Our senior physiotherapist, Ying, working with a grandpa post-stroke, which left him paralysed over his left side. He hasn't been able to stand for 1.5 years since his stroke due to a lack of follow up rehab care. In stroke recovery, early intervention is very necessary for optimal recovery. The earlier, the more focused (this means very speciifc and targeted work to his needs and impairments specific to his stroke) and the more consistent the better. Public healthcare system had great acute care, but the resources available weren't able to provide for sufficient early and consistent follow up care. Only recently that gramps had voiced out his interest to his son that he would like to try again and that he would like to stand and even try to walk again. And so his son had reached out to Maison for help.
In the 1.5 years after his stroke, grandpa succumbed to fatigue. Fatigue from the overpowering experience of this neurological condition, as Dr Jill had described the experience as “the inability to identify the boundaries of the body” “shocked to find myself inside of a silent mind”. Dr Jill bolte taylor (neuroanatomist and author of “stroke of insight”). In her TED talk ( https://www.youtube.com/watch?v=UyyjU8fzEYU) , she described her experience with stroke. While she was experiencing the stroke, she described how she was unable to feel her body. In her own words, her “consciousness shifted away from normal perception of reality”, “every step was rigid, deliberate without any fluidity in pace” and “there’s this constriction in my area of perception”.
In many parallels, grandpa wasn't able to control many aspects of his body. The stroke affected both the affected left side as well as the right side of his body. A lack of motion over his left side resulted in a general reduction of mobility over the right side. Paralysis over his left side affected grandpa's ability to stand. And since grandpa wasn't standing and walking, his right side eventually started deteriorating too with disuse.
Each rehab session and each step of the rehab process required the deliberate choosing of positivity over the more passive and natural negativity - giving in to pain, regret, frustration, fatigue. Grandpa described this recovery process as exhausting, as it took a lot of concentration to even try to figure out what aspect of the limb he was trying to move and in which direction the limb was moving. Some motions, such as movement through the full range of motion of his knee or his arm required assistance as when left alone, grandpa could only perform in jerky and fast motions, without the ability for precision in control. Grandpa didn't have the strength to perform motions in completion of the entire range, so Ying had to perform the movements with him in a very slow motion, without any jerkiness or speed, allowing grandpa's brain to match up to the motion.
Because of the stroke, Grandpa also lost the ability to coordinate his mind and body, and of coordination within his body. The desire to move often didn't result in the expected motion. It was extremely exhausting and frustrating for grandpa.
Throughout the entire rehab process, Ying worked with grandpa on relearning fundamental strategies of weight shifting of his body, increasing his range of motion at his upper body as well as his core and postural strength from the neck and his trunk. and 6 months later, we eventually managed to get him up into upright sitting and onto his feet.
In the subsequent phase progressing to walking, Ying progressed with grandpa on weight shifting techniques in static standing. This involved guiding grandpa via shifting him from left to the right feet. Months later, we finally progressed to more advanced weight shifting techniques, allowing grandpa to advance towards a walking like motion. Ying would weight-shift grandpa from the hips towardsto the left, and help him lift his right leg up and vice versa, while grandpa manages support using his right arm onto a quad-stick (a type of walking stick with a 4 point end). Shifting grandpa’s body to the side imitates the way we shift our weight left and right while we walk and, grandpa’s brain was able to relearn this automatic ability to weight shift that so we take for granted.
6 months later, grandpa is now able to manage walking with a smoother gait and with greater endurance for exercise. The recovery continues and even though it may be long, but more than the outcome, it is in the process that we find hope and inspiration to live for another day.
