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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