Strokes that cause one-sided weakness often have another frustrating consequence: swelling in the affected arm and hand.

Managing Arm Swelling Following a Stroke

Strokes that cause one-sided weakness
[https://www.neofect.com/us/blog/hemiplegia-vs-hemiparesis] often have another
frustrating consequence: swelling in the affected arm and hand. In a
normally-functioning arm, muscle and joint movement pump lymph (tissue fluid)
throughout the body. Weakened arm muscles from a stroke are less able to pump,
causing fluid to accumulate towards the bottom of the limb. This fluid buildup
results in arm swelling, which is also known as edema. Early recognition and
treatment of edema is vital to prevent pain and improve arm function. (1, 2)

Strategies for managing post-stroke arm swelling:
 1. Elevation
 2. Compression
 3. Massage
 4. Exercise
 5. Electrical stimulation

 Elevation
“Dependent” or downward arm positioning can contribute to edema, as gravity will
pull tissue fluid to the lowest point of a weakened limb. Elevating the limb
throughout the day can help reduce fluid pooling and associated swelling. When
in bed at night, prop up your arm with pillows, ideally above the level of your
heart. During the day, you can try to keep your arm higher than your lap by
supporting it with pillows, a padded chair armrest, or with an arm trough or lap
tray if you are a wheelchair user.



 Compression
Compression garments for the hand and arm may help push tissue fluid from the
bottom of the limb back into bodily circulation. There are various types of
compression gloves and sleeves that can be considered for edema. It is best to
seek advice from a healthcare professional before purchasing a compression
garment, as they often need to be sized for your body to work correctly.

 Massage
Edema massage can assist with fluid circulation throughout the affected arm. It
is best to consult with a therapist or nurse who is also a certified lymphedema
specialist to teach you to perform this technique, as it involves specific
pressure, speed, and direction of massage strokes on the swollen limb. Massage
is contraindicated with some health conditions, and should not be performed if
you have blood clots, heart or kidney failure, or certain cancers.



 Exercise
Exercise is an excellent way to manage edema. Whether you can move the affected
arm by itself, or you have to move it with the help of your strong arm, getting
your muscles to shorten and lengthen can help reduce swelling. Depending on how
strong your affected arm and hand are, you may chose to complete active
movement
exercises
[https://www.health.harvard.edu/pain/5-exercises-to-improve-hand-mobility-and-reduce-pain] 
with or without additional weights or passive stretches
[https://www.drugs.com/cg/passive-range-of-motion-exercises.html]. Both
techniques can pump pooled tissue fluid back towards the heart. Exercise also
helps maintain joint flexibility and can improve overall strength and arm
function. (1 - 3)



 Electrical Stimulation
Your occupational or physical therapist may perform electrical stimulation
(e-stim)
[https://www.neofect.com/us/blog/electrical-stimulation-for-stroke-recovery] to
reduce hand swelling following a stroke. This treatment modality involves
application of electrode pads over the skin for the targeted transmission of an
electrical current. There are many types and purposes of e-stim; however,
studies show that certain stimulation parameters can enhance vascular
circulation or aid in muscle pumping to move excess tissue fluid throughout the
body. (4)

Watch for out for dangerous swelling
If you have arm swelling that also associated with redness, pain, and skin that
is warm to the touch, seek medical advice immediately as this might indicate a 
blood clot [https://www.healthline.com/health/blood-clot-in-arm#symptoms]. It is
always a good idea to discuss edema management strategies with your medical team
to find out which techniques might work best for your particular case before
beginning a routine.

The Neofect [https://www.neofect.com/en/] line of Smart Rehabilitation Solutions
[https://www.neofect.com/us/for-home] can serve as a part of an active movement
exercise program to help manage edema and improve upper extremity function
following stroke. Our neurorehabilitation products include support from 
occupational therapists [https://www.neofect.com/us/therapist] to maximize
functional gains. Please call (888) 623-8984 [tel:+18886238984] or email 
info@neofect.com for further inquiry.





 * References

 1. Boomkamp-Koppen, H. G., Visser-Meily, J. M., Post, M. W., & Prevo, A. J.
    (2005). Poststroke hand swelling and oedema: prevalence and relationship
    with impairment and disability. Clinical Rehabilitation, 19(5), 552–559.
    doi: 10.1191/0269215505cr846oa
    
    
 2. Leibovitz, A., Baumoehl, Y., Roginsky, Y., Glick, Z., Habot, B., & Segal, R.
    (2007). Edema of the paretic hand in elderly post-stroke nursing patients.
    Archives of Gerontology and Geriatrics, 44(1), 37–42. doi:
    10.1016/j.archger.2006.02.005
    
    
 3. Miller, L. K., Jerosch-Herold, C., & Shepstone, L. (2017). Effectiveness of
    edema management techniques for subacute hand edema: A systematic review.
    Journal of Hand Therapy, 30(4), 432–446. doi: 10.1016/j.jht.2017.05.011
    
    
 4. Faghri PD. The effects of neuromuscular stimulation-induced muscle
    contraction versus elevation on hand edema in CVA patients. J Hand Ther.
    1997;10(1):29‐34. doi:10.1016/s0894-1130(97)80008-7
    
    


--

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Stroke Recovery

Spinal cord injuries can happen in a variety of ways, a traumatic injury or a disease. These types of injuries result in damage to the spinal cord. 

Difference Between a Complete Spinal Cord Injury and Incomplete Spinal Cord Injury


Spinal cord injuries (SCI) can happen in a variety of ways, whether that’s
through a traumatic injury (i.e. motor vehicle accident, shallow diving, acts of
violence, or sports injuries) or a disease acquired at birth or later in life
(i.e. tumors, electric shock, loss of oxygen related to surgical or underwater
accidents). These types of injuries result in damage to the spinal cord by a way
of dislocation, compression, fracture, burst, hyperextension, or hyperflexion.
The spinal cord doesn’t have to be cut in order to have a loss of function.

Understanding the levels of Spinal Cord Injury

Cervical Spinal Cord injury- C1-C8: Cervical spinal cord injuries results in
paralysis or weakness in the arms and legs which results in quadriplegia. This
region of the spinal cord controls our head, neck, arms, legs, and diaphragm.
Our neck is so fragile do to its flexibility that it makes it difficult to
stabilize after an injury so it may result in the person wearing a neck brace or
a stabilizing device. Cervical injuries are accompanied by loss of sensation,
bowel and bladder function, regulating body temperature, and sexual dysfunction.

Thoracic Spinal Cord Injury-T1-T12: Thoracic spinal cord injuries are not as
common due to the protection it receives from the rib cage. These types of
injuries cause paralysis or weakness in the legs along with loss of physical
sensation, bowel, bladder, and sexual dysfunction. Arms and legs are not usually
affected in these types of injuries. To help produce stability for the trunk
patients usually wear braces around the abdomen.

Lumbar Spinal Cord Injury- L1-L5: Lumbar spinal cord injuries only affect the
lower extremities which also is referred to paraplegia. Physical sensation,
bowel, bladder and sexual dysfunction can also be lost during these types of
injuries. Lumbar injuries usually require surgery and external stabilization.
The lumbar region of the spinal cord controls signals to the back, abdomen, and
buttocks, along with some aspects of the external gential organs.

Sacral Spinal Cord Injury- S1-S5: Sacral Spinal Cord injuries cause loss of
bowel, bladder and sexual dysfunction. They can cause weakness and/or paralysis
in the hips and legs. Sacral region of the spine controls signals to the thighs,
lower parts of legs, feet, and gential organs

There are two types of spinal cord injuries: Complete and incomplete injuries.



Complete Spinal Cord Injury happens when the spinal cord is compressed or
severed completely which affects the ability of the brain to communicate motor
and sensory functions to the body below the level of injury. Symptoms of a
complete spinal cord injury could be loss of sensation below the level of
injury, complete loss of function below the level of injury, unable to control
bowel or bladder, and depending on how high the level of injury is a person
could have difficulty breathing.

Incomplete Spinal Cord Injury happens when the spinal cord is compressed or
injured but the brain still has the ability to send signals below the site of
injury. The effects of this type of injury vary. Symptoms of an incomplete
spinal cord injury could be retaining some sensation below the site of injury
that comes and goes, being able to move some muscles below the level of injury
or pain having chronic pain below the level of injury. For example, a patient
recovering from a spinal cord injury from an infection may regain a large about
of function back.

Spinal cord injuries are unpredictable and vary from person to person depending
on the level and type. After a spinal cord injury the goal is to restore as much
function as possible to a person's body in order to perform activities of daily
living (i.e. cooking, getting dressed, showering, bathing, toileting, etc) and
get back to living life. The best way to do this is to find a good inpatient
hospital or outpatient center with intense therapy to help teach you ways to
increase your daily function whether that's through exercises, compensatory
techniques, or assistive technology. Throughout the process of recovering from a
spinal cord injury it is vital to remember that each patient still can fulfill
their dream of living life to the fullest it may just look different.