Tag Archives: Stroke

Motor Imagery Therapy That Stroke Survivors Do

Hi! haven’t been posting for a month! My apologies for the long delay partly due to computer problems and busy with other things! This is a continuation of my earlier post Bilateral Isokinematic Therapy (BIT) and today I would like to introduce the use of Motor Imagery in stroke-rehab.

Motor imagery (MI) is the mental representation of movement without any body movement. Abundant evidence on the positive effects of motor imagery practice on motor performance and learning in athletes, people who are healthy, and people with neurological conditions (eg, stroke, spinal cord injury, Parkinson disease) has been published.

An advantage of MI is that patients can practice it independently during the regeneration phase between two physical therapy sessions. MI can also be practiced in all stages of stroke recovery. In an early stage of recovery, MI allows patients to mentally practice a task which they cannot yet carry out physically due to motor impairment. However, it has not been determined yet, when it is best to start with MI.

The Video Links given below are the routine MI and BIT exercises that Rock goes through daily! The use of the mirror is to create the artificial impression to her brain that her affected hand is moving in tandem with her good hand! In a way this is also considered Bilateral Isokinematic in a sense. There are in total 8 Videos of different exercises involved and you may watch each specific exercise to get a better understanding of how it is done. These Videos were recorded at the University Hospital Stroke Rehab Clinic with the kind permission of Puan Noorieni the Chief Physiotherapist there. Hope these Videos are helpful to other caregivers who want to use them at home but you need to purchase or make those accessories yourself. Thank-you.

Exercises that Rock did since 2005 … 3 times a day with each exercise lasting an hour or more.

  1. Motor Imagery – Wrist Rotation Exercise.
  2. Motor Imagery – Wrist Up-down Exercise.
  3. Motor Imagery – Wrist Open-close Exercise.
  4. Weight Bearing Exercise.
  5. Bilateral Isokinematic – Elbow Exercise.
  6. Bilateral Isokinematic – Fingers Exercise.
  7. Bilateral Isokinematic – Wrist Up-down Exercise.
  8. Bilateral Isokinematic Relaxation Procedures.

Tool To Measure Your Risk Of Getting A Disease!

This is not directly about healthy living or eating healthy, but this is a very interesting tool that we can all try out. Named “Your Disease Risk“, this is a really cool set of questions that you can answer online, and instantly get an estimate of your risk level for:

– Cancer
– Diabetes
– Heart Disease
– Osteoprosis
– Stroke

Quote from the Harvard School of Public Health:

Your Disease Risk has been transferred to the Washington University in St. Louis and can be accessed at: www.yourdiseaserisk.wustl.edu.

This important health tool was originally developed at the Harvard Center for Cancer Prevention at the Harvard School of Public Health and is also accessible at www.diseaseriskindex.harvard.edu.

So, if you think you are really healthy now, or if you think you might be a tad at risk, go answer some questions and have a feel for what your risks factor are with Your Disease Risk.

Stroke & Diet – Part 3

Firstly my apologies for missing-in-action for sometime. We were relocating and it was a terribly busy few weeks for us. Anyway this is Part 3 on Stroke & Diet and sharing on a very important part of a stroke survivor’s diet and it is none other than Fruits.

Personally I feel that it is equally important to address the issue of Antioxidants in relation to a healthy diet be it for stroke survivors or ordinary folks. Sufficient quantity of fiber and antioxidants in our diet are the building blocks for good health.
Antioxidants are disease-fighting compounds that prevent and repair damage caused by oxidation from environment pollutants, chemical toxins, tobacco smoke, lifestyle abuse and poor diet choices. Unchecked oxidation can lead to cancer, heart disease, Alzheimer’s diseases and Parkinson’s diseases.

From the Book “The Antioxidant Miracle” by Lester Packer Ph.D., Lipoic Acid, Pycnogenol, Vitamins E and C will help you to prevent oxidation. One source for these antioxidant content can be found in fruits. A five to ten servings of fruits daily should supply you with sufficient antioxidants. One serving is about the size of your fist. Locally in South-East Asia we have the following fruits that are rich in antioxidants.


Red-fleshed Guava contain high quantity of the antioxidant Lycopene, more than strawberries, spinach and broccoli. Lycopene may lower the risk of cancer such as prostate, ovarian, cervical, oral, pharyngeal, esophagus, stomach, colorectal, lung and pancreatic cancer. One pink-flesh Guava contains 37 calories and is a good source of fiber and Beta-Carotene another antioxidant. Helps to lower cholesterol as well as blood pressure too. Continue reading

Stroke & Diet – Part 2

My earlier post Stroke & Diet Pt. 1 was sharing on what a healthy diet is suppose to do and that is about effective control of Blood Pressure, Sugar Levels and Cholesterol levels. In Part Two, let us be more specific and explore some appropriate food that will help keep these levels in check. Here are some helpful guidelines.

Recommended Food:

  • Choose lean meats, fish and poultry and bake, broil or grill whenever possible. Add beans, peas, lentils, nuts and seeds to it.
  • For Calcium supply, include 3 cups of low-fat or fat-free milk, yogurt or low-fat cheeses for good bone health. For those who cannot consume milk use calcium fortified foods and beverages to fill the gap.
  • Limit your fat, sugar and salt for these extras can add-up. Check food labels and look for low in saturated and trans fats. Sugars often only provide added calories with little added nutritional value so reduce your intake and if possible avoid it. Choose and prepare food with little salt or sodium.
  • Eat any type of fish with edible bones, such as canned salmon or sardines. Fish contains Omega 3 Fatty Acids which helps to reduce risks for Arrythmia or sudden death, blood clots and Atherosclerosis, reduce Triglycerides levels and lower Blood Pressure.
  • Choose dark-green vegetables like kale, broccoli, turnip greens and mustard greens. The calcium in these veggies is better absorbed than the calcium found in spinach, rhubarb, beet greens and almonds.
  • Calcium-fortified tofu, soymilk, orange juice, breads and cereals are excellent staples. Tofu, soy, walnuts and flaxseed oil are the plant sources of Omega 3 Fatty Acids.
  • Vitamin D also plays an important role by helping in with calcium absorption. Exposure to the sun is another way where our bodies produces Vitamin D say 15 – 20 minutes exposure. Be careful with supplementation because Vitamin D is stored in the body and can be toxic in relatively low amounts (>2,000 i.u./day).

Watch out for my next post on Stroke & Diet Part 3, which will cover Recommended Fruits which are beneficial for stroke survivors!


Stroke & Diet Part 1 ~ Stroke & Diet Part 3

What is a Stroke? ~ Facts of Stroke & The Warning Signs. ~ Stroke Risk Factors. ~ Understanding Spasticity Eating & The Stroke Survivor ~
The Job No One Asks For Caregivers Month ~ Botox & Spasticity ~ The ABC’s of Caregiving Behavioural Changes ~ There is Hope ~ Improving Awareness
Fall Prevention for Stroke Survivors ~ Sleep Disorders.

Haemorrhagic Stroke & PPA

Received an email from a friend highlighting the connection between Haemorrhagic Stroke and PPA (Phenylpropanolamine). PPA is an ingredient used in many over-the-counter (OTC) and prescription cough and cold medications as a decongestant and in OTC weight loss products.

I did a search on this and confirmed that this is true. A Research Team at Yale University did a project called Haemorragic Stroke Project and the findings were given in a Report on May 10th 2000. For those who want to know more please go to the following site :-


The implications are serious in this findings. Many people buy OTC medicine for common cough and cold and for some weight-loss prescriptions without realizing the danger if such prescriptions or drugs contain PPA. Even for first time users taking drugs that contain PPA stand the risk of a Haemorragic Stroke. Perhaps this explains why young and healthy people died suddenly of a Stroke although they never possessed any symptoms or tell-tale signs like High Blood Pressure, Diabetes etc.

The next time you run to your local drug store for some cold medicine please check that it does not contain PPA! In the US, the FDA has stopped drug companies from using PPA in their prescriptions.

What is a Stroke?
Facts of Stroke & The Warning Signs.
Stroke Risk Factors.
Understanding Spasticity
Eating & The Stroke Survivor
The Job No One Asks For
Caregivers Month
Botox & Spasticity
The ABC’s of Caregiving
Behavioural Changes
There is Hope
Improving Awareness
Fall Prevention for Stroke Survivors
Sleep Disorders.

Sleep Disorder

Lately heard from a friend about her mom being observed for sleep patterns which are necessary for the doctors to determine how her sleep pattern affects her recovery process after an operation. The Idaho Neurological Centre did a survey on Sleep Disorder and Stroke Risk discovered the following :-

Out of 15 stroke survivors observed, all show some form of sleep disorder.

Obstructive sleep apnea, which causes a person to stop breathing temporarily and happen repeatedly was more common among stroke survivors than others.

Stroke survivors has stage one sleep (lightest sleep) and snored more loudly than others.

Between 31% to 70% occurs during sleep.

However after saying all these, Continue reading

Fall Prevention for Stroke Survivors

As high as 40% of stroke survivors have serious falls attributed to Balance Problems. Rock fell from the stairs twice and thank God she did not incurred serious injuries except for some vicious looking bruises and having aches and pain for a week.

People with balance problems often benefit from physical therapy. Your first step is to get a therapy prescription from your physician. According to physical therapist Sapan Palkhiwala your body uses a combination of three systems to stay balanced.

1. Vision:
This is self explanatory.

2. Vestibular:
The vestibular system helps by monitoring changes in your head movements with respect to the pull of gravity. It includes two parts: the central system (housed in your brain) and the peripheral system (in your inner ear). These systems are connected by the vestibular nerve. Strokes are more likely to affect the central system. If the vestibular system is injured by stroke, you may experience dizziness and imbalance

3. Somatosensory:
With the somatosensory system, your body uses information it receives from the pressure of your feet on the floor, and your ankle positioning, to help balance your body.

Sapan says a majority of stroke survivors have balance problems because one side is stronger than the other. He encourages survivors to build up their affected side by using it in daily activities, such as reaching for a glass of water.

Caregiver can bring a chair into a corner of a room. While the survivor stands in the corner, he or she can hold on to the back of the chair and practice moving shoulders and hips together from side to side and then forward to backward. This exercise also forces the survivor to use and strengthen his affected side.

If a stroke affects your vision, you can learn to compensate. If you have a visual field cut so that you cannot see anything out of the left side of both eyes, you can practice scanning the room with the right side of your eye while turning your head.

With the help of a therapist, survivors can also practice balancing on shifting surfaces like foam, grass, sand or seat cushions. Since your feet are not on a flat surface, you can’t use your feet to reference yourself. You are forced to use vision to balance yourself, thus strengthening this system.

Some Recommended Steps For Preventing Falls : Continue reading

There is Hope

Christmas is coming soon and what is more appropriate than to do a post giving HOPE to stroke survivors! Basically a Stroke causes brain damaged or more accurately brain cells damaged. Contemporary Medical Science says that there is no way to recover that part of the brain that is damaged. The only hope for recovery is through the process of Physotherapy to train the good part of the brain to take over the function handled by the damaged part.

Research done at MIT by Elli Nedivi assistant professor of Neurobiology shows that the adult brain cells do grow contradicting what used to believe otherwise. In 3D time lapse images, the brain cells pushed out tentative tendrils that grows round neighbouring cells. What it means is that one day it is possible to grow new cells to replace cells damaged by stroke. (See the photo)

Although this is new and the growth detected were of a small scale but the fact that it grows is the amazing thing said Nedivi. Lets pray and hope that as research progresses it won’t be too far a distant future to see big strides in this area and one day stroke survivor can re-grow the damaged part of the brain!