There are many effective methods for regaining arm movement after stroke. Which one will work best for you? The answer is that it depends.
Regaining mobility after a stroke works differently for everyone based on your unique conditions, such as whether you lost partial movement or struggle with post-stroke paralysis. Fortunately, rehabilitation methods can be adapted to all ability levels.
Experimentation is key, so this post will explore the best practices for regaining arm movement after stroke. We hope it inspires you to take action.
Use the links below to jump straight to any section:
- Why Does Arm Weakness or Paralysis Occur?
- How to Regain Use of Your Arm After Stroke
- Methods for Regaining Arm Movement After Stroke
- How Long Does It Take to Regain Arm Movement?
- Getting Movement Back in the Arm
Why Does Arm Weakness or Paralysis Occur After a Stroke?
To understand how to regain arm movement after stroke, it helps to understand why arm movement becomes affected in the first place.
All voluntary movement in the body is initiated from the brain. The brain tells your muscles to move by sending signals via neural pathways to the appropriate muscles.
A stroke is a neurological event that compromises the supply of blood in the brain, which causes damage to the neural pathways in the affected area. Therefore, when a stroke impacts the area of the brain that controls arm movement, it can cause weakness or paralysis in the arm.
Usually there is nothing wrong with the arm itself. Some muscle atrophy (when muscle tissue wastes away) may occur if a survivor stops using their affected arm. But aside from that, the arm muscles themselves are unaffected.
Paralysis or weakness of the arm is caused by damage to the brain. Thus, recovering arm movement after stroke revolves around healing the brain and rebuilding neural pathways.
This is possible through neuroplasticity, your brain’s natural ability to rewire itself and learn new skills or re-learn old skills after a neurological event like stroke.
How to Regain Use of Your Arm After Stroke
Although you cannot revive dead brain cells, the brain is incredibly adaptive. It can recruit new, healthy areas to take on lost functions through neuroplasticity.
This means that, although you cannot “cure” brain damage, the brain is resilient and function can be recovered. For example, in extreme cases where someone has a hemispherectomy (removal of half the brain), neuroplasticity allows the remaining half of the brain to eventually function as the whole.
The brain’s neuroplasticity occurs based on your experiences and practices. To regain use of your arm after stroke, you need to encourage your brain to adapt through repetitive practice.
When we practice something, specific neural pathways in our brain are activated. Initially, these pathways might be weak. But when you practice a skill over and over, these neural pathways become stronger. For example, we get better at riding a bike by practicing it.
For this reason, the best way to regain arm movement after stroke is by practicing arm rehabilitation exercises. Practice helps strengthen the neural pathways in your brain that tell your arm muscles when and how to move.
Although movement may feel difficult or clumsy at first, continued practice will improve arm mobility over time.
Methods for Regaining Arm Movement After Stroke
Below you will discover almost a dozen different forms of therapy to help improve mobility in your arm after a stroke. You will notice some common threads among them: practice, repetition, and movement. These are the keys to stroke recovery.
Here are some methods your therapist may recommend for regaining arm movement after stroke:
1. Arm exercises
As previously mentioned, practicing arm rehabilitation exercises is the best way to regain arm movement after stroke. It stimulates the brain and encourages neuroplasticity.
While creating any kind of rehabilitation exercise regimen, it’s important to find balance. Aim to feel challenged but not frustrated by your exercise program.
Also, remember to pay attention to the quality of your movements. While the quantity of exercises helps to form and solidify neural pathways, practicing good quality movement patterns is essential to recovering optimal arm mobility.
If you have no movement in your arm, the next option will be a more suitable start.
2. Passive exercises
What if your affected arm has no movement after stroke? Can exercise help with paralysis recovery? Absolutely!
Neuroplasticity works no matter how severely your arm mobility has been affected. What matters is that you are stimulating the brain by moving your arm.
Therefore, if your affected arm has no movement, you can exercise passively. This can be done independently by using your non-affected arm to move your affected arm through therapeutic arm exercises, or by having a therapist or trained caregiver move your affected arm for you.
Passive movements like this help stimulate the brain and activate neuroplasticity. With consistent practice, some survivors may be able to regain arm movement this way. Be aware the results will likely happen slowly.
For instance, you may start to see twitches in your arm after a few months of practice. This can be a sign that your arm is starting to “wake up.” Hopefully progress like this helps motivate you to keep pursuing recovery.
Also, even if you do not see results right away, rest assured that passive exercise is still benefitting you. It’s important to move flaccid (paralyzed) limbs through their range-of-motion to help prevent muscle shortening and joint stiffness.
3. Mental practice
Visualizing yourself practicing something helps activate neuroplasticity the same way that physically practicing does. This is why professional athletes spend time visualizing themselves playing their sport to improve their game.
“Mental practice” has positive implications for stroke survivors with paralysis. Even if you can’t move your arm yet, you can still visualize it and activate neuroplasticity.
Combining mental practice with physical practice leads to better results than just mental practice alone. Try spending 5-10 minutes visualizing your arm exercises before actually doing them.
4. Mirror Therapy
Sometimes, therapists may use mirror therapy to help survivors better visualize their affected limb moving. A mirror is placed at the center of the body facing the non-affected limb. When a survivor working to regain arm mobility moves their non-affected arm, the mirror reflects an image that appears to be their affected arm moving, tricking the brain into visualizing the affected arm moving.
5. FitMi Home Therapy
FitMi home therapy is a high-tech, interactive exercise device. It’s designed to help you achieve high repetition of various rehabilitation exercises, including exercises for the arm. Many stroke survivors have used it to regain movement in their arm after stroke, even if they started with no movement. (See a success story here.)
The primary benefit of using FitMi is the motivation to intensify rehabilitation with highly repetitive exercises. Some other benefits of using the device include diversified feedback (such as auditory and haptic feedback) which provides even more stimulation to the brain. FitMi also adjusts your exercise program to suit your ability level. That way you stay challenged but not frustrated.
6. Botox Injections
Spasticity is a condition characterized by muscle stiffness, and it’s a common effect of a stroke. If your arm mobility has been affected, it’s likely that you have some spasticity in your arm, too.
Arm rehabilitation exercise helps reduce spasticity, but sometimes spasticity itself gets in the way of exercise. Thus, when spasticity is severe, you can use nerve blockers like Botox to temporarily reduce the spasticity. While the effects eventually wear off, requiring repeat treatments, it can help loosen your arm up enough to practice exercises.
This creates a window of opportunity to get neuroplasticity activated so that, eventually, you won’t need repeat Botox injections. Instead, your arm spasticity will naturally go down and mobility improvements you’ve made will carry over and continue to progress through further rehabilitation.
7. Arm Splints
If you have severe spasticity or paralysis in your arm, you can also use splints to prop your arm or hand open. After doing this, you can do little exercises like this video with popular YouTube physical therapists, Bob and Brad:
Note that Bob and Brad emphasize the importance of repetition in the beginning of the video. Regaining arm movement after stroke is all about establishing new neural pathways in the brain.
8. Constraint-Induced Movement Therapy
Another rehabilitation method used for regaining arm movement after stroke is constraint-induced movement therapy. It involves restricting your non-affected arm to encourage you to use your affected arm. One way to do this is to place an oven mitt over your non-affected hand while doing an activity to encourage you to use your affected arm and hand.
This type of therapy is proven to be effective, but it can also be frustrating because you cannot use your non-affected side. Remember that therapy should be challenging but not frustrating. Although oftentimes CIMT is most effective when used for the majority of the day in conjunction with intensive therapy, consider trying it for shorter periods of time and work your way up if you find yourself getting too frustrated.
9. Electrical Stimulation
Electrical stimulation is another arm rehabilitation technique with plenty of research behind it. It works by applying electrodes to the skin over the muscles responsible for the affected movements. When electrical stimulation is applied through the electrodes, the current causes the muscles to contract, resulting in arm movement. Studies have shown that pairing electrical stimulation with rehabilitation exercise leads to better results than just e-stim alone.
Consult with your therapist before attempting e-stim on your own. Your therapist can show you the right areas to place the electrodes and how to use the machine safely. Those with affected sensation in their arm should be especially careful using e-stim, checking the skin for any redness or irritation as needed.
10. Arm Pedaling
An arm peddler is a great piece of stroke rehab equipment for arm mobility because the movement is bilateral. This means that you can use your non-affected arm to assist your affected arm, which is therapeutic during rehabilitation.
Bilateral training like this is particularly beneficial for stroke survivors starting with limited arm mobility. Although you are relying on your non-affected side to initiate movement, both sides are still moving, which helps stimulate the brain.
11. Weight Bearing
Another way to increase use of your arm is by bearing weight through it. This can be done while sitting or standing, and involves setting your affected forearm or hand on a surface and putting some of your weight through it. This helps to provide input from your arm to your brain to rewire their connection through neuroplasticity.
Weight bearing can also be easily incorporated into your normal daily activities by leaning on your affected arm while it is on the countertop during teeth brushing, on the armrest of your chair while chatting, or on the table while you’re playing cards. By doing this, you can be activating neuroplasticity and promoting recovery without really thinking about it.
How Long Does It Take to Regain Arm Movement After a Stroke?
After exploring all these arm rehabilitation methods, you might be wondering how long it will take to regain movement.
Every stroke is different and therefore every recovery will be different. It’s impossible to determine any single person’s stroke recovery timeline.
The results you see will depend on a variety of factors such as the size of your stroke, the area of the brain affected by stroke, and the intensity of rehabilitation — just to name a few.
When you stick with something consistently and put in the reps, the brain will respond. For example, one stroke survivor regained initial movement in his paralyzed arm within three weeks of daily exercise with FitMi home therapy.
Not everyone will experience the same results. Therefore, instead of focusing on how long recovery will take, focus on finding the right rehabilitation method for you and sticking with it.
Consistency is a great way to improve your chances of recovery and see results as quickly as possible.
Getting Movement Back in the Arm After Stroke
Regaining arm movement after stroke is all about finding the right rehabilitation method that works for you.
Gentle rehabilitation therapies such as passive exercise or mental practice are great starting points if you have no movement in your affected arm. Other therapies that encourage high repetition, such as FitMi home therapy, help accelerate results by intensifying rehabilitation.
Remember to choose something that’s motivating but not frustrating and you’ll be on the road to recovery.