A stroke can happen in two main ways. Either there is a blood clot or plaque that blocks a blood vessel in the brain or a blood vessel in the brain breaks or ruptures.

HISTORY:

A 61 year old man (GV) self referred post left middle cerebral artery stroke in 2014 (speech and right arm function predominantly affected). GV is naturally left hand dominant, and still works as an accountant. Car licence was automatically cancelled after the stroke. Main therapy goal was to:

• reduce right shoulder pain, and
• restore functional movement in the shoulder, wrist and hand.

EXAMINATION:

Right upper arm and shoulder pain, with limited shoulder, elbow, wrist and hand range of movement and power. Poor ability to stabilise muscles around the scapula. Increased spasticity in right arm flexor muscles

TREATMENT:

GV commenced a program of specific scapular muscle retraining exercises, with manual techniques to loosen tight structures and bilateral functional exercises to promote motor relearning. GV has been extremely committed to his recovery, also attending separate hydrotherapy and gym sessions.

OUTCOME:

GV now has full range of motion at his shoulder and elbow, with no shoulder or upper arm pain. He successfully passed his driver's licence practical test, and has recently begun swimming and tennis. Spasticity in the right arm has improved with only localised index finger tone on effort. GV continues to have regular reviews, with a refined goal of finger and wrist  fine motor control and endurance.