Stroke
Can reflexology help un-paralyze those left paralyzed by stroke?
Our 88-year old friend Nadine suffered a stroke resulting in paralysis on the left side of her body. We went into action with 13 reflexology sessions over five weeks. Contrary to predictions she would be paralyzed and live her life out in a nursing home, she walked out of the rehabilitation facility with the aid of a walker and sufficient mastery over activities of daily living to live in an assisted living residence.
One Small Step for Nadine
It was the week before Christmas and we were up against it. We were visiting our friend and stroke patient Nadine on a Sunday afternoon at her skilled nursing center. It had been 38 days since her stroke and two weeks since our reflexology work had begun. Nadine had made remark- able progress on her paralyzed left side—she could feel sensation; move the hand, arm and leg previously paralyzed and was showing postural improvements when she stood using parallel bars.
The session that day had a particular urgency. We all knew that during her physical therapy session in the following days Nadine would need to take an unassisted step while holding onto the parallel bars. The consequences loomed just outside the door and down the hall. The failure to show progress would result in a cessation of the daily hour of physical therapy and a move to “long term care” which was housed within sight just beyond a nursing station. The dictates of the health insurance company would consign Nadine to the nursing home (or “warehouse” as her daughter called it) down the hall.
Everyone had worked hard. We had worked hard. The physical therapy staff had worked hard, convinced that, given more time, Nadine could take that step. She had practiced moving her paralyzed limbs constantly while lying in bed. That Sunday Nadine showed us how she could move her left leg. Her problem: her leg didn’t always move when she wanted it to such as taking an independent step.
So what happened? Two days later Nadine not only took one step but five to six steps. Following the progress she had shown at the skilled nursing center, she was transferred to an advanced physical therapy facility. It was here two weeks later that Nadine walked 150 feet twice while using a walker.
She received three hours of physical therapy a day (as opposed to the one hour at the previous facility), geared toward acquiring the “activities of daily living” needed to move on with her life. Her progress continued with positive weekly evaluations necessary for another week of rehabilitation. It assured her eventual return to real life would be to an assisted living center.
Nadine was discharged to an assisted living center 68 days after her stroke and 39 days after the start of our reflexology work. She had progressed sufficiently week by week to receive the maximum rehabilitative care allowed by her health care provider. To ensure continued progress, she will receive further therapy at the assisted living facility paid for by the health insurer.
Why would reflexology work impact a stroke patient?
Working with Nadine brought to our minds the importance of the foot’s connection to brain for the purpose of walking.
During a stroke blood cells die as they are cut off from oxygen when blood flow is blocked by a rupture or blockage of a blood vessel. Paralysis and loss of speech can result.
- Following the chaos created by a stroke event, the pressure techniques of reflexology provide a means of re-establishing contact between the brain and foot.
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- Just as certain procedures are followed to “re-boot” or restart a computer following chaos in its system, reflexology provides key information to re-order a disordered brain.
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- Under any circumstances, perception of pressure by the foot is central to the function of walking.
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- As the brain tries to re-organize itself during a chaotic situation, a stroke, application of reflexology’s pressure techniques to parts of the foot particularly meaningful to the locomotive process sends a “ping” through the system providing key information for the re-organization.
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- Continued application of reflexology techniques contributes to the body’s re-building process.
Reflexology Applied to Stroke
What would happen if reflexology was widely perceived as impacting individuals who have experienced stroke? Would research result? Would reflexology techniques be added to protocols for physical therapists’ rehabilitation work with stroke patients? Could millions of dollars be saved and thousands of lives changed?
What is the Cost of Stroke?
Our research lead us to wonder what would happen if research were to be conducted with individuals who have experienced stroke. Would reflexology techniques be added to protocols for physical therapists’ rehabilitation work with stroke patients? Could millions of dollars be saved and thousands of lives changed?
Our own experience shows the possibilities of such speculation. Working with recent stroke patient Nadine over the short period of five weeks, our reflexology sessions are credited by the patient and physical therapy professionals with speeding recovery and producing remarkable results.
Consider the impact of stroke on society—the individuals, financial costs, and the medical professionals .
First, consider the human cost. Strokes are the fourth leading cause of death in the US. Some 157,000 die among the 700,000 Americans who suffer a stroke each year. Aside from stroke victims who survive and their quality of life, family members who act in various capacities as care givers create a large body of individuals who are directly effected by stroke.
Then, consider the financial facts. It is estimated that strokes will cost $2.2 trillion in the US over a 45 year period (2005-2050). According to Jennifer Warner of WebMD Health News. “Researchers estimated both direct stroke costs, such as ambulance services, hospitalization, rehabilitation, nursing home costs, and drugs, as well as indirect costs like lost wages for stroke patients under 65. Studies show nearly half of stroke survivors under the age of 65 do not return to work.”
Finally, for medical professionals who specialize in various aspects of stroke care, effective methods of care and rehabilitation are constantly sought. For physical therapists, for example, anything that would speed up rehabilitation of their patients would be valued. Physical therapists are well aware of the time constraints within which they work. The length of a patient’s rehab care is dictated by the health care provider and its rules—sometimes at odds with the physical therapist’s professional opinion. Such is the extent of the situation, physical therapists as a profession across the country are concerned about their ability to do their jobs according to our source.
Rehabilitation Milestones in Reflexology Applied to a Stroke Survivor
During our work we noted milestones such as Nadine wrapping her left, paralyzed hand around the handle of a mug as someone else held the mug (Day 29) and, then 4 days later, holding the mug by herself and drinking unassisted.
Weekly evaluations were conducted during rehabilitation to consider what progress Nadine had made as well as whether she was capable of making more progress. Decisions were, thus, made whether or not to allow Nadine to continue at the rehabilitation facility. One particular milestone was reached when Nadine took multiple steps on Day 40, allowing her to continue. (See “One Step for Nadine.)
Day 47: “… she has gone from a state of left side paralysis to the ability to move some in bed (bed mobility), assist some in moving from the bed to a wheelchair (transferring), balance herself and take steps while holding parallel bars (transferring) and assist some in dressing (dressing)…. it is expected that she likely will not progress to a higher level of accomplishment of ADL items, even with the present level of therapy. Barring a major break-through accomplishment in one of the
ADL categories this week, it is likely she will be discharged to long term care on Friday, Dec. 31.”
Day 56: “She will be re-evaluated on Tuesday (Jan. 4), to determine if she gets to stay another week. If she can progress from ‘moderate’ (50%) assistance to ‘minimal’ (25%) assistance in at least one of the categories of lower body dressing, bathing & toileting, and transferring.”
On 68th day following her stroke, Nadine was released to an assisted living facility.
Chronology of Rehabilitative Events
Day 11: Nadine’s first evaluation to chart a course for rehabilitation showed her to be “completely dependent (on the help of others) in all areas of evaluation with left side paralysis.”
Nadine is sent to a skilled nursing center where she is to receive 1 hour a day of physical and occupational therapy.
Days 12, 13 and 14: Using instructions communicated over the telephone, Nadine’s daughter-in- law and daughter applied: (1) pressure to the big toe and areas of the foot under all toes and (2) movement to the toes. On Day 14, they observed independent movement of the toes of Nadine’s left, paralyzed foot.
Day 24: We applied the first of what would be 13 sessions over 39 days. Our reflexology work consisted of hour-long hand and foot reflexology sessions applied simultaneously.
Day 29: During the third session, Nadine grasped the handle of a water tankard to take a drink with assistance in holding the mug itself.
Day 33: During a fourth reflexology session, Nadine grasped the handle, held the mug independently and took a drink of water.
Day 38: During a fifth reflexology session, Nadine demonstrated moving her paralyzed left leg while lying in bed.
Day 40: During her physical therapy session, Nadine took 5 to 6 independent steps while holding onto parallel bars.
Day 48: Nadine is transferred to an advanced rehabilitation therapy center. where she is to receive 3 hours a day of physical and occupational therapy. At the time of her transfer the head of the physical therapy department of the skilled nursing facility notes Nadine’s remarkable progress. She and other therapists express the desire to apply reflexology to all stroke patients to speed up their rehabilitation as they had seen in Nadine’s case.
Day 52: Nadine walks 150 feet twice using a walker.
Day 56: Nadine is cleared for independent eating and speech.
Day 68: Nadine is released to an assisted living facility having demonstrated appropriate skills in activities of daily living (ADL) (speech, eating, bathing, dressing, continence, toileting, transferring) as well as demonstrating the ability to traverse beyond the ‘household distance’ in walking with a walker.
