We have identified 3 key areas to post stroke motor rehabilitation that need to be addressed prior to regaining walking function; fluid and comfortable sit-to-stands, standing balance and lower leg engagement of the effected side. Here you will find practice videos for standing plantar flexion into knee flexion, a key exercise/movement for both regaining lower leg engagement and sequencing the proper gait mechanics.
For Right Sided Weakness
For Left Sided Weakness
In an attempt to make it easier and more efficient to access the motor exercises I am putting them all together here.
Swaying Side-to-Side and Front-to-Back
Rocking in Full Stride Position
Knee Flexion
Knee Drops
The following is an exercise program that addresses what we perceive to be the most limiting factors in gait rehabilitation, impaired sequencing and decreased proprioception. Through the Conklyn Method for Gait Reintegration we have seen impressive results in a short amount of time at all stages of recovery. Music is the key element in the success of this program as it is the music that helps to drive each exercise, allowing for more efficient movements and faster integration of each piece of the walking pattern. Optimal results will be achieved with a Music Therapist trained in the Conklyn Method.
Conklyn Method for Gait Reintegration
We have identified 5 core exercises for relearning a more functional gait pattern and improved proprioception, irregardless of where you are in your recovery process, and should be done in this order. These exercises are most effective when done barefoot. If you are not comfortable doing these barefoot we recommend doing them in shoes without the use of any orthotics. These exercises can be done using a counter, or balance bar, for support but as you gain strength and confidence we recommend trying these unassisted. For safety reasons please have someone there to assist when necessary.
After completing the exercises we encourage you to walk a little, trying to put all of these elements into your walking pattern.
This is a difficult but common query. There are varying opinions in the medical world regarding recovery of speech following brain incidents. One of the most prevalent theories taught today states there is a window of 6-12 months for optimal recovery and following this time period one should not expect to see much improvement. With many recent research articles showing improvements outside this window, I believe we will begin to see a shift in education that describes a very different model for recovery, be it speech or motor. In the meantime the key is finding professionals who can address your specific need(s). In regards to speech I recommend the following self-assessment:
1. Try singing the words to Row Row Row Your Boat.
2. Now try speaking the words.
Was there any difference in these? Did you find it easier to speak the words before or after you sang them?
Singing and speaking use the same set of words yet are conveyed through different mediums and initiated with different regions of the brain. Many people with acquired speech deficits, whether Aphasia, Apraxia, or Dysarthria, say it’s easier to sing these words then to speak them. Of those, a large percentage said they felt it was easier to speak them once they’d sung the words. While overly simplified, this demonstrates an ability to improve on one’s speech production.
If you are interested in exploring this further feel free to contact me to set up an initial assessment.
This is not Speech Therapy, Physical Therapy, Occupational Therapy or anything other than Music Therapy. While addressing similar goals as other therapies, Music Therapy is quite different in practice and utilizes regions in the brain that process musical properties to achieve the desired results. Music Therapy education focuses on the intersection of music and function, whether that be speaking and singing, walking and rhythm, etc., and how the network connections for musical properties, such as melody and rhythm, can be utilized for positive improvement. In the model I am educated in and utilize at DBC3, this also entails knowledge of neurological function, physiology, psychology, anatomy, the mechanics of the vocal apparatus and motor function.
If you are having speech difficulties, chances are seeing both would yield the best results. Many research papers have demonstrated that multi-modal approaches to recovery show the best results. Speech pathologists often work on a wide range of communication goals, both verbal and non-verbal, whereas a Music Therapist is likely going to work predominantly on verbal communication. This can be a good team approach and allow for each therapist to compliment the other. Many of my clients have come to me after being discharged from Speech Pathology. However, as soon as there are improvements in verbal communication I recommend being re-evaluated by an SLP.
July marks the first year anniversary for DBC3 Music Therapy and it has been a rather successful one, if I do say so myself. When I started this venture the hope was to offer neurologic music therapy services to a wider range of clients while providing more consistent treatment, and overall I believe that has been achieved. Through new clients, research and conferences we are looking into new areas that neurologic music therapy can have a positive impact on. These include Fronto-Temporal Dementia and Aspiration/Dysphagia.. We also had some success in getting 3rd party reimbursement and had another article accepted for publication. Over the next couple of weeks new posts will provide more information on all of these areas, including upcoming presentations, so stayed tuned!!
I’m proud to present the website for DBC3 Music Therapy, LLC. DBC3 is a provider of Music Therapy services in the Northern Ohio region. This website is designed to be informative to those interested in Music Therapy services while also being interactive. Feel free to leave questions or input on things you would like to see and I will see what I can do. Welcome to DBC3 Music Therapy and I look forward to meeting your Music Therapy needs.
Everyone has their own criteria or hierarchy for choosing any service provider, whether it’s a physician, lawn care, a hair stylist or any other specialist. Whether based on referrals from other professionals you trust, experience with your situation/population, expertise in a certain area, years in the field, etc., choosing a Music Therapist should be no different. DBC3 Music Therapy will provide professional references and be open about their music therapist’s education, experience and methodology, allowing you to make the decision that works best for you. We will always tell you in advance who your music therapist will be and will never change treating music therapists without first consulting you.