Arm Care After a Stroke
What is arm care after a stroke?
Many people who have a stroke are left with problems with 1 of their arms. Correct
arm care after a stroke can help treat these problems. It can also help prevent new
problems. Arm care after a stroke includes techniques such as correct positioning.
A stroke happens when part of the brain is deprived of oxygen. This can happen if
a blood vessel to the brain gets blocked (ischemic stroke), or if there is a bleed
in your brain (hemorrhagic stroke). This causes some of the cells in your brain to
Stroke often causes paralysis or weakness of one or more of the muscles in your arm
or shoulder. The muscles might feel tight instead of weak (spasticity). In general,
stroke might increase or decrease the muscle tone in these muscles. You may also have
numbness or limited feeling in your arm.
The shoulder is a key problem area after a stroke. The shoulder blade and the upper
arm bone come together to form the shoulder joint. This joint is shaped like a ball
and socket. Problems with the shoulder muscles can cause this joint to partly dislocate
due to the weight of your arm. This partial separation makes your shoulder droop down.
The partial separation can cause pain with movement and a sensation that your shoulder
is out of joint. Muscles, tendons, and ligaments can become overstretched. These muscle
problems can lead to other shoulder problems as well, such as reduced range of motion.
Some of the muscles may also be permanently shortened. This is called contracture.
Correct arm care after a stroke helps prevent and treat these problems. Arm care may
Placing the arms in the correct position
Using devices such as a sling or brace
Preventing further injury
Why might I need arm care after a stroke?
If you have had a stroke, you may need arm care treatment while you recover function.
Some people who have a stroke need treatment for trouble with the muscles of their
arm or shoulder, and shoulder pain is common. This treatment often starts right after
a stroke. Even if you only have minor harm from your stroke, correct arm care can
help prevent future problems.
For instance, correct positioning of your arm is important. You may not have proper
feeling in your arm and shoulder. So it's easy to damage your arm without knowing
it if you don’t keep your arm in the correct position. Some people still have shoulder
pain and arm problems months after a stroke. This may need specific rehab (rehabilitation)
What are the risks of arm care after a stroke?
If your arm is paralyzed, you may be at higher risk for bone fracture.
How do I get ready for arm care after a stroke?
Learn everything you can about your treatment plan. Your healthcare team will work
with you to design a treatment plan specific to your needs. You may work with a physiatrist.
This is a healthcare provider who specializes in rehab medicine. You will likely work
with a physical therapist. This is a therapist who can teach you safe exercises to
improve the strength, endurance, and range of motion in your arm, shoulder, and hand.
An occupational therapist can help you learn to regain skills needed for everyday
living using your arm. This may include using assistive devices, such as braces or
Expect your treatment plan to change as you recover. Talk with the members of your
medical team about how things are going. If an exercise causes pain, stop the exercise
and let someone know right away.
What happens during arm care after a stroke?
Preventing partial separation, or subluxation, is one of the most important goals
of arm care after a stroke. To prevent this problem, you must protect your arm at
the shoulder joint.
You will need to control the shoulder joint during movement. It's important that all
your caregivers know about the correct ways to help you. No one should pull on your
arm. Damage can result from getting underarm support to stand or walk. Instead, support
your affected arm and use your strong arm to help pull yourself up.
Support devices may also be part of your treatment. You may need to have your arm
in a sling or harness after your stroke. This will support your arm and help prevent
more damage. If you’re in a wheelchair, the chair’s arm support may also help. Other
devices include special lap trays or pillows. You may need to use these for weeks
Other types of proper positioning after stroke include:
When lying on your unaffected side, use 1 or 2 pillows for your head. Your affected
shoulder should be forward with your arm supported on a pillow.
When lying on your affected side, use 1 or 2 pillows for your head. Your affected
shoulder should be positioned comfortably.
When sitting up, sit fully back into the chair. Place your arms forward onto 2 pillows
on a table. Your feet should be flat on the floor.
When lying on your back, place 3 pillows supporting both your shoulders and your head.
Place your affected arm on a pillow.
When sitting in bed, sit upright, with support by pillows. Place both arms on pillows.
This is often only recommended for limited periods.
Your physical therapist will make other suggestions about positions that are safe
and comfortable for you. They may also start physical therapy exercises with you.
These are to help you regain strength and flexibility in your affected muscles. This
might include muscle stretches, strengthening exercises, and range-of-motion exercises.
What happens after arm care after a stroke?
Some people regain full use of their arm in the weeks after a stroke. Many others
still have some weakness, pain, or other problems with their arm. You may continue
to benefit from arm therapy. Your medical team can tailor your treatment plan to your
If you continue to have arm problems, your healthcare team might try other treatments
Constraint-induced movement therapy. This involves using your affected arm a lot and not using your unaffected arm. A
therapist might help you with this. Or it could be robot-assisted.
Botulinum toxin injections. This can help to reduce tightness in the arm muscles.
Electrical stimulation of muscles. The weak muscles in your arm or shoulder may be treated with electricity. This can
help to help strengthen your weak arm.
Electrical stimulation of the brain. This may be done during rehab exercises, and may help increase mobility.
Motor imagery. This method may help improve arm use.
Biofeedback exercises. These may help you regain mobility and reduce pain.
Pain medicine. These may be needed to decrease shoulder pain if subluxation has occurred.
Spasticity medicine. These are used to ease muscle spasms and loosen your arm.
Depending on your case, these treatments might be used early or late in your therapy.
Ongoing physical therapy may also help you ease chronic pain as you regain your strength
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