Physical impairments cause functional deficits

Upper extremity hemiparesis is a persistent physical impairment that affects the motor control system, often limiting independence.  Prominent manifestations of compromised motor control include:

• Impaired intersegmental coordination
• Hyperreflexia or spasticity
• Weakness

Current methods of rehabilitation overlook upper extremity weakness

Weakness results primarily from disorganized neuro-motor output and is one of the most significant post-stroke impairments.  In fact, weakness plays more of a role than traditionally believed and contributes directly to compromised, post-stroke motor function.

Lack of proper strength training underserves the patient

Typical strengthening approaches use resistance bands such as TheraBand™. Unfortunately, because this method does not ensure sufficient intensity or progression of the strengthening activities required to achieve necessary overload, hemiparetic patients seldom show improved function. In addition, trunk stabilization is often not properly addressed, which promotes compensatory movement patterns.

It’s important to note that neither high exertion nor resistance training exacerbates spasticity.  Therapeutic outcomes are improved when the motor capacity is enhanced prior to engaging in repetitive task practice.