Diagonals part five: Pathology. How can we develop the diagonals so each individual achieves optimal recovery following a stroke?

van de Rakt, Jan and Mccarthy-Grunwald, Steven (2017) Diagonals part five: Pathology. How can we develop the diagonals so each individual achieves optimal recovery following a stroke? Italian Journal of Sports Rehabilitation and Posturology, 4 (1). pp. 746-788.

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In part four we discussed the difficulties some individuals experience when moving independently whilst in bed following a stroke. We identified the benefits of exercise in promoting recovery, and provide greater opportunity improve movement which receive the most attention within rehabilitation for instance, standing up and walking. The article indicates the need for practitioners should consider the exercise program and specifically put it into context of their occupational performance such as getting in and out bed, on to the toilet or in and out the shower, which although traditionally is seen as a nursing task, in reality should not be ignored. Re-establishing skills therefore requires the need for rehearsing such activities providing variation of movement and exercise, with the best outcomes being achieved in the individuals home environment. Primarily, practitioner’s start working with individuals whilst they are still within the ward of the rehabilitation centre.Once they have reached the point of discharge, particular attention should be afforded to assisting with the transformation back to their home environments, to ensure the skills developed as identified above, remains appropriate in the new setting such as standing up and walking. Consequently, the exercise programs should be developed for use in all settings and with all healthcare professionals and not just for the clinic area. This provides both the consistency of approach to ensure the skills are practiced and developed over time, whilst providing the context for daily activities, and variation of performance with differing environmental constraints. Using diagonals help to create task specific resistance therapy which provides the right ‘Repeated Maximum’ (RM) and the right intensity of exercise specific for each individuals need. This in turn helps practitioners calculate optimal time required for each individual to maximise their potential for recovery. Appendix gives an picture about the synergy. This is an part of the restoration of the brain after the stroke and makes movement with support possible but gives also restriction on selective movement and therefore problems with the balance. Therefore is every improvement of the synergy an reason for therapy and not only in the first 3-6 month after stroke but lifelong!

Item Type: Article
Journal / Publication Title: Italian Journal of Sports Rehabilitation and Posturology
Publisher: Societcientifica Riabilitazione e Posturologia dello Sport
ISSN: 2385-1988
Departments: Academic Departments > Health, Psychology & Social Studies (HPSS) > Rehabilitation
Additional Information: Steve McCarthy-Grunwald MSc BSc RMN is Senior Lecturer in Mental Health Nursing with Dementia Specialty, University of Cumbria, UK.
Depositing User: Anna Lupton
Date Deposited: 07 Dec 2017 12:57
Last Modified: 06 Jul 2021 10:02
URI: https://insight.cumbria.ac.uk/id/eprint/3456


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