practicing therapeutic hand movements on a consistent basis helps spark neuroplasticity: the process the brain uses to rewire itself. As hand spasticity exercises are practiced with high repetition, the brain works to create and strengthen neural pathways that communicate with the affected hand muscles.

As the brain starts to regain the ability to send signals to the affected hand, it also regains the ability to send signals that tell the hand and fingers to relax, decreasing spasticity. Ask your therapist to recommend hand spasticity exercises that are most suitable for you.

Keep in mind that active hand exercises may not be immediately accessible for  survivors with a clenched hand or curled fingers after stroke. If active exercise is not yet achievable, passive exercise can still be utilized to help reduce hand spasticity.

3. Passive Exercise

Quick tip: Passive exercise is an accessible form of hand spasticity exercise for all stroke survivors with clenched hands. Best of all, it helps spark neuroplasticity and promotes recovery.

When severe hand spasticity and contractures lead to a clenched hand or curled fingers, patients may need to start with passive exercise first. Passive exercise involves assisting your affected hand and fingers through their range of motion. This can be done by using your non-affected side to move your hand or can also be performed with the help of a caregiver or therapist.

Although you’re not exerting effort with your affected hand, studies have shown that passive movement helps spark neuroplasticity. Even if the brain has lost connection with the affected hand, passive movement can help rekindle that connection.

There is always hope for stroke survivors with hand contractures as we know recovery is possible with time, dedication, and consistency. Passive hand exercise is an excellent starting point for reducing spasticity in the hand after stroke.

4. Botox

Quick tip: Botox is a “nerve block” medication that temporarily relieves hand spasticity and helps relax curled fingers after stroke. Your doctor can provide you with more information about this treatment and determine if this may be appropriate for you.

Even with passive exercise, some patients may have severe contractures that do not allow the hand to open at all. When spasticity is severe, your doctor or rehab team may suggest Botox injections, which help relax targeted muscles to loosen the fingers and help correct a clenched hand after stroke.

It is important to note that Botox wears off after several months and often requires repeat injections. For long-lasting improvement, daily hand spasticity exercises and prolonged stretching are necessary to help maximize the effects of Botox.

These exercises, along with the assistance of a hand splint, can help rewire the brain to improve hand function, increase mobility, and correct curled fingers after stroke. Many stroke patients see the best results when they use Botox to create the opportunity to wear a splint comfortably, as the hand and fingers will be more relaxed. Use of a hand splint after Botox can provide prolonged stretch to tight muscles and joints, increasing potential for hand function in the future.

5. Electrical Stimulation

Quick tip: Electrical stimulation provides input to the muscles of the hand to decrease spasticity and encourage muscle activation, improving curled fingers after stroke.

If your therapist feels electrical stimulation is an appropriate treatment for you, this can be a great way to treat spasticity in the hand after stroke. Electrical stimulation is applied via electrodes placed on the skin, sending input to specific muscles and causing them to contract. When electrical stimulation is applied to the forearms, for example, this can help extend the fingers so that they open away from the palm.

In the video below, you can watch a therapist demonstrate electrical stimulation for finger extension. He places the pads on muscles in the arm to help extend the fingers. This is a great example of why you need a therapist’s help to teach you how to safely apply electrical stimulation and where to place the pads for optimal results.

Electrical stimulation works best when combined with hand therapy exercises to provide as much stimulation to the brain as possible. While it helps to use electrical stimulation to cause your fingers to extend, it’s even better to intentionally try to extend your fingers during exercise. Intentional movement is key for activating neuroplasticity and improving spasticity in the hand after stroke.

6. Hand Therapy Exercise Devices

Quick tip: Consistency and repetition are the keys to recovery from hand spasticity and curled fingers after stroke. To help with this, survivors can look to interactive devices for motivation.

Your therapist will provide you with a home program of hand exercises to practice on your own between therapy sessions to keep neuroplasticity engaged. This requires motivation and accountability to help maximize recovery. However, studies have shown that conventional home exercise programs tend to have poor compliance rates.

This is where interactive hand therapy devices can help. For example, Flint Rehab’s MusicGlove is a sensorized glove that tracks your movement as you exercise your hand in sync with a musical game. It’s fun and motivating to use, and it’s both FDA-approved and clinically proven to improve hand function within 2 weeks of use. Survivors with clenched hands may need to use the device passively to accomplish the exercises, but this still sparks neuroplasticity and promotes improvement in spasticity and overall hand function.

Bob & Brad, two physical therapists on YouTube with over 4.5 million subscribers (at time of writing), gave MusicGlove the thumbs up. They were not paid to review MusicGlove and they are not affiliated with Flint Rehab in any way.

7. Baclofen

Quick tip: Baclofen is not used to stimulate neuroplastic changes in the brain but rather to provide short-term relief from spasticity. This, in combination with therapy exercises, can be used to address curled fingers after stroke as well as other spasticity-related deficits.

Baclofen is a medication that helps relieve spasticity by inhibiting the release of body chemicals that cause muscle contractions. This decreases spasticity by reducing overactive nerve firing and involuntary muscle contraction. Baclofen can be taken orally or, in some cases of severe spasticity, it can be administered directly to the spinal cord via an intrathecal baclofen pump.

If spasticity is not only affecting your hand but also severely affecting your quality of life, you can talk to your doctor about this treatment option. Placement of an intrathecal baclofen pump requires surgery and should be considered only once all other options have been exhausted.

8. Progressive, Combination Therapy

Quick tip: Every stroke is different, and every patient will benefit from different approaches. Experiment until you find what works for you.

A clenched hand after stroke is often a result of severe spasticity and, in some cases, muscle contractures. It’s likely that survivors will need multiple techniques to help relax and open the hand in order to improve function. Progressive combination therapy does not refer to a specific treatment, but rather a blend of therapies to help maximize stroke recovery.

Talk with your therapy team to explore your best options for treating curled fingers after stroke. Some patients will benefit from hand splints while others may require medication such as Botox. Additionally, these treatments are often implemented at the same time to optimize results.

No matter which path you choose, it is vital to make hand therapy exercise the foundation of your rehab regimen. Exercise helps activate neuroplasticity, which rewires the brain and allows the fingers to slowly relax and loosen. Movement is key to recovery.

How to Treat Spasticity in the Hand After Stroke

Overall, spasticity in the hand after stroke can lead to a clenched hand and curled fingers when the condition is left unmanaged. The best hand spasticity treatment is exercise because movement helps rewire the brain and restore the brain’s ability to communicate with the hand.

Passive exercise (where the hand is passively moved through each exercise) is a great place to start as this activates neuroplasticity and is accessible to most survivors with curled fingers after stroke. Talk to your physical or occupational therapist to see which combination of hand spasticity treatments is most suitable for you.

A stroke can make everyday tasks feel impossible – but there’s hope. Our FREE eBook “Hand Exercises for Stroke Patients at Home” provides easy-to-follow hand exercises you can do at home to improve strength and coordination.

• Effective exercises designed specifically for stroke patients.
• Step by step instructions and clear illustrations.
• Tips and advice to maximize your recovery.

Download our FREE eBook Hand Exercises for Stroke Patients at Home!

The post Understanding a Clenched Hand & Curled Fingers After Stroke: How to Treat Hand Spasticity appeared first on Flint Rehab.

The chances of hand recovery increase with consistent practice and repetition of rehabilitation exercises. In this article we will discuss techniques to maximize recovery after stroke and promote return of hand function.

Fundamentals of Hand Recovery After Stroke

Hand function is often one of the slowest to return after stroke. Since the hands and feet are distal to (far away from) the midline of your body, this means they are also located farthest from the brain and spinal cord. This increases the distance nerve signals must travel to communicate. Following a stroke, this communication is often delayed or inhibited, resulting in decreased hand function.

Additionally, the muscles of the hand are small and tend to fatigue quickly. Inhibited muscle activation and decreased use of the hand after stroke can cause muscles to atrophy, or become smaller and weaker. This contributes to diminished hand function and extreme difficulty with fine motor movements.

As many as 80% of stroke survivors experience arm and hand impairment, which can dramatically affect performance of daily activities such as dressing, bathing, and cooking. Although hand recovery after stroke can be slow and, at times, frustrating, there is always hope for regaining function through consistent rehabilitation. To help maximize progress and functional performance, here are some fundamental treatment aspects for hand recovery:

Hand Rehabilitation Exercise

Rehabilitation exercise is perhaps the most crucial aspect of fine motor recovery after stroke. Practicing intentional movements of the hand is vital to help regain lost function and it is important to begin exercising as soon as possible.

Focus on practicing hand therapy exercises to improve your fine motor skills and coordination. Ideally, you can practice the exercises and skills your occupational or physical therapist suggests, or you can use our hand exercises for stroke patients.

While traditional exercise focuses on strengthening muscle groups, the main goal of hand rehab exercise after stroke is connecting the brain to the body through intentional movement. This helps promote motor relearning and improvement in performance of daily tasks.

High Repetition

Following a neurological injury such as stroke, your brain relearns skills through neuroplasticity. Neuroplasticity refers to your brain’s ability to rewire neural pathways and connections, allowing other parts of the brain to adapt and compensate for lost function. This process is activated through rehab exercise and, more specifically, high repetition of those exercises. 

Practicing high repetition of a specific skill or task maximizes motor relearning and neuroplasticity. The more you practice rehab exercise, the more your brain rewires itself, and the more movement you recover. This means that if you want to regain use of your hand after stroke, you need to use your hand often. This will stimulate your brain and encourage it to improve control of your hand function.

Consistency

In addition to high repetition, another vital aspect of hand recovery after stroke is consistency. The only way to enhance recovery and notice steady improvement in hand function is through frequent, consistent practice. Repetitive practice will be the most effective when it is performed on a daily basis. This consistent stimulation helps your brain create and retain the new neural pathways that you’re building through exercise.

Talk with your rehab team about a rehabilitation exercise program that will help you achieve your hand recovery goals after stroke. It is important to find exercises you can be consistent with to maximize your functional outcomes. It is also important to find a hand therapy program that you enjoy, as this will help you be more consistent.

Additionally, it can be beneficial to create a consistent schedule or routine to make your exercise program a daily habit. Prioritizing your rehab exercises allows you to improve your chances of recovery and take charge of your healing.

Additional Methods to Boost Hand Recovery After Stroke

Rehabilitation exercise, high repetition, and consistency are three fundamental components of effective hand recovery after stroke. These fundamentals are vital for promoting neuroplasticity and regaining hand function. Now that we have discussed the basic components of hand recovery, we will review additional treatment methods that can improve functional outcomes after stroke.

MusicGlove Hand Therapy

It is important to find hand exercises you enjoy and can be consistent with in order to enhance your recovery after stroke. At times, rehabilitation exercise can feel tedious, or you may become frustrated if you experience occasional plateaus in your progress. To help achieve the high repetition necessary for hand recovery after stroke, you can try fun, high-tech devices like Flint Rehab’s MusicGlove.

MusicGlove is clinically proven to improve hand function within 2 weeks as it makes exercise more engaging and can motivate you to accomplish hundreds of repetitions per exercise session. Additionally, your therapy team may be able to help you identify exercises that coincide with your hobbies or other activities you enjoy to help you maintain consistency and stay motivated.

Mirror Therapy

Mirror therapy is another technique that can be used to maximize hand recovery after stroke, especially for individuals who have minimal hand function. This is a standard hand recovery method for individuals with severe hand paralysis and is also highly effective for reducing clenched hands after stroke.

Mirror therapy involves placing a tabletop mirror over your affected hand so that it reflects your unaffected hand. Rehabilitation exercises are then performed with your unaffected hand as you watch the reflection in the mirror, “tricking” your brain into thinking you’re moving your affected hand.

This technique can spark neuroplasticity and help you create new neural pathways, allowing you to regain movement or fine motor skills in your affected hand. As with other techniques, repetition and consistency are necessary for mirror therapy to be an effective treatment.

Electrical Stimulation

Electrical stimulation involves using electrical currents via electrodes placed on the skin to provide stimulation to your nerves and muscles. This therapy technique amplifies the stimulation your brain receives and can help enhance neuroplasticity, improving rewiring of new motor pathways.

Electrical stimulation is a commonly used method to help patients recover from paralysis after stroke and can be applied to the hands, wrists, and arms to promote muscle activation and stimulation. There is widespread evidence to support the use of electrical stimulation for hand recovery after stroke. Talk with your doctor or therapist before beginning this treatment to determine if electrical stimulation is appropriate for you.

It is important to note that electrical stimulation is most effective when paired with rehab exercise. Sometimes referred to as functional electrical stimulation or FES, this specific type of electrical stimulation is applied to your muscles to increase contraction while you perform a series of exercises or tasks. This maximizes muscle activation and enhances neuroplasticity, promoting recovery of fine motor skills and lost function.

Mental Practice

Mental practice is the art of visualizing yourself performing a specific movement or task. This treatment method can be used to help improve motor function and is especially helpful for stroke survivors who have limited hand function. This technique can be performed before and after your regular rehab exercises to enhance recovery.

Even if you have minimal or no hand function after stroke, mental practice can help your brain “rehearse” and rewire the connections needed to perform a specific movement. In this way, mental practice can engage neuroplasticity in the same way as physical practice. This technique has been clinically proven to boost results and is even used by professional athletes to visualize skills and successful outcomes before competition.

Understanding Hand Recovery After Stroke

A large percentage of stroke survivors experience hand involvement, which can affect many daily tasks and activities. Although hand recovery after stroke may be slow or frustrating, there is hope for recovery with a comprehensive rehabilitation program that focuses on neuroplasticity.

Neuroplasticity is optimized when recovery includes three fundamental components: rehabilitation exercise, high repetition, and consistency. Additionally, supplementary treatment methods such as electrical stimulation, mirror therapy, mental imagery, and MusicGlove can improve the likelihood of hand recovery after stroke. We hope this article helped review methods for hand recovery that you can use during your own rehab journey.

The post Maximizing Hand Recovery After Stroke: How to Improve Hand and Finger Mobility appeared first on Flint Rehab.

Table of contents:

• Fine motor activities for adults after stroke
• How to improve fine motor skills
• Occupational therapy fine motor activities

Fine Motor Activities to Practice After Stroke

Fine motor skills play a major role in our ability to perform everyday tasks in an efficient manner. They’re what allow us to accurately grab an item, type words on a keyboard, and tie our shoelaces.

After a stroke, individuals may struggle with tasks that involve fine motor skills. Fortunately, these skills can be improved through repetitive practice.

Here are some fun and effective fine motor activities for adults after stroke:

1. Therapy ball exercises

Hand therapy ball exercises are great for individuals following stroke, especially for those that have hand weakness or struggle with clenched hands. Some exercises involve squeezing or pinching a therapy ball, which would benefit patients who need to strengthen the finger flexors (the muscles that allow you to bend your fingers and make a fist).

However, hand therapy balls can also be useful for patients with spasticity that present with clenched fists. Placing their hand and fingers around the ball can allow them to stretch out the tightened muscles. If spasticity is severe, these patients may need to use their unaffected hand to help place the spastic hand around the ball.

See all hand therapy ball exercises »

2. Therapy putty exercises

Therapy putty is a popular hand rehabilitation tool used in occupational therapy. By manipulating the putty in various ways, you can give your hand a good workout. For example, you can practice finger extension by wrapping the putty around your index finger and then extending your finger up, pushing through the resistance of the putty. As your hand grows stronger, you can increase the resistance of the putty you’re using to continue challenging yourself and improving muscle function.

See all therapy putty exercises »

3. MusicGlove hand therapy

While most hand therapy exercises can be dry and boring, MusicGlove is a high-tech home therapy system that incorporates gaming and music into your hand exercises. It’s clinically proven to improve hand function in just 2 weeks because patients are motivated to achieve higher repetition of finger exercises.

See MusicGlove hand therapy »

4. Tabletop exercises

Whenever you’re sitting at a table, it’s a great time to do some hand exercises. You can use various household items like coins, paper clips, silverware or pens to practice a variety of fine motor skills. For example, you can practice gripping a pen, sliding it across the table, and releasing it. Additionally, you can work on using your thumb and fingers to spin the pen in a circle on the table in both clockwise and counterclockwise directions. Practicing tracing and writing can also be effective for improving fine motor coordination skills.

See all hand exercises for stroke patients »

5. Moving beans

If you have any dried beans in your pantry, pour some onto a table and practice moving them into a cup, one by one. While this might be mundane, it’s a commonly-practiced occupational therapy exercise for fine motor skills. Once you become skilled at picking up one bean at a time, try using smaller beans, or attempt picking up multiple beans in your hand at once, then manipulating them to your fingertips one at a time to place into the cup.

6. Stacking coins

Have any spare change lying around? Try flipping the coins all one direction (either heads or tails side up) and stacking the coins on top of each other as a simple and affordable fine motor activity. This activity helps develop grasp and release functions, as well as careful placement. Sorting coins is also great for developing fine motor skills, as well as addressing cognitive functions. Furthermore, to work on building strength, try adding coins to therapy putty and attempt to remove them.

7. Rubber band resistance

Rubber bands make great “resistance training” for your fingers. Simply place the bands around your thumb and index finger and try to push the band apart. You can do this with all 4 of your fingers.

8. Play the piano

Learning how to play a simple tune on the piano is an excellent way to develop your fine motor skills. By pressing the correct keys, you’ll not only improve your precision but also develop a new hobby.

The best part is, there’s almost an infinite number of songs you can learn to play. Therefore, no matter what your level of ability is, there’s always a way to challenge yourself and improve your fine motor skills.

9. Board games

Are you a board game fanatic? Most board games require you to maneuver a small object across the board to keep track of your position. This is a fun and engaging way to practice holding onto small objects and moving them in small increments.

Board games can also involve rolling dice across the board, pressing buttons, flipping cards, and spinning a wheel. These various activities can all help you develop your fine motor skills after a stroke.

10. Shuffling a deck of cards

There are endless ways to work on developing your fine motor skills with a deck on cards, including:

• Shuffling the deck
• Laying the cards out on a table so you can see each one
• Flipping each card over one by one
• Picking a card out of the middle of a deck
• Standing the cards on end to make a house of cards (great for those really looking to challenge their fine motor skills)

Cards are thin, which helps you develop your grip and precision. Additionally, there are numerous card games you can learn to play with a single deck of cards. You can entertain yourself for hours while developing your fine motor skills.

Now that you’re familiar with some activities that can help you develop your fine motor skills after a stroke, the following section will address the underlying mechanism that allows you to recover them.

How to Improve Fine Motor Skills

The key to improving fine motor skills after stroke is to consistently perform high repetitions of targeted exercises. High repetition is key to recovery because it helps activate neuroplasticity, the mechanism the brain uses to rewire itself and recover.

If you struggle with severe spasticity, which often results in clenched hands after stroke, you can start with passive exercises and stretching. Passive exercise involves assisting your affected hand though a movement, either with the help of a therapist or by using your non-affected hand.

Both passive and active exercise helps stimulate the brain and encourages neuroplasticity to recover affected functions. The more repetitions you practice on a consistent basis, the more your fine motor skills will improve. This is called “massed practice.”

Although progress may come slowly, especially with severe hand impairments, your brain is on your side. As long as you put in the reps, you’ll improve your chances of recovery. The brain never runs out of neuroplasticity, so even if it has been months since your stroke and recovery appears to slow down, there is still potential to improve.

One of the most effective ways to practice targeted hand exercises and develop your fine motor skills is to participate in occupational therapy.

Occupational Therapy Fine Motor Activities

Many individuals participate in occupational therapy after stroke to improve their functional independence. Occupational therapy involves practicing many of the activities you perform daily such as grooming, feeding, and getting dressed. Most of these everyday activities require fine motor skills, which makes it an excellent and practical way to achieve high repetition of therapeutic movements.

For example, getting dressed requires a wide range of fine motor skills. Everything from grabbing your shirt to pulling up your zipper and buttoning your pants uses fine motor skills. Because these are activities you perform regularly, it’s easy to see the real-world application of developing these skills. The more you practice, the easier they become.

Occupational therapists can also develop a home exercise program for you using various household items to allow you to continue improving your fine motor skills on your own. This may involve exercises such as those listed above, adapted to your specific skill level to challenge your fine motor skills without being too easy or too difficult.

Additionally, an occupational therapist can recommend adaptive tools to improve your independence while you work on developing your fine motor skills. Improving your fine motor skills takes time. While you may initially struggle to perform the activities, as long as you trust in the process and keep practicing, you’ll stimulate the brain and promote adaptive changes.

Fine Motor Activities for Adults After Stroke: Key Points

Believe it or not, most of the activities you perform daily involve fine motor skills. Therefore, it’s essential to practice them to improve your independence after a stroke.

We hope you try some of these fine motor activities for adults after stroke. Remember, the key to recovery is to consistently practice the skills you wish to improve. This helps stimulate the brain to make adaptive changes and strengthens those functions.

The post Fine Motor Activities for Adults After Stroke: Example Exercises to Try appeared first on Flint Rehab.