We have been doing stretching exercises with a right sided stroke (left sided hemi). This patient tends to neglect her left side, she wont talk to anyon who is on her left side. When we first saw her, I thought that she didnt like me and only would respond to Jenna. After the second visit and continuing ed from out supervisor, we realised what it was.
This patient is bed bound and we are to stretch her affected arm. At the first visit we realised that the patient said her arm was too sore so that she could get out of stretching. We never pushed the patient past where she said there was pain but the next time we saw that patient we gave her a massage first and she didnt complain of pain at all and we were able to give a better stretch to her.
Another idea we had was to work her good arm, using a ball to squeeze to maintain her grip strength. When we do this she also allows us to stretch her arm better and tells us that its is "good".
In the days that wehave been seeing her we have felt that her contracture is improving slightly.
We have noticed that she doesnt wear a splint and that we beleive she would benefit from using one. We talked to our PT about it and as far as she was concerned she had had one, so she is currently following up about the splint.
It feels good when the patient now responds to us because she now remembers who we are.
I was happy with the way in which we worked out what worked with this patient for her to be compliant with Physio treatment.
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