Flaccidity, also generally known as flaccid paralysis, refers to the entire absence of voluntary movement of a limb. After a stroke, nerve connections within the nervous system are interrupted, causing hemiparesis or hemiplegia. When an individual has flaccid paralysis within the arm, she or he cannot initiate any voluntary movement of the arm. What does it mean? Which means that the affected arm is unable to maneuver by itself and typically hangs loosely as a result of lack of muscle function. Moreover, laxity is usually related to low muscle tone (hypotonia).
Moreover, for some stroke survivors, the flaccid phase is the initial period they experience immediately after a stroke, and is the primary stage of recovery from a Brunnstrom stroke. Brunnstrom’s stages of stroke recovery describe the progression of neuromuscular recovery(1).
Brunnstrom’s 7 Stages of Stroke Recovery include:
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Stage 1: The flaccidity stage
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Stage 2: Coping with the onset of spasticity
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Stage 3: Increased spasticity
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Stage 4: Decreased spasticity
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Stage 5: Complex move mixtures
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Stage 6: Spasticity disappears
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Stage 7: Return to normal function
Here is an academic video about Brunnstrom Stages of recovery after a stroke!
It can be crucial to know concerning the laxity stage within the stroke recovery process; If laxity persists for too long without treatment, the muscles may begin to atrophy or decrease in size. Atrophy may occur as a result of decreased muscle activity within the affected arm. Laxity and atrophy can negatively impact day by day activities. At this stage, compensatory strategies are most useful in performing day by day activities (3).
Causes of limpness
What may cause a floppy arm? Shoulder laxity is attributable to damage to the nerves that prevent the muscles from receiving the suitable signals from the brain, which occurs within the event of a stroke. When a stroke occurs, whether it’s ischemic or hemorrhagic, the stroke causes brain damage. The situation of a stroke affects its severity. Especially if the stroke occurs within the frontal lobe, especially the motor cortex, the shortage of blood supply and nerve pathways running down the spinal cord from the brain to the muscles may cause upper limb weakness. The more severe the stroke, the more severe the sagging.
Some symptoms it’s possible you’ll experience through the sagging stage include (1):
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Weakness or inability to maneuver the affected arm
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Numbness or tingling within the arm
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Lack of muscle tone (hypotonia)
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Weakened reflex within the arm
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Lack of feeling within the arm
Doctors can perform detailed assessments to assist diagnose shoulder laxity. Some physical examinations may include (3):
Your doctor may perform special imaging tests to assist diagnose shoulder laxity, comparable to:
Treatments for laxity
Can a floppy arm after a stroke be treated? The reply is yes! There are a lot of limp arm treatments after stroke which you could use to assist you to deal with it. Crucial a part of treating shoulder laxity is neuroplasticity. Neuroplasticity refers back to the brain’s ability to transform neural pathways. These recent pathways enable undamaged areas of the brain to take over the functions of areas affected by stroke. Essentially the most effective method to activate neuroplasticity is intensive rehabilitation exercises.
How can we do that with a limp hand? Passive range of motion! When exercises can’t be performed voluntarily or actively, passive range of motion permits you to maintain range of motion and stimulate muscle function.
Passive range of motion
Passive range of motion refers to exercises wherein your therapist, care partner, or unaffected arm moves it for you. Even if you happen to don’t technically activate the affected muscles, engaging them in passive movement might help stimulate neural pathways.
Mirror therapy
Mirror therapy is one other great treatment method that helps engage neuroplasticity. The aim of this treatment is to simulate visual feedback and “idiot” the brain into pondering that the affected arm is performing a task.
Electrical stimulation
Electrical stimulation encourages electrical communication between the brain and muscles. This works by sending an electrical impulse on to the arm muscles, causing them to contract. The mixture of electrical stimulation and intensive rehabilitation exercises has been shown to be effective in improving functioning after stroke.
Mental practice
Mental practice engages the identical areas of the brain as physical movement. This might help reconnect your mind together with your muscles and overcome post-stroke limpness. Imagining your affected arm moving while your care partner provides passive range of motion might help increase neuroplasticity and increase the probabilities of your muscles functioning properly.
Constraint-induced exercise therapy
Constraint-Induced Movement Therapy permits you to deal with the affected limb during exercise and/or functional tasks. The way it’s working? This intensive therapy restricts the less injured arm during most waking hours, forcing the patient to make use of the affected arm while performing day by day activities (4).
IpsiHand Neurolutions
The IpsiHand uses the most up-to-date solutions brain-computer interface technology to reconnect the affected limb to the unaffected side of the brain after a stroke. The device stimulates neural pathways, encouraging the brain to regain control of the affected hand. This device could be used at home.
In some cases, your doctor will prescribe medications for secondary complications of sagging. For instance, pain and depression can negatively impact your motivation to proceed with rehabilitation.
Living with limpness
Listed here are some suggestions if you happen to experience arm sagging!
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Arm position is essential: resting on a pillow, tray or armrest is the perfect position
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This helps reduce painful swelling while stopping shoulder subluxation
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Shifting weight to the affected arm: May be done on a mat, table, ball or the side of a bed
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Passive range of motion within the pain-free zone
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Compensatory strategies in on a regular basis activities
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Muscle facilitation: tapping, electrical stimulation, rapid stretching
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Try to maneuver the affected arm as much as possible!
There are particular risk aspects related to living with shoulder laxity. If left untreated, arm contractures may occur as a result of immobilization. Moreover, muscles may begin to atrophy and spasticity may occur after the comfort stage after a stroke. It is important to remain energetic and move!
It’s possible you’ll need to alter your lifestyle and techniques for performing day by day activities. Remember to ask for help while you need it. Arm weakness after a stroke could be life-changing. For many stroke survivors, this stage may not last very long, although some may find it lasts longer. Nonetheless, with the appropriate medical team and support, you possibly can live an extended and successful life. You possibly can improve your performance with neuroplasticity through the use of many alternative rehabilitation techniques! Confer with your healthcare team and begin your stroke rehabilitation early!
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