Physical Therapy for Hemiparesis
One sided paralysis or weakness occurs when a stroke affects the corticospinal tract of one side of the brain. The right side of the brain controls the motor function of the left side of the body. The left side of the brain controls the motor function of the right side of the body. Thus when one side of the brain is damaged, it causes only one side of the body to be affected.
One-sided weakness in your arms, hands, face, chest, legs or feet can cause:
- Loss of balance
- Difficulty walking
- Impaired ability to grasp objects
- Decrease in movement precision
- Muscle fatigue
- Lack of coordination
How can physiotherapy help cure hemiparesis?
Positioning – It is important to position the weak arm or leg appropriately. When sitting, one can support the affected arm on a pillow, lapboard, or tray. If using one of these devices, make sure that the height is appropriate and not pushing the shoulder up too high. The leg during sitting should be positioned comfortably without too much rotation at the hip. Try to position the knee where it is facing forward and not out to the side or turned inward. The foot should be flat on the floor or footrest with no rolling of the ankle.
Strengthening – Strengthening and active range of motion exercises can be done with stroke patients who have hemiparesis. Patients with more severe paralysis may have some small individual movements that can be strengthened as well. Electrical stimulation (e-stim) can also be used to help activate and strengthen weak muscles.
Range of Motion – Moving the paralyzed or weak limb or extremity can help prevent stiffness and muscle contractures. Range of motion can be passive, active-assistive, or active depending if the extremity or limb can voluntarily produce any movement or if it has to be moved by an external factor such as a caregiver.
Orthotics (Braces) – One may be prescribed a wrist and hand orthoses (WHO), elbow brace, or ankle foot orthoses (AFO) to help maintain proper joint alignment, provide support to weak muscles, and prevent contractures.
Slings – There are various arm slings that help support the arm when subluxation is a problem. Subluxation occurs when the head of the humerus (upper arm bone) has dropped out of the shoulder socket due to weakened ligaments and musculature.
In addition to rehabilitation treatment, exercise at home and assistive aids can help increase mobility. Repeated practice and regular activity will help increase control and flexibility and re-establish nerve circuitry. You can learn specific activities to do at home that will help continue recovery after inpatient therapy. Always consult a healthcare professional physiotherapist before starting any exercises.