Problems with sensation are common for stroke survivors. Up to 85% of stroke patients will suffer from some form of sensory impairment. It’s one thing to exercise weak muscles during recovery, but how can we help sensations heal?
Right now, there isn’t a good strategy for the recovery of sensation impairments after a stroke. However, American doctors have found a possible solution. They discovered a particular exercise that helped one stroke patient with her sensation problems.
One woman’s recovery story
A 66-year-old woman was able to improve her abnormal sensations of tingling after doing home exercises for two months. She had suffered from a lacunar thalamic stroke, which is in the deep brain. She suffered from these sensory symptoms after her stroke as well as some functional issues of her left upper arm limiting her ability to type, reach overhead, and cook.
Doctors described the woman’s sensory symptoms as dysesthesia, which merely means “abnormal sensation”. The woman’s tingling would affect almost the entire left side including her lower face, arm, trunk, and leg. Sometimes, she described the sensation as feeling like a “metal-brace”.
After two months of close follow-up, the patient’s dysesthesias got better with her physical therapy program, which was initially not geared for her sensory symptoms. Therapy was directed at the joints that seemed to reproduce this “metal-brace” sensation. Her home exercises consisted of passive oscillatory joint mobilization, which is when your therapist gently moves your joint back and forth for you. It’s a pretty standard rehabilitation practice that is used for people who suffer from painful conditions.
She was doing these exercises 3-4 times each week for 20-30 repetitions. Her therapist taught her how to sit and open her chest with the help of a towel creating a smooth arc over her spine. The patient also performed cane flexion, which gently flexes the spine, as well as shoulder abduction and stretches of the arm with the towel supporting the spine. She also worked on wall walks in different positions.
After two months, the woman noticed her dysesthesias were much better. They were few and far between compared to before, and the intensity had gone down as well. She also had improvements in her left shoulder strength, mobility, and function.
It appeared that in this case, passive exercises in which your therapist mobilizes your joint for you helped improve dysesthesias. But how could this be? It turns out that because someone else is moving your body, brain activity possibly decreases, which helps to alleviate unpleasant sensations. The experts think that passive movement may actually block the hyper-excitement of brain nerves which often contribute to the phenomenon of abnormal sensation.
Are you experiencing sensory problems due to a stroke? You might want to consider passive oscillatory mobilization to see if it could help. Ask your physical therapist whether or not you can add this to your rehabilitation program. There aren’t any known side effects, so it’s worth trying!
The lead author of this case report is Kristina Griffin, Outpatient Orthopedics, Shirley Ryan Ability Lab, Chicago, Illinois, USA.
Ask your physical therapist if you can add this therapy to your rehabilitation program. There aren't any known side effects, so it's worth giving it a try!