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Rebuilding left side motor skills?

by Tiffany
(Las Vegas, Nv)

Question: Hi, my dad had a stroke on 1/20/14. He is doing okay but the question is he has difficulty with his left side. He has strength, however, it seems that side is still "clumsy" as he puts it. What can I do to help rebuild the connection from hands to his brain? I am a licensed massage therapist.Any input would be greatly appreciated! Thank you for your time.


Answer: Some things I might try with my patients would include mental or graded motor imagery, mirror therapy, and repetitive use of the hand especially for in hand manipulation skills. Graded motor imagery can be done by having the patient imagine that the hand is working in a normal fashion doing different fine motor tasks. Recordings with vivid descriptions of using the hand can also be used while the person imagines using the hand. This technique would be used several times a day. You can find out more about graded motor imagery at www.gradedmotorimagery.com.

Mirror therapy would also be used for several sessions throughout the day. The patient would look at the reflection of the non-affected hand doing different motions and fine motor tasks. This has the effect of "tricking" the brain into thinking the affected hand is working as the brain will perceive the reflection in the mirror as the affected hand. The patient can still be trying to perform the same movements with the affected hand, but it will be occluded from the patient's vision. This technique is also described on the graded motor imagery website mentioned above. You can also view youtube videos on how to make a mirror box and use it at home.

In hand manipulation skills are the way that we handle small objects within our hand. Three important skills include translation, rotation, and shift. You can view a video of these movements at https://www.youtube.com/watch?v=wGdyXpqO7Jo. These in hand manipulation skills are movements that can be practiced to help improve fine motor function. You can also view a list of fine motor activities for practice at http://www.stroke-rehab.com/hand-exercises.html.

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