Normal efficient movement can be affected by the following factors after a stroke:
- Joint range can be impaired and muscle length shortened – hand, foot, hamstrings, Achilles tendons, shoulder movement
- Gait or walking pattern require more effort and can be uncoordinated
- Balance, normal righting reactions are slower
- Falls or fear of falling
- Functional problems, reaching, grasping objects
- Contractures
- Pain (particularly shoulder pain)
- Pressure areas at risk due to reduced mobility
- Decreased mobility
- Increased dependency
- Limb paralysis
After her stroke Sally is much slower performing functional tasks like making tea. She has to focus on balance and the position of her body in relation to the task. She may not be able to balance for long periods. Her movements require much more effort. Coordination, strength and grip have been affected. She may have difficulty opening cartons and jars. If she has muscle shortening or a contracture she may not be able to reach and grasp objects she needs. There may be sensory loss which could lead to dropping objects or risk of injury from spilling hot liquid.
An Occupational Therapy assessment along with Sally’s self management priorities and goals could help her to position her affected upper limb in stretched positions, relaxed positions or using bilateral techniques to improve both her tone and performance.
When assisting your patients during functional tasks, bear in mind the position of their limbs and use the task to move or support the limb in as normal a movement pattern as possible.
Page last reviewed: 01 May 2020