Seriously you are awesome.... Kinda sad where some therapists can't relate but you can on TH-cam especially the video being three years old. Thank you.
After following your recommendations and doing lots of your exercises daily since 3 months, my muscle tone goes down and the muscles in leg and arm really relax gradually. Thank you so much, Dr. Tara! I am watching one video every evening before sleep and watch them repeatedly to implement as many stretching as possible. Great results, especially with the very basic, calm long stretches. 🧡💖🧡
I love your vedios doctor realy helpeed me so much iam from egypt and lam 40 years old and l have a stroke from 4 months and you helped me so much and given me a hope thank you so much for help others
i am a 70 year old man who had a stroke 5 months ago. Your videos explain what I am going through. Hopefully your videos will help me to walk correctly in the future. I am happy to take it on the gradient that you present. I am working simple to hard. Thanks!
Steve Hall we watch your videos and find them vey helpful I am battling with balance on my involved leg because of a knee injury it has no cartilage and I do not trust the leg it is really painful to put my weight on the leg we are doing leaning against the wall but I am just not getting there with this knee
Hi guys! Just to clarify one point that came up today. When you do the exercise with your legs crossed the involved leg is on the bottom. The weight of the top leg (uninvolved) places more downward pressure on the involved leg to give more weight bearing through the foot.
Thank you very much. I was diagnosed with foot drop and given an FES unit but I realise I have been misdiagnosed as my knee locks out and I turn over on my foot. I have started doing your e exercises and already managed to stop the foot rolling. I will continue with these and show your videos to my physio. Thank you again.
Hi Dr Tobias! Oh my! our videos are very educational. Thank you so much for taking the time to create them. I wish to pick your brain about my particular situation. But first here's a little background on the matter. It's been over almost 2 years since my stroke/seizures. I was in a wheelchair for a couple of months as I couldn't walk after I woke from a coma. It took a lot of work and tears but I began to take some steps after a couple more months. Since then, my gait has been poor. At the time, it was believed that it was because I only started walking again after that much time of being unable to. Well, about 3 months ago I noticed that I was walking on the outside of my foot, of course I brought this up with my providers and care team. I saw a slew of experts in an effort to figure out what the problem was and a way to resolve it. In one of my doctor's notes, I noticed the phrase "inverted foot". Up to that point I didn't know how to medically describe what was happening to my foot and I'm grateful for that. I was able to use that phrase to search for resources about that on the internet. Luckily, I saw your video on "Inverted Foot" and there, you described exactly what I was experiencing. Well long story short, I followed your advice and was able to see an orthotist about a suitable brace for my foot. However, that didn't magically solve my problem as I expected it would, thankfully, they are sources was very portraits about this situation refusing to give me any brace until he sees a recommendation that would manage both situations simultaneously. This is because the problem was not just "inverted foot" but there is something else added to the mix. So, the thing is that as I attempt to walk, my toes point upward and stay pointed that way for the duration of the walk and the only time they stay down is when I stand on both feet and focus on putting a bit more weight towards the tippy toes of the involved foot, which oftentimes leads to me almost toppling over. What are your thoughts on this? I'm still working on finding a physical therapist that focuses on neuro rehabilitation. I've not been lucky yet in that regard. Please do let me know what you think and/or point me in the right direction where to go searching. Thank you very much for your help. I appreciate you. Thanks again for taking the time to make these videos. You are a godsent.
Wao Dr ,u are such a blessing to me. After I got frustrated about progressive exercises for stroke patients. Av learnt alot. U're God sent. Keep doing the good job. U inspire us young physical therapists. I really wanna learn more about treatment protocol for stroke patients . Thanks a million
Every since I have been watching your videos, I realized you were describing my problem. I have been doing physical therapy since June 2019 and my foot and leg never changed. I am starting your exercises. I hope it makes a difference. Thank you.
I like the videos with the break which helps with progression. One process at a time and get next progressive step. Thank you for your time and investment towards our recovery!
This is a great video I started doing this on my front steps after seeing your other video with the steps. I didn’t do them every day but I do enjoy them. Especially since I thought I could not get on my bottom step I was nervous but it was super easy than I thought. I am planning on bringing them back into my routine. I enjoy these videos and spasticity and tone are my biggest problems which is something my therapists also said . Thanks and please continue .
Brilliant. I especially like where you introduced the shoulder turn into your pattern, Dr. That is where you got me. Call it a precursor, in this case an intent to act in the future...action and intent. Again, I love how you had determined in a previous video that learning to stand motionless for an extended period is an important teaching moment in the brain for learning how the motor-neuro-sensory system coordinates and times the transition from extension to flexion. I can see it in my mind as the internal actions of an escapement, that momentary click & hesitation we used to hear distinctively coming from inside the mysterious inner workings of the loud, spring-driven wall clock hanging in Aunt Ollie's kitchen. An ultimate coordination of rotational forces coupled with net vector movements at right angles along all 3 dimensions. You're turning 2 dimensional geometry into 3 dimensional trigonometry. So simply stated you managed to create a 3 dimensional movement pattern out of a two dimensional exercise. You froze the pose for a second, and in doing so established a clear demarcation in the mind of an initial first step in a continuation pattern. It took a bit but I think I understand you now. I can no longer think as fast as you speak but I def like the challenge. The shoulder turn then coordinates with the opposing hip turn/sway, which times the alternating arm/opposing leg swing & dorsi-flexing foot action. I know from other courses the medical profession likes to break anatomical locations down with Latin terms along horizontal and vertical axes to make it more convenient for doctors from different cultures to converse. Dorsi, meaning dorsal or on the top, in this case, on top of the foot. Hope that's correct. And what follows intent and action? It's entirely dependent on if there was any action that followed in the first place, because if we hesitate too long and stop there is nothing, and wow, aren't we humans good at both overthinking and inaction when faced with weighing the value of our intentions against the risks of our failing if we dare to take action? No stopping allowed. We soldier on. Results then of course follow actions, and then hopefully a little feedback cometh while making adjustments to our gait. Dr. Tobias's Philosophy of Motion on the Surface of a Sphere. Move over Isaac Newton. No, I am not mocking you, Dr. I love it. You are the exact opposite of your peers. You have zero qualms about sharing what you know.
Hi Andrew! Wow, you are definitely helping me to see my own thoughts from another's perspective :) Thank you for that. Of note, you can click the gear icon and adjust the speed of the video. Sometimes I talk too fast and sometimes I talk too slow. I still have not fully dialed that in. :) I am a work in progress. Oh, and by the way, as a self proclaimed "movement scientist", without Sir Isaac Newton, does life even exist? 🤷🏻♀️ 🙃
@@rehabhqofficial Okay, now you're the one who's showing off. I haven't figured out how to include imogis yet and you're putting them in upside down, lol. That's a very good question btw about the existence of life, especially far beyond our earthly domain. You caught me off guard with Newton's Philosophiæ Naturalis Principia Mathematica. Your split cultural Japanese heritage has gifted you with a much deeper understanding in the balance and forces of nature and movement in this life, as short as it is. Your yin, and the yang and feng shui, they are quite apparent in how organized and at peace you are in your own heart and within your space. I find it remarkable how sensitive and in tune you are with your patients and how much more aware you are of what stroke survivors have to deal with just to achieve some semblance of normalcy. I find comfort in your ways of understanding. Cogito ergo sum.
Thank you so much for your kind words! To know they are helping people is what keeps me going so I appreciate you and hope you will continue following!
I absolutely adore your videos. I’m new at TH-cam so I don’t know how to search by date, I’m trying to reference your first two videos part part one that says watch first
Thank you for all your hard work Dr Tobias you've taught me more than any physical therapy I went to or neurologist that I want to we really need your guidance and once again thank you it helps me so much
Thank you for your guidance and video clips .trying to stand straighbut it hard to move forward.iit takes times to do it.hoping I can do it in the future.
I'm focused on loading the left leg when walking with quad can trying to mimic single canebytmy brain won't let me be more confident goes into don't fall mode hard to concentrate to load the affected leg I'll keep practicing Thank you you're the best I wish you were up in Washington it eve great to do a virtual consultation right now I'm at a point where I'm trying to walk but I am walking with a clock game. Pretty decently but ready for the next progression. Thank you!
Just adding a creative taught to one of your tip. When legs are crossed, uninvolved leg over involved leg for weight bearing. Grabbing your involved wrist around un involved leg helps keeping fingers opened and to send gripping signals to the brain. Hope it helps all viewers. Wishing you all speedy recovery
Great information. In the case where the person can not flex both knees at all , the person is stuck in full knee extension after a brain injury. Where do you begin. What helps is that the person has dorsiflexion and extension to both ankles.
thank you so much, i have started all the exercises and also the standing and i already see results. thanks to you i understand more my body and the steps i need to make to come where i want after my stroke.
Have MS but struggles are same. The hypertonicity causes my foot to point downward and PTs in the past have tried to force the dorsiflexion. Frustrating for them and for me. So glad to have found you here before resorting to an invasive procedure
MY DOCTOR SAID I HAVE LOST MUSCLE STRENGTH IN MY LEG AND MY BACK MUSCLES ARE SO TIGHT THAT IS THE REASON I CANNOT STAND OR WALK. ANY THOUGHTS DR. TOBIAS? WISH I HAD A THERAPIST LIKE YOU. YOU ARE THE BEST!!!!!!
I have just come across these! Thank you fantastic..15 years ago bleed on brain or so more than likely very bad habits.. i didnt get any spasticity arm or leg.. they removed a bit of my cerebellum to reduce swelling. As a result I always look drunk.. I can walk a bit now. I use to walk "to the left"in a circle effectively...it wasnt funny, but saw one of your videos explained everything....thank you...I swing my leg...Im not conf on other leg.
Thanks a lot for this great content. Quick question- How many times in a day would you recommend doing these exercises? I understand from your video on neuroplasticity that one should try doing these exercises as much as they can to break the pattern. Still, can you please recommend the minimum number of times one should definitely do these exercises each day based on your clinical experience.
You have helped me soooo much to understand about spasticity, I am greatful. Please,will this help with a leg that is not extending to a stand. My brother's leg has started to move at his hip, but I can't get his knee to straighten. I'm doing the exercises with the wedge for the spasticity in his foot. But his ligaments and tendons seem not to want to loosen to extend the knee. Even some muscles in the thigh. They are starting to move some but I can't get the leg out of the bend at the knee. I've had 3 strokes myself. And was able by God, and a lot of walking and balancing to not go into high tone. But working my brother out of his very, very high tone has been very heart breaking and difficult. I get one area better and another gets tight. I just can't get his leg straight. Not sure if it's because his knee is not opening especially at the top of the knee cap, of if it's more muscles in the thigh that needs to lengthen. Soo frustrating. But thank you for all you do and give.
I wear an AFO, should I stand and do these exercises with it on? I’m already walking with the AFO and cane, I’m 31 months post stroke, but I’m sure I have a lot of spasticity in my leg. I see that this question was already asked. Thank you.
Hi Dr. Tara, how often should I be doing this exercises daily and how many reps? How can I tell when I am ready to move on to the next progression? Thank you!
Going back to this. I am beginning to walk without a cane. Minimally as it completely changes my gait, so I mostly use trekking poles to mimic a correct (arm/leg swings) walking motion. My issue is the toe lift up of toes 3, 4, &5 (roast beef, none, and wee wee wee). I can scrunch down to gather a towel, but I cannot lift up.
Thanks for watching and for commenting!! as far as the toes, practice whatever movement you are trying to achieve (hard to visualize your exact issue), either in sitting and/or standing versus walking. simplifying things might make it easier to focus on the toes. I hope that helps!
@@rehabhqofficial I think I get it. Maybe I can clarify to make sure. As a musician, I learned time/beats by tapping my toes. Foot flat on the floor and lifting the toes UP in order to tap toes. The same bend of the toes as the walking "push off" in normal movement patters. Based on your response, I think you are saying to hold my foot in that push off position, or a tippy toes position?
are these exercises to be done with afo on I have yet to recover my ham string use my quad on the affected side is pretty strong not near the other side what I am concerned about is when I walk I lurch to the left the left being my affected side I can walk with out using a cane butswing my leg around when I do
I I'm new in your content but listening to your theory makes just the sense to resolve lifting up the affected leg. I had a stroke in 2021. I have the probl of lifting up my left leg from the ground. My difficulty is that,the leg wiould seem stuck into the ground,and I will remain poised in that position for a minute or so before imt able to lift it up and follow up with my other leg. Now I would need to transfer weight from the former ground stuck leg to the healthy leg. This also becomes rocket science. The point I wanted to bring forward is; that everything you saying makes sense, but I can't see what you're doing behind your talking face.thank you
You are doing a great job i have a dought if a person with circumdactory gait will back to normal walking pattern if she tried to walk 1 month like that
Thanks for watching! Here is a series that might help: th-cam.com/video/N05oGFJMooA/w-d-xo.html(part one); th-cam.com/video/vBewElX9M08/w-d-xo.html (part two); th-cam.com/video/IxtP4wagMRE/w-d-xo.html
@@rehabhqofficial spasticity where! Generates hip or sciatica or sacroilliav and butt pain on non stroke effected side, but the leriche syndrome side..!?
as much as possible. Just to clarify, this will not "cure" spasticity but the more you stand, and do weightbearing activities, the body can learn how to move better (with the spasticity) when walking. I hope that helps!
How do we manage the patients that still have a high risk of having a new stroke, with hight bp, and cardiac issues, embolism? how do we work with them without creating the possibility for a new stroke to reappear ?
You could do the low seated exercises, seated on a chair with the feet elevated onto the low stool/step instead for people who have too much difficulty getting down to sit on the stool. They may just need assistance getting the involved leg onto the step.
Hi Find your videos to be very helpful Is there a way to schedule an online appointment with you I have written a couple of emails to you but didn’t get a response from your team Please help
I should add that I have been walking pretty well after left side weakness from a stroke 18 months ago, I would say my balance is pretty good, but my toes are still a problem.
It’s so sad for me to find your videos 5 years post brain surgery. I don’t know if it’s too late me to learn from your videos. My entire left side is effected by the surgery, I have issues with my shoulders, with my gait, with my balance, my toes curl and the list goes on. Can i undo the bad habits I develop?
My partner has a spastic hamstring and her knee always stays a little flexed while walking. While sitting her involved leg is flexed that it bends and goes beneath the chair and she is unable to get that leg forward. Her quads are weak. But during walking her foot goes in plantarflexion and inversion. What to do?
@@rehabhqofficial I still cannot stand from sitting. I am 70yo . I do need weight bearing to arms to strengthen it. I am a massive stroke survivor for 5 yo now. Please need help.
Thanks again for another great series of videos. I'm 18 months post stroke and am walking with and without a cane depending on conditions around me. I've just started the progression in this video (for about 3 days now) to see if loading the "flexure pattern" you talk about in this video will help my walking gait.. One modification, that I'm trying, is to sit in low rocking chair while weight bearing on my affected leg. I then rock back and forth while leaning on my affected leg with my elbow to increase the pressure. I think this is helping but I'd like to know if you think this is productive. Am looking forward Progressions 2 and 3 in a few more days.
Hi good day just wanted to ask when my is at rest I can move my finger freely but when I wanted to move it but itself it cannot...what I should I do to move it
Dr Tara, in my previous comment you replied that 5 years post surgery that it isn’t too late to begin to correct all the bad habits . I have been watching your videos but I am lost in terms of the sequence of the videos. My surgery to remove a brain cavernoma left me hemipligea with severe numbness and propioception. I currently walk with a cane but constantly trip on my own foot since I am not able to lift my toes when I walk. I had severe spasticity in my toes and ankle. Can you assist me by advising the correct sequence of your videos. I know I have a lot of work and it would help if I have a list . Thank you so much.
Thank you for watching. I am glad to have you as part of this community. My advice is to do as much as you can to stay mobile and keep muscles/joints moving :)
I don't have a stiff leg, I have toes that lock up, and my foot turns into a paw. I can control the stiff knee nut the toes are driving me crazy., as soon as I put weight on the foot it locks up.
Hi hello, are these exercises best suited for individuals whom experienced a recent injury (0-6months) or do they also aid individuals whom have had an injury for a longer amount of time?
This is an EXCELLENT question! It is NEVER to late to start. Our brains have some potential to create new nerve connections throughout our life. I encourage you to never stop working. You can be a little bit better if you put in the work. 😊
Eight years after I had numerous strokes I managed to be able to walk even if not correctly I then downloaded post stroke exercises from u tube and 2 days after doing these execises I cannot walk at all and I would like some comment on what could have gone
Jeffrey Johnson this channel provides general information and should never replace a face to face visit with a healthcare provider. Stop any activity that causes you pain. And in this case negatively impacts your walking or general mobility and seek in-person medical care
How about (when you’re trying to get somewhere) you get a sudden warm feeling down an affected limb (or leg in my case)? And no- it’s not pee, either… Fatigue would set in around the same time (I’m betting it was a bout of neurofatigue). I had my stroke a month ago, and I’ve been doing all the exercises my PT/OT as well…
Dorsiflex? I can cross my legs no problem and cross my legs no problems but I have dropfooot on my left leg I believe. I have burning sensa toon in my left leg foot! I’ve been walking for about 4 months. But my heel hurt now and then!
Hi Tara. I just started watching your videos. I like what you are showing and how you present the exercises. I however do get a bit lost sometimes as I am not medically trained and don't know much of the nomenclature you use. Like "Dorsey" and "Flex" and the muscle names like "Tibialias". I think for many of us its like having to learn a new language. Perhaps you could include a laymen"s simple definition as you go along. Thank you.
Thank you for watching!! I appreciate the feedback!! I do my best to simplify things as much as possible without losing the "why" behind the "what". Hopefully the images help a little but I will keep this in mind when making the videos :)
Believe, believe in recovery, it will come, it takes years, recovery can be done decades after the event. My recommendation is to put a dumbbell on the arm and leg in order to get a stretch. Make circular movements of the hands, legs, head. Gentle circular movements in all positions standing, sitting, lying down. Transfer weight to the injured leg, climb stairs with the injured leg. Sleep on a hard surface. Good luck with God's help.
Wish I could go to your clinic for evaluation and help but don't live near there. I am right hemiplegia for 25 years from a brain tumor. It never came back. First 21 years I managed to function well staying very active with kids and ministry. I walked usually without a cane unless hiking or uneven ground and fell only 3 times leaving bruises within 21 years. Now in past 4 years I’ve had a desk job and deterioted. I have fallen 3x a year always leaving bruises or even hurt tailbone doing simple things, this year 4x . I am back in therapy for past year and still falling even though they’ve strengthened my muscles. Current therapist not good at watching for mechanics. I do a lot of home exercises but know I'm missing mechanics help. I also got a sit/stand desk to help. Hamstring doesn't work well ( tummy leg lift really hard) can't get get over hurdles backward well always goes around it at least a bit Knees - don't lift high well when I walk - the locking has reduced drastically Foot is really bad- can lift toes but cannot move to side. Cannot do heel raise by itself the other foot has to also do it. Using a wobble board and have yoga ball thing for balance practice Ankle is improving, I think - I can deep squat holding one side of parallel bar with one hand. I think Kurtis fixed my hip movement - still do the exercises because I am not sure. My sit to stands and walking look awful. Whereas in the past some wouldn't even notice I was handicapped until winter came around and spasticity really kicked in. Sometimes my husband would tell me to limp more when using my handicap placard 😂 No need now. Any suggestions? I try to figure out where I fit in the ”progression” by trial and error but never sure.
Hands down the best series of videos for understanding regaining movement after stroke that I have come across (and I've done a LOT of looking).
Seriously you are awesome....
Kinda sad where some therapists can't relate but you can on TH-cam especially the video being three years old.
Thank you.
After following your recommendations and doing lots of your exercises daily since 3 months, my muscle tone goes down and the muscles in leg and arm really relax gradually. Thank you so much, Dr. Tara! I am watching one video every evening before sleep and watch them repeatedly to implement as many stretching as possible. Great results, especially with the very basic, calm long stretches. 🧡💖🧡
This makes me sooo happy! Keep up the great work! Hard work ALWAYS pays off 😊
Right! Muscle tone goes down. That was the crux of the lesson.
I love your vedios doctor realy helpeed me so much iam from egypt and lam 40 years old and l have a stroke from 4 months and you helped me so much and given me a hope thank you so much for help others
i am a 70 year old man who had a stroke 5 months ago. Your videos explain what I am going through. Hopefully your videos will help me to walk correctly in the future. I am happy to take it on the gradient that you present. I am working simple to hard. Thanks!
I use to stand and walk with a walker now I fell one day and my progress went backwards I feel. My legs are heavy and it hard to lift my feet.
I am walking with a cane at smaller pace. Hope I can walk unaided in the future through your videos. More power
Steve Hall we watch your videos and find them vey helpful I am battling with balance on my involved leg because of a knee injury it has no cartilage and I do not trust the leg it is really painful to put my weight on the leg we are doing leaning against the wall but I am just not getting there with this knee
excellent! finally a tool for all the people with neurological issues! i will never thank you enough
11 years post stroke and I'm loving your videos. Im doing well but still work on improving my self
Hi guys! Just to clarify one point that came up today. When you do the exercise with your legs crossed the involved leg is on the bottom. The weight of the top leg (uninvolved) places more downward pressure on the involved leg to give more weight bearing through the foot.
This one really works..10 min. of this and I can lift my leg up. But stil spasticity comes back.
This is one e of my favorite places to learn great exercises. Thank you for sharing the great information with us.
You should pin this comment above )
I had my stroke in late November 2018 and I love watching your videos very inspirational
Thank you very much. I was diagnosed with foot drop and given an FES unit but I realise I have been misdiagnosed as my knee locks out and I turn over on my foot. I have started doing your e exercises and already managed to stop the foot rolling. I will continue with these and show your videos to my physio. Thank you again.
I am so glad it was helpful. :)
Hi Dr Tobias! Oh my! our videos are very educational. Thank you so much for taking the time to create them. I wish to pick your brain about my particular situation. But first here's a little background on the matter. It's been over almost 2 years since my stroke/seizures. I was in a wheelchair for a couple of months as I couldn't walk after I woke from a coma. It took a lot of work and tears but I began to take some steps after a couple more months. Since then, my gait has been poor. At the time, it was believed that it was because I only started walking again after that much time of being unable to. Well, about 3 months ago I noticed that I was walking on the outside of my foot, of course I brought this up with my providers and care team. I saw a slew of experts in an effort to figure out what the problem was and a way to resolve it. In one of my doctor's notes, I noticed the phrase "inverted foot". Up to that point I didn't know how to medically describe what was happening to my foot and I'm grateful for that. I was able to use that phrase to search for resources about that on the internet. Luckily, I saw your video on "Inverted Foot" and there, you described exactly what I was experiencing. Well long story short, I followed your advice and was able to see an orthotist about a suitable brace for my foot. However, that didn't magically solve my problem as I expected it would, thankfully, they are sources was very portraits about this situation refusing to give me any brace until he sees a recommendation that would manage both situations simultaneously. This is because the problem was not just "inverted foot" but there is something else added to the mix. So, the thing is that as I attempt to walk, my toes point upward and stay pointed that way for the duration of the walk and the only time they stay down is when I stand on both feet and focus on putting a bit more weight towards the tippy toes of the involved foot, which oftentimes leads to me almost toppling over.
What are your thoughts on this? I'm still working on finding a physical therapist that focuses on neuro rehabilitation. I've not been lucky yet in that regard. Please do let me know what you think and/or point me in the right direction where to go searching. Thank you very much for your help. I appreciate you. Thanks again for taking the time to make these videos. You are a godsent.
Wao Dr ,u are such a blessing to me. After I got frustrated about progressive exercises for stroke patients. Av learnt alot. U're God sent. Keep doing the good job. U inspire us young physical therapists. I really wanna learn more about treatment protocol for stroke patients . Thanks a million
Every since I have been watching your videos, I realized you were describing my problem. I have been doing physical therapy since June 2019 and my foot and leg never changed. I am starting your exercises. I hope it makes a difference. Thank you.
I like the videos with the break which helps with progression. One process at a time and get next progressive step. Thank you for your time and investment towards our recovery!
I wear an afo and still can't put my good leg in front of my affected leg when walking , please any suggestions
HANDS UP YOUR AWESOME LOVE THE WAY YOUR HELPING ME
This is a great video I started doing this on my front steps after seeing your other video with the steps. I didn’t do them every day but I do enjoy them. Especially since I thought I could not get on my bottom step I was nervous but it was super easy than I thought. I am planning on bringing them back into my routine. I enjoy these videos and spasticity and tone are my biggest problems which is something my therapists also said . Thanks and please continue .
Brilliant.
I especially like where you introduced the shoulder turn into your pattern, Dr. That is where you got me.
Call it a precursor, in this case an intent to act in the future...action and intent. Again, I love how you had determined in a previous video that learning to stand motionless for an extended period is an important teaching moment in the brain for learning how the motor-neuro-sensory system coordinates and times the transition from extension to flexion. I can see it in my mind as the internal actions of an escapement, that momentary click & hesitation we used to hear distinctively coming from inside the mysterious inner workings of the loud, spring-driven wall clock hanging in Aunt Ollie's kitchen. An ultimate coordination of rotational forces coupled with net vector movements at right angles along all 3 dimensions. You're turning 2 dimensional geometry into 3 dimensional trigonometry.
So simply stated you managed to create a 3 dimensional movement pattern out of a two dimensional exercise. You froze the pose for a second, and in doing so established a clear demarcation in the mind of an initial first step in a continuation pattern. It took a bit but I think I understand you now. I can no longer think as fast as you speak but I def like the challenge.
The shoulder turn then coordinates with the opposing hip turn/sway, which times the alternating arm/opposing leg swing & dorsi-flexing foot action. I know from other courses the medical profession likes to break anatomical locations down with Latin terms along horizontal and vertical axes to make it more convenient for doctors from different cultures to converse. Dorsi, meaning dorsal or on the top, in this case, on top of the foot. Hope that's correct.
And what follows intent and action? It's entirely dependent on if there was any action that followed in the first place, because if we hesitate too long and stop there is nothing, and wow, aren't we humans good at both overthinking and inaction when faced with weighing the value of our intentions against the risks of our failing if we dare to take action?
No stopping allowed. We soldier on. Results then of course follow actions, and then hopefully a little feedback cometh while making adjustments to our gait.
Dr. Tobias's Philosophy of Motion on the Surface of a Sphere. Move over Isaac Newton. No, I am not mocking you, Dr. I love it. You are the exact opposite of your peers. You have zero qualms about sharing what you know.
Hi Andrew! Wow, you are definitely helping me to see my own thoughts from another's perspective :) Thank you for that. Of note, you can click the gear icon and adjust the speed of the video. Sometimes I talk too fast and sometimes I talk too slow. I still have not fully dialed that in. :) I am a work in progress. Oh, and by the way, as a self proclaimed "movement scientist", without Sir Isaac Newton, does life even exist? 🤷🏻♀️ 🙃
@@rehabhqofficial Okay, now you're the one who's showing off. I haven't figured out how to include imogis yet and you're putting them in upside down, lol.
That's a very good question btw about the existence of life, especially far beyond our earthly domain. You caught me off guard with Newton's Philosophiæ Naturalis Principia Mathematica. Your split cultural Japanese heritage has gifted you with a much deeper understanding in the balance and forces of nature and movement in this life, as short as it is.
Your yin, and the yang and feng shui, they are quite apparent in how organized and at peace you are in your own heart and within your space. I find it remarkable how sensitive and in tune you are with your patients and how much more aware you are of what stroke survivors have to deal with just to achieve some semblance of normalcy. I find comfort in your ways of understanding. Cogito ergo sum.
Idk y the fkkkk would someone dislike such a great video
Makes a lot of sense I hope u can add more upper extremities exercises please
Love your videos , teaching style and pace. Thanks for your sharing your skills !
Thank you so much for your kind words! To know they are helping people is what keeps me going so I appreciate you and hope you will continue following!
Thanks a lot for your videos. My mother has benefit a lot from your tutorials.
So much luvs from Albania, Doc❤️❤️
Thank you very much for your service to others.
I absolutely adore your videos. I’m new at TH-cam so I don’t know how to search by date, I’m trying to reference your first two videos part part one that says watch first
Thank you for all your hard work Dr Tobias you've taught me more than any physical therapy I went to or neurologist that I want to we really need your guidance and once again thank you it helps me so much
Thank you for your guidance and video clips .trying to stand straighbut it hard to move forward.iit takes times to do it.hoping I can do it in the future.
Great video Dr Tobias thank you!
Thank you so much ! Just your voice makes work ! Can I email you and tell you my case ?
I'm focused on loading the left leg when walking with quad can trying to mimic single canebytmy brain won't let me be more confident goes into don't fall mode hard to concentrate to load the affected leg I'll keep practicing Thank you you're the best I wish you were up in Washington it eve great to do a virtual consultation right now I'm at a point where I'm trying to walk but I am walking with a clock game. Pretty decently but ready for the next progression. Thank you!
Just adding a creative taught to one of your tip. When legs are crossed, uninvolved leg over involved leg for weight bearing. Grabbing your involved wrist around un involved leg helps keeping fingers opened and to send gripping signals to the brain. Hope it helps all viewers. Wishing you all speedy recovery
Great information. In the case where the person can not flex both knees at all , the person is stuck in full knee extension after a brain injury. Where do you begin. What helps is that the person has dorsiflexion and extension to both ankles.
thank you so much, i have started all the exercises and also the standing and i already see results. thanks to you i understand more my body and the steps i need to make to come where i want after my stroke.
Have MS but struggles are same. The hypertonicity causes my foot to point downward and PTs in the past have tried to force the dorsiflexion. Frustrating for them and for me. So glad to have found you here before resorting to an invasive procedure
MY DOCTOR SAID I HAVE LOST MUSCLE STRENGTH IN MY LEG AND MY BACK MUSCLES ARE SO TIGHT THAT IS THE REASON I CANNOT STAND OR WALK. ANY THOUGHTS DR. TOBIAS? WISH I HAD A THERAPIST LIKE YOU. YOU ARE THE BEST!!!!!!
You are the best teacher!!!
I love this..it’s very heard to do but it’s a good plan thank you.
I have just come across these! Thank you fantastic..15 years ago bleed on brain or so more than likely very bad habits.. i didnt get any spasticity arm or leg.. they removed a bit of my cerebellum to reduce swelling. As a result I always look drunk.. I can walk a bit now. I use to walk "to the left"in a circle effectively...it wasnt funny, but saw one of your videos explained everything....thank you...I swing my leg...Im not conf on other leg.
Thank you very much for your videos, they are very very helpful.
madam i cannot sit stand and walk please suggest me excercise
Thank you so much 😍how can we know that we can move onto progression 2 ?
Thanks a lot for this great content. Quick question- How many times in a day would you recommend doing these exercises? I understand from your video on neuroplasticity that one should try doing these exercises as much as they can to break the pattern. Still, can you please recommend the minimum number of times one should definitely do these exercises each day based on your clinical experience.
th-cam.com/video/HIrSWm70MBo/w-d-xo.html
You have helped me soooo much to understand about spasticity, I am greatful. Please,will this help with a leg that is not extending to a stand. My brother's leg has started to move at his hip, but I can't get his knee to straighten. I'm doing the exercises with the wedge for the spasticity in his foot. But his ligaments and tendons seem not to want to loosen to extend the knee. Even some muscles in the thigh. They are starting to move some but I can't get the leg out of the bend at the knee. I've had 3 strokes myself. And was able by God, and a lot of walking and balancing to not go into high tone. But working my brother out of his very, very high tone has been very heart breaking and difficult. I get one area better and another gets tight. I just can't get his leg straight. Not sure if it's because his knee is not opening especially at the top of the knee cap, of if it's more muscles in the thigh that needs to lengthen. Soo frustrating. But thank you for all you do and give.
I wear an AFO, should I stand and do these exercises with it on? I’m already walking with the AFO and cane, I’m 31 months post stroke, but I’m sure I have a lot of spasticity in my leg. I see that this question was already asked. Thank you.
Thanks for sharing this video.great content.
God bless you. You are amazing
Hi Dr. Tara, how often should I be doing this exercises daily and how many reps? How can I tell when I am ready to move on to the next progression? Thank you!
How can someone correct over extension of the knee on an unaffected leg??
Going back to this. I am beginning to walk without a cane. Minimally as it completely changes my gait, so I mostly use trekking poles to mimic a correct (arm/leg swings) walking motion. My issue is the toe lift up of toes 3, 4, &5 (roast beef, none, and wee wee wee). I can scrunch down to gather a towel, but I cannot lift up.
Thanks for watching and for commenting!! as far as the toes, practice whatever movement you are trying to achieve (hard to visualize your exact issue), either in sitting and/or standing versus walking. simplifying things might make it easier to focus on the toes. I hope that helps!
@@rehabhqofficial I think I get it. Maybe I can clarify to make sure. As a musician, I learned time/beats by tapping my toes. Foot flat on the floor and lifting the toes UP in order to tap toes. The same bend of the toes as the walking "push off" in normal movement patters. Based on your response, I think you are saying to hold my foot in that push off position, or a tippy toes position?
are these exercises to be done with afo on I have yet to recover my ham string use my quad on the affected side is pretty strong not near the other side what I am concerned about is when I walk I lurch to the left the left being my affected side I can walk with out using a cane butswing my leg around when I do
Duration for weight bearing
I I'm new in your content but listening to your theory makes just the sense to resolve lifting up the affected leg. I had a stroke in 2021. I have the probl of lifting up my left leg from the ground. My difficulty is that,the leg wiould seem stuck into the ground,and I will remain poised in that position for a minute or so before imt able to lift it up and follow up with my other leg. Now I would need to transfer weight from the former ground stuck leg to the healthy leg. This also becomes rocket science. The point I wanted to bring forward is; that everything you saying makes sense, but I can't see what you're doing behind your talking face.thank you
You are doing a great job i have a dought if a person with circumdactory gait will back to normal walking pattern if she tried to walk 1 month like that
This is an exercise progression for someone with spasticity. Circumduction would be a slightly different progression of exercises :)
Please need more exerciseabout hand fingers
I want to know how to position in early flaccid stage.
Pl guide me my upper arm is not able to lif suuestsomvedios of rexercise
Thanks for watching! Here is a series that might help: th-cam.com/video/N05oGFJMooA/w-d-xo.html(part one); th-cam.com/video/vBewElX9M08/w-d-xo.html (part two); th-cam.com/video/IxtP4wagMRE/w-d-xo.html
Could I ask if riding a stationary bicycle is helpful or not please
Thanks for watching and for commenting! I am not a fan of riding a stationary bike if you have spasticity.
Thank you
@@rehabhqofficial spasticity where! Generates hip or sciatica or sacroilliav and butt pain on non stroke effected side, but the leriche syndrome side..!?
How many minutes do you hold each position? Thanks so much
I am wondering the same thing. When I sit, my hip flexors get really tight once I stand. Don't know
if its an even trade off.
How long to stand to get ride from spasticity
Minimum duration to stand
as much as possible. Just to clarify, this will not "cure" spasticity but the more you stand, and do weightbearing activities, the body can learn how to move better (with the spasticity) when walking. I hope that helps!
Can these done to the old age person with over weight. Please suggest me
How do we manage the patients that still have a high risk of having a new stroke, with hight bp, and cardiac issues, embolism? how do we work with them without creating the possibility for a new stroke to reappear ?
I I have a question when I try and get up to stand my knees pull together and everything tightens
Will these really help my tone if I am 2 1/2 years post hemmoragic stroke?
You could do the low seated exercises, seated on a chair with the feet elevated onto the low stool/step instead for people who have too much difficulty getting down to sit on the stool. They may just need assistance getting the involved leg onto the step.
affected stroke leg also has arthritic knee, making all thid difficult. any ideas?
Kudos for your nobel work, after stroke i am not able to move my foot in eversion pl. help
check out my playlist on spasticity. That has a lot of great info on how to get eversion in standing
Hi! How many repetitions for each exercise? Thank you 8n advance
I can't quite follow the terms but I do enjoy the videos a lot
Multiple Sclerosis. Diagnosed in 2005. Before the confirmed diagnosis test did show some schematic issue.
Thanks for sharing
I have foot drop from neuropathy. Will these exercises help me? Or is it hopeless to improve my situation?
Hi, would can you do for stuff ankle on foot drop. I also have very tight hips that don't allow me to walk well. Thank you
just want to ask mam how cani av9id smoking cigarrette hope you can help me
Hi
Find your videos to be very helpful
Is there a way to schedule an online appointment with you
I have written a couple of emails to you but didn’t get a response from your team
Please help
Just want to say why my foot. Only moves when i stretch it moves but is still numb when it just hangs there is it trying to come back
What if both your legs are affected by the stroke
Love your videos!!
Thanks for watching!
I should add that I have been walking pretty well after left side weakness from a stroke 18 months ago, I would say my balance is pretty good, but my toes are still a problem.
It’s so sad for me to find your videos 5 years post brain surgery. I don’t know if it’s too late me to learn from your videos. My entire left side is effected by the surgery, I have issues with my shoulders, with my gait, with my balance, my toes curl and the list goes on.
Can i undo the bad habits I develop?
Lily, thanks for watching. It is never too late 😊
Liah- it’s never ever ever too late! Please don’t give up- my dad is 5 years post stroke and we just started doing these. We are hopeful
My partner has a spastic hamstring and her knee always stays a little flexed while walking. While sitting her involved leg is flexed that it bends and goes beneath the chair and she is unable to get that leg forward. Her quads are weak. But during walking her foot goes in plantarflexion and inversion. What to do?
Stay tuned for this weeks video :)
@@rehabhqofficial I still cannot stand from sitting. I am 70yo . I do need weight bearing to arms to strengthen it. I am a massive stroke survivor for 5 yo now. Please need help.
Thanks again for another great series of videos. I'm 18 months post stroke and am walking with and without a cane depending on conditions around me.
I've just started the progression in this video (for about 3 days now) to see if loading the "flexure pattern" you talk about in this video will help my walking gait.. One modification, that I'm trying, is to sit in low rocking chair while weight bearing on my affected leg. I then rock back and forth while leaning on my affected leg with my elbow to increase the pressure.
I think this is helping but I'd like to know if you think this is productive. Am looking forward Progressions 2 and 3 in a few more days.
I am glad to hear you are benefiting from this series. I think the rocking chair is an EXCELLENT idea. Keep up the great work!!
Hi good day just wanted to ask when my is at rest I can move my finger freely but when I wanted to move it but itself it cannot...what I should I do to move it
i have pain in the top of my foot when going up on my toes
Thanks for all the comments!! I LOVE comments. for those who have plantar flexion spasticity, you should not be going up on the toes :)
Dr Tara, in my previous comment you replied that 5 years post surgery that it isn’t too late to begin to correct all the bad habits . I have been watching your videos but I am lost in terms of the sequence of the videos. My surgery to remove a brain cavernoma left me hemipligea with severe numbness and propioception. I currently walk with a cane but constantly trip on my own foot since I am not able to lift my toes when I walk. I had severe spasticity in my toes and ankle.
Can you assist me by advising the correct sequence of your videos. I know I have a lot of work and it would help if I have a list .
Thank you so much.
Dear doctor
I am suffering with mnd(als), please give the suggestion
Thank you for watching. I am glad to have you as part of this community. My advice is to do as much as you can to stay mobile and keep muscles/joints moving :)
I don't have a stiff leg, I have toes that lock up, and my foot turns into a paw. I can control the stiff knee nut the toes are driving me crazy., as soon as I put weight on the foot it locks up.
Hi hello, are these exercises best suited for individuals whom experienced a recent injury (0-6months) or do they also aid individuals whom have had an injury for a longer amount of time?
This is an EXCELLENT question! It is NEVER to late to start. Our brains have some potential to create new nerve connections throughout our life. I encourage you to never stop working. You can be a little bit better if you put in the work. 😊
Why is the other side of my face feeling numbness during my post stroke?
Eight years after I had numerous strokes I managed to be able to walk even if not correctly
I then downloaded post stroke exercises from u tube and 2 days after doing these execises
I cannot walk at all and I would like some comment on what could have gone
Jeffrey Johnson this channel provides general information and should never replace a face to face visit with a healthcare provider. Stop any activity that causes you pain. And in this case negatively impacts your walking or general mobility and seek in-person medical care
This can be relevant for MS as well
How about (when you’re trying to get somewhere) you get a sudden warm feeling down an affected limb (or leg in my case)? And no- it’s not pee, either…
Fatigue would set in around the same time (I’m betting it was a bout of neurofatigue).
I had my stroke a month ago, and I’ve been doing all the exercises my PT/OT as well…
Should I remove my AFO when starting progression one exercises?
That is an excellent question! Keep you AFO on if you have severe spasticity. I hope that helps :)
@@rehabhqofficial Was about to ask the question. So AFO on for this progression.
Dorsiflex? I can cross my legs no problem and cross my legs no problems but I have dropfooot on my left leg I believe. I have burning sensa toon in my left leg foot! I’ve been walking for about 4 months. But my heel hurt now and then!
Hi Tara. I just started watching your videos. I like what you are showing and how you present the exercises. I however do get a bit lost sometimes as I am not medically trained and don't know much of the nomenclature you use. Like "Dorsey" and "Flex" and the muscle names like "Tibialias". I think for many of us its like having to learn a new language. Perhaps you could include a laymen"s simple definition as you go along. Thank you.
Thank you for watching!! I appreciate the feedback!! I do my best to simplify things as much as possible without losing the "why" behind the "what". Hopefully the images help a little but I will keep this in mind when making the videos :)
Believe, believe in recovery, it will come, it takes years, recovery can be done decades after the event.
My recommendation is to put a dumbbell on the arm and leg in order to get a stretch.
Make circular movements of the hands, legs, head. Gentle circular movements in all positions standing, sitting, lying down.
Transfer weight to the injured leg, climb stairs with the injured leg.
Sleep on a hard surface.
Good luck with God's help.
Thanks
I am the incomplete spinal cord injury,, can't do sit to stand
You are good 😊
Wish I could go to your clinic for evaluation and help but don't live near there.
I am right hemiplegia for 25 years from a brain tumor. It never came back. First 21 years I managed to function well staying very active with kids and ministry. I walked usually without a cane unless hiking or uneven ground and fell only 3 times leaving bruises within 21 years. Now in past 4 years I’ve had a desk job and deterioted. I have fallen 3x a year always leaving bruises or even hurt tailbone doing simple things, this year 4x . I am back in therapy for past year and still falling even though they’ve strengthened my muscles. Current therapist not good at watching for mechanics. I do a lot of home exercises but know I'm missing mechanics help. I also got a sit/stand desk to help.
Hamstring doesn't work well ( tummy leg lift really hard) can't get get over hurdles backward well always goes around it at least a bit
Knees - don't lift high well when I walk - the locking has reduced drastically
Foot is really bad- can lift toes but cannot move to side. Cannot do heel raise by itself the other foot has to also do it. Using a wobble board and have yoga ball thing for balance practice
Ankle is improving, I think - I can deep squat holding one side of parallel bar with one hand.
I think Kurtis fixed my hip movement - still do the exercises because I am not sure.
My sit to stands and walking look awful.
Whereas in the past some wouldn't even notice I was handicapped until winter came around and spasticity really kicked in. Sometimes my husband would tell me to limp more when using my handicap placard 😂
No need now.
Any suggestions?
I try to figure out where I fit in the ”progression” by trial and error but never sure.
Hi Franny, Thank you for sharing your story! It is never to late to get back on track. I firmly believe that. I hpe these videos help you :)
Could somebody link me to the previous videos?
First video: th-cam.com/video/aMcazVftpaA/w-d-xo.html
Second video: th-cam.com/video/7AVddDvArRU/w-d-xo.html
It's been 9 years since my stroke still not walking my left leg will not bend
Thank u maam