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Compensatory Strategies for Stroke Patients: Are They Stepping Stones Toward Recovery?

physiotherapist helping a stroke patient to use compensatory strategies safely

Compensatory strategies allow stroke patients to use “shortcuts” that work around limited mobility.

If a stroke survivor eats with her left hand, when normally she holds a utensil with her right hand, she is using a compensation strategy.

Sometimes compensation is necessary for carrying out the activities of daily living and ensuring safety. But many patients reach a “tipping point” where compensation gets in the way of recovery.

You’re about to learn when it’s appropriate to use compensation techniques, and when you should challenge yourself to stop.

This will help you get as close to a full recovery from stroke as possible.

What Counts as Compensatory Strategies for Stroke Patients

Compensation involves accomplishing a task in a different way than before injury. A common compensatory strategy seen in stroke patients is leaning the trunk forward to reach an object instead of fully extending the affected arm.

Recovery, on the other hand, involves accomplishing a task the same way you did before injury, with minor neurological deficits. This involves working hard during rehabilitation so that you can use your affected arm to reach for an object like normal.

It’s important to note that compensatory strategies are not bad. They are helpful and necessary sometimes.

But there often comes a “tipping point” where stroke patients can accomplish tasks without them. Over-reliance on compensatory strategies after this tipping point gets in the way of recovery.

To prevent this from happening, you need to first understand spasticity and synergy patterns.

When Spasticity and Synergistic Movement Get in the Way

shoulder taping on stroke patient

©iStock.com/julief514

Many stroke patients struggle with “normal movement” after stroke because of spasticity and synergy patterns.

Spasticity involves stiffness of the affected muscles. It can make it difficult to open your hand or fully extend your arm.

Synergy patterns disrupt “normal movement” by causing agonist and antagonist muscles to misfire. This can cause the shoulder to hike when you try to move your affected arm forward, for example.

It can be encouraging for patients to view these “problems” as signs of recovery from stroke, because they are!

The presence of spasticity means that the patient is not paralyzed. And the onset of synergy patterns means that movement is returning to the body.

Spasticity and synergy patterns will diminish over time as long as the patient continues with physical therapy and rehabilitation. Mobility will improve as a result.

Then, somewhere along the way, the stroke patient will outgrow the need for certain compensatory strategies. But when?

Curiosity Is the Cure for Compensation Techniques After Stroke

Remember that compensatory strategies for stroke patients are helpful, but eventually get in the way of recovery.

To work past the need for compensation techniques, you need to constantly question your methods — preferably on a daily or weekly basis.

Each morning, or each Monday, ask yourself, “What am I doing differently than before, and where do I feel ready to challenge myself?”

Never give up compensatory strategies that are necessary for your safety, like using a cane or walker, without consulting your therapist. When you’re on your own, start small.

For example, if you noticed that your lean your trunk forward when you reach for the table salt, see if you can sit back and extend your arm to get it.

And if you can’t do it today, try again next week. This is how you can prevent yourself from getting stuck in a rut and keep progressing.

Benefitting from the Slow Pace of Stroke Recovery

stroke patient holding up dumbbells with help of a physical therapist

©iStock.com/Victor_69

Aside from curiosity, recovery will also involve slowing down and doing things the “slow” or difficult way.

Choosing to slowly use your affected arm instead of leaning forward means you might take longer to accomplish certain tasks. Try to be patient when doing things without compensation techniques.

When you slow down and accomplish tasks normally (the way you did before injury), you are stimulating your brain. It doubles as physical therapy.

Stimulating your brain this way will help you strengthen the neural networks responsible for movement. The more you practice, the better you’ll get thanks to neuroplasticity.

This is how you can improve your chances of a full recovery from stroke. Patients that accomplish a full recovery are constantly challenging themselves to do things the “hard way” – without compensatory strategies.

Although it’s more difficult, and perhaps more frustrating, it leads to more recovery in the long-run.

Maximizing Motor Recovery After Stroke

Compensatory strategies should not be viewed as bad. They are often helpful and necessary to get things done safely.

However, if patients become too reliant on these “shortcuts,” they may get stuck in a rut and stop progressing.

But if patients remain curious and constantly challenge their compensation techniques, they’ll have the best chance at recovery.

Featured image: ©iStock.com/Victor_69

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See how Susan is recovering from post-stroke paralysis

“I had a stroke five years ago causing paralysis on my left side which remains today.

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