Physical therapy after a stroke , whats available in Thailand ?

[BKKdreaming]

Hi

I am interested in what is available in Thailand for Physical Therapy after a stroke 

 

My friends Mom had a stroke 3 months ago  ,and cannot move her arm and leg on one side , she does have a Physical Therapist come in a couple times a week and do the normal things ( push-pull etc her arm and leg) to try and get the muscles working again ,  and it is going slowly after 3 months

 

http://www3.nhk.or.jp/nhkworld/en/vod/sidebyside/20160810.html

 

its a 30 minute show on Japanese TV , it is in English , link will work for 2 more weeks, 
it shows a special wheelchair that is made in Japan , and the program shows it being used in Vietnam , 

"Profhand" pedal wheelchair is the name of it , look on google for more info ....

 

Is there anything like this in Thailand ? 

 

something that will get her Moms legs working better , maybe just a stationary exercise  bicycle machine would work to ,  ?
the idea on the Japanese Profhand is that the good leg knows how to use the pedals and "teaches" the bad leg and then both legs work together and get the weak leg stronger.

 

Maybe someone who makes bicycles can copy it ?  
They are 90,000+ baht ($3000 US ) if you buy one in Japan !

it would also be nice to have the same idea but so she can use her arms,

 

Any ideas of something like this appreciated ,

Thanks 

Edited August 11, 2016 by BKKdreaming

[Sheryl]

I haven't seen anything like this here.

 

In general, physical therapy is a weak point in Thai medical care and far better in the West...especially outpatient PT.

 

There is a good facility (inpatient) in CM though where more intensive PT can be  received.

 

3 month post stroke though, should not expect too much improvement. The sad fact is that many patients are permanently paralyzed on one side after a large stroke.  The problem is in the brain, so muscle exercises will not do much more than avoid contractures.  This sounds like it may be the case for her.

[colinneil]

Maybe physical therapy is weak in Thailand.

I must point out i get first class physio from our local  hospital, here in Banphai.

I go every 2/3 weeks and get the best of treatment/ help from all the staff in the physio department.

 I also get home visits, and i must say the help i have received has helped me tremendously.

 

Edited August 12, 2016 by colinneil

[little mary sunshine]

Have your local hospital 's PT Department send a

physical therapist to your home with a program

designed to regain as much range of motion for the

lady.  Emphasis to work as hard as she can for

12-18months post stroke.  This is when the bulk

of  your return occurs .  Most PT's will help to incorporate

PT into every day activities.  Use affected side as much

as possible to wash, comb hair, fold clothes, if possible.

"If is Physical, it's Therapy". Good luck

 

[little mary sunshine]

Sammoms Preston. )Google catalog living AIDS)

[charliebadenhop]

There is a great form of physical therapy that comes from the States, relating to recovering from strokes.

 

The basic process is that the patient is ONLY allowed to use the limb(s) that have been negatively effected from the stroke.

In other words if the right arm is affected the left arm is wrapped next to the body so it cannot be used. Very hard for a person to do something with the effected limb, but apparently this method has great results if stuck to over time.

 

Sorry to not know the name of this therapy. I think it is from a researcher in Georgia.

When I read about it a while ago, it seemed to be well documented. 

[Paul Laycock]

After my stroke I was given little or no advice, I eventually purchased parallel bars, a walker frame and tripod stick. That all happened quite a few years ago, I still can't walk unaided but get by with a little help from my sister in law.

Sorry I can't be of much help, it's a long and sometimes painful road to go down, I hope the woman has/gets the care she needs.

Simple things suddenly become a nightmare, going to the toilet, having a shower and sleeping.

Good luck.

 

[adhd]

for anyone with a stroke, why not check out this:

 

http://www.webmd.com/vitamins-supplements/condition-1594-Stroke.aspx

 

if the doctor's tell you they cannot do anything for you, maybe nature can give you a helping hand ?

 

you can find all these supplements rather cheap on  Iherb.com

 

 

Edited August 12, 2016 by adhd

[Harveyg]

If alternative health methods interest you then drop me a line.   I'm familiar with a body of work that is done with brain injury. 

[realenglish1]

I designed a  a regime  19 years ago when I had a stroke Was paralyzed on the right side Slurred speech Could not walk very well. In bed I decided I was not

going to let this get the best of me as I was young at the time about 40.

Today I do not have any lasting problems I walk well I talk normal I can use my right hand again for writing normally.

I am from the USA.  There they say use it or loose it . You have to go through pain to get better It was not easy It took me  4 years but no one can tell I had a stroke

 

I will not thank god here that I got well I will thank myself for HARD work and a desire  to get better . You can to if you want it Maybe not 100% but dont listen to these snake oil doctors here they do not know what they are talking about . If  you want some direction on this then contact me and I will be happy to help

[BKKdreaming]

Thanks for all your thoughts , she does has a physical therapist visiting a couple times a week , 

and that started in the first month , as that seemed to be important to start treatment early , 

 

But when I watched the TV show at the link above and the work they are doing in Vietnam , it got me wondering if the same was being done in Thailand , 

Of course the TV show is about the pedal wheelchair and does not show all the other rehab work they are doing daily ,

but if true it is an interesting idea ,  and seems like more "fun" than a stationary bike , 

 

its going to be a long road , but  I hope she can keep trying and not give up , being 100% again  is a dream , but even being able  to get  around the house would be great , 

 

Anyway , if you have any more ideas please share , it seems the Stroke  is very common in Thailand  and not much is being done as far as rehab ,  maybe there are just too many who need help

 

Thanks again

 

 

[Speedo1968]

On 8/12/2016 at 7:07 AM, Sheryl said:

I haven't seen anything like this here.

 

In general, physical therapy is a weak point in Thai medical care and far better in the West...especially outpatient PT.

 

There is a good facility (inpatient) in CM though where more intensive PT can be  received.

 

3 month post stroke though, should not expect too much improvement. The sad fact is that many patients are permanently paralyzed on one side after a large stroke.  The problem is in the brain, so muscle exercises will not do much more than avoid contractures.  This sounds like it may be the case for her.

Sheryl

Many thanks for all your excellent advice.

 

Could I ask. "What are your views on acupuncture treatment related to stroke damage ?"

[Sheryl]

Well there is nothing to loose by it, except perhaps money.

 

More likely to be of help (and ditto use of a TENS unit, similiar idea) if there is just weakness rather than complete paralysis. If it is weakness then there is still function in parts of the brain that communicate with nerve fibers on that side of the body, and nerve stimulation - by exercise, massage, use of TENS, or accupuncture - might help to strengthen the CNS - peripheral nerve linkages.

 

If there is complete paralysis - no sensation, no movement at all - on one side of the body, and it persists more than a few months after the stroke, frankly the prognosis is virtually nil for regaining function on that side, though of course there are things that can be done to help the person learn to cope with the impairment. That is mostly seen with large hemorraghic strokes (as opposed to stroked caused by a blot clot/embolus).

[charliebadenhop]

I forgot to mention before-

I have a friend here in Chiang Rai who had a stroke that sounds similar to what the original poster described, and he has gotten truly gratifying results from acupuncture.

 

Really impressive!

[Speedo1968]

15 hours ago, Sheryl said:

Well there is nothing to loose by it, except perhaps money.

 

More likely to be of help (and ditto use of a TENS unit, similiar idea) if there is just weakness rather than complete paralysis. If it is weakness then there is still function in parts of the brain that communicate with nerve fibers on that side of the body, and nerve stimulation - by exercise, massage, use of TENS, or accupuncture - might help to strengthen the CNS - peripheral nerve linkages.

 

If there is complete paralysis - no sensation, no movement at all - on one side of the body, and it persists more than a few months after the stroke, frankly the prognosis is virtually nil for regaining function on that side, though of course there are things that can be done to help the person learn to cope with the impairment. That is mostly seen with large hemorraghic strokes (as opposed to stroked caused by a blot clot/embolus).

 

Many thanks Sheryl for the explanation of the effects of TIA's / stroke.  

Two reasons that I asked, although you have mentioned in past postings various hospitals that have a practitioner, things such as acupuncture and osteopathy were considered almost quackery in the UK back in the 50s, 60s, 70s, - fortunately that attitude has changed - to some extent at least.

I also asked because I have had multiple TIA's, always on the right side of the brain.   Fortunately paralysis has only been temporary, ranging from a few minutes to a few hours; of course there is always some damage that does not fully improve e.g. gait.

 

I have had acupuncture in the past in the UK, many many years ago and it worked well for what I was being treated for.

I have had treatment in Thailand for migraine but it set off Parkinson like symptoms, so treatment was stopped.

 

I have tried acupuncture in Thailand for the after effects of TIA's and it certainly helped recovery.   I have a friend who has qualified in acupuncture, Chinese cupping, cortzaar, traditional massage, osteopathy.   However, as I live alone I have learned to manage an attack before ( meaning I feel changes in my body that often occur before an attack ) and, during if I am quick enough, then, if available, my friend carries out acupuncture.

 

The greatest thing I have learnt is to be aware of ones self, to recognize small changes that may be a warning of an attack and prepare.    For this I lay down and use acutouch, which is using certain fingers on each hand to touch.   It works for me, but I do have a high electricity level in my body.

 

As a last point, which you may wish to delete, my friend has also treated a dog that suffered a stroke and, because of its deteriorating condition, was to be put down.  Following regular treatment within 2 months the dog was again able to eat, stand, walk, climb stairs.

Edited August 16, 2016 by Speedo1968
Missing sentence in one but last paragraph.

[Speedo1968]

10 minutes ago, charliebadenhop said:

I forgot to mention before-

I have a friend here in Chiang Rai who had a stroke that sounds similar to what the original poster described, and he has gotten truly gratifying results from acupuncture.

 

Really impressive!

 

Hello "charliebadenhop"

Please see my posting below in reply to 'Sheryls' reply to my question about acupuncture.

[charliebadenhop]

Ok, yes, so acupuncture has already been shown as an alternative.

 

My problem with acupuncture here so far-

I have been to two different guys here, each with a vocal group of fans, and both of them hurt me a lot. I had about 12 treatments with each of them, and they both speak some English, AND I did not have any serious condition. I very much understand the need to get energy running, but at least one-three needles a treatment, with each of them, when they "twizzle" the needle it send an electric type jolt down my leg (either leg) that is quite painful, and I would scream out in pain. I asked them both to do less of that, but neither one of them really listened and they would both chuckle some most times. 

[Speedo1968]

Hello "charliebadenhop"

 

Sorry to read you have had bad experience of acupuncture practice, but, did the treatment itself work ???

 

The needles can hurt for a number of reasons other than heavy handedness by the "practitioner".

 

Ideally you should always see the same practitioner each time - you have the right to refuse if the practitioner had a sidekick who was a trainee.   Make that clear when booking an appointment.

 

May I ask what you have had treatment for ?

 

In the UK I was treated by 2 different practitioners, but for different things, different decades and different places.   Both treated privately and at large county hospitals and both taught at University.     Treatment was for motorcycle impact during accident and migraine.

In Bangkok the practitioners were Chinese ( husband / wife ) - Bangkok Hospital I think - in their 70's and highly skilled.   Treatment was for migraine.

 

Please remember that points are specific and a little to one side or the other may not produce the effect required.

 

Some reasons it hurts is that the point at which the needle MUST be placed e.g. between thumb and forefinger, the wrist, toes, head to name a few, are highly sensitive

The points are often close to bone, muscle.

 

Try, difficult I know, to be relaxed when receiving treatment, this can be helped if you are confident in your practitioner.

Stay of coffee / tea etc on the day of treatment.

Arrive early so you have time to relax.

After treatment, sit down for at least 30 minutes and do not drink stimulants of any kind.    If possible DO NOT DRIVE use taxi to get home.

 

Three needles is not uncommon, even more for some treatments.   They could be placed anywhere between the head ( yes here is painful ) and the toes.    However, if you wish to prove a point - sorry for the pun - there is a point on the body where, if a needle is placed, you can feel heat move around the body from the left to the right kidney, you can almost feel the blood flowing !

 

Needles may be placed for a few seconds, minutes or even longer.   The shorter period indicates that the response time to the needle is instant and the response is also high.    Sometimes such points cannot be activated for a long period without causing 'bad effects'.

Treatment can be from a few minutes to an hour.   Generally initial treatments are short as, remember, "you are playing around with the electrical wiring of a living body - yours"; imagine what happens when you cross wires in a 3 pin plug !

 

Needles may be blunt or of the wrong size.  Needles should always be new and sterile.    Sometimes gold needles are used.

 

"Twizzling" the needle as you call it, or turning or tapping gently is often done, it stimulates the energy points.

Long term treatment can include the needle being connected to a small electric current, this can be increased as treatment continues.

 

Feeling pain down the leg /s is dependent on points that are used.   It can hurt, especially if you have not had feeling in that part of the body for a long time.    To be painful enough for you to scream, you will have to think about why it hurt and discuss with the practitioner.    

 

I have a relatively low pain threshold but have high body electricity.    Yes, I have felt severe pain, especially if the points between thumb and forefinger or wrist are used, but not enough to scream.   The high natural electricity is good for some things - predicting the weather for example but, I used to run my car battery flat when I lived in Saudi Arabia and, there was a sandstorm and I touched the car door handles.   A good side is that I can use it to divine for water - but that's rather off subject.

I have little feeling in my feet and lower legs due to a allergic response to treatment following a spider bite, that does make it a bit difficult to treat using acupuncture.

 

I have had treatment by my friend for severe neck and shoulder pain, recurring pain from two motorcycle accidents ( handlebars in to groin area on two accidents in 1960's and 1980 ) also during an actual TIA event.    It was a rare occasion that she happened to be there when an attack was starting.    The treatment may have helped but I was / am used to "dealing" with them myself and "having company" disrupted the way I deal with an attack.     Treatment after the attack certainly helped with some of the damage caused e.g. limb stiffness and gait.

 

Rather long winded reply but the practice ( acupuncture - 'fun chem' ) is not new, the offshoots being "acupressure" and what I call, and treat myself with, "acutouch". 

 

Don't give up if you feel the treatment helped, if it gave what you may wish to call 'unnecessary pain' then perhaps you need to try another practitioner - I think Sheryl gave a list of hospitals some time ago.

 

Good luck and take care.

 

[charliebadenhop]

Thanks for your thoughtful reply.

 

I have two lingering injuries from many years as a professional martial artist. My left shoulder has limited movement and one finger on my left hand locks up.

 

Both guys were getting results but the amount of pain each session was more than what made sense to me. For me, it was a metaphor that was not working- Experiencing a lot of pain in the treatments, to get over much lesser pain than I feel on a regular basis. 

I could not relax during the treatments, which makes the treatments less effective.

 

I am trying a good massage person currently and she seems to be slowly helping.

 

Again, thanks for your thoughtful reply.

 

 

[Speedo1968]

20 hours ago, charliebadenhop said:

Thanks for your thoughtful reply.

 

I have two lingering injuries from many years as a professional martial artist. My left shoulder has limited movement and one finger on my left hand locks up.

 

Both guys were getting results but the amount of pain each session was more than what made sense to me. For me, it was a metaphor that was not working- Experiencing a lot of pain in the treatments, to get over much lesser pain than I feel on a regular basis. 

I could not relax during the treatments, which makes the treatments less effective.

 

I am trying a good massage person currently and she seems to be slowly helping.

 

Again, thanks for your thoughtful reply.

 

 

It wasn't Kendo by any chance was it, that caused the injuries ?

 

Perhaps your acupuncturists were too keen to get a result quickly.

 

No doubt seeing someone about to stick a big needle in to you does make it difficult to relax.

 

Sometimes treatment can give a very fast response, especially neck pain.

Sometimes acupuncture works for a few months and the pain starts to return.

 

I am not a doctor but, could the locking finger joint be down to arthritis setting in due to previous physical damage ?

 

Where I live there is a small local free ( donation ) clinic, it includes a number of retired nursing staff.  Apart from general services that they offer freely, massage ( old style ), including using a hot cloth on a hammer like object is available at a change of 100 baht for one hour.    The lady that does the massage must be in her 70's, whatever she did my neck pain improved a hundred fold just with one treatment.

 

Glad  you are carrying on with some form of "alternative" treatment.

[charliebadenhop]

Aikido. Did it professionally for many years.

 

The shoulder and the locking finger are related, and not arthritis. 

[Speedo1968]

On 8/17/2016 at 4:31 PM, charliebadenhop said:

Aikido. Did it professionally for many years.

 

The shoulder and the locking finger are related, and not arthritis. 

 

Glad there is no arthritis.   Be careful about drinking too much soy milk, I have found that more than a certain amount daily affects my finger joints.

 

Although not related to a "locked finger" .  When I was 15 I started work in farming in the UK, in the Winter hands got very very cold to the point of hurting, the best treatment was to stick your hand and forearm in stinging nettles, better than slapping your arms across your back.

 

I took up Kendo for a few months when I returned to England from Australia for a short time, not sure why.    I used to surf everyday in Australia, mainly body surfing but found the board riding I had done helped tremendously with balance in Kendo, being a "goofy foot" probably didn't help though.     The guy that taught classes was from Trinidad, very tall and bounced like Tigger ( looked like he had springs tied to his feet, so agile and you were never quite sure where his bounce would take him ).

I did find it rather disconcerting sometimes having a female opponent.  

 

Good luck with the massage.

[chubby]

better off, gettting a "hemi height" wheelchair, or a w/c which when pushed manually on one side it moves both wheels, educating yourself about bedsores/pressure ulcers, and shoulder subluxation with chronic pain , 

 

if she has any volitional movement, eg can slightly flex her fingers or toes, then the prognosis goes up. 

 

she can steer the wheelchair with her foot, assuming the environment is w/c friendly.  concentrate on safe transfers, tolieting, showers  etc 

 

what is her age.......

[1FinickyOne]

On August 16, 2559 BE at 1:58 PM, charliebadenhop said:

I forgot to mention before-

I have a friend here in Chiang Rai who had a stroke that sounds similar to what the original poster described, and he has gotten truly gratifying results from acupuncture.

 

Really impressive!

 

Charlie B. - that is wonderful. I was once cured of a back trauma resulting from a fall by acupuncture after traditional medicine could do nothing... that said, I have a  good friend here who suffered a stroke, I don't ask too many questions but I know he works at rehab and has not seemingly to my eye progressed... I mention this as his daughter is an acupuncturist at the local hospital. So, it must work for some situations and not others and also can depend on the different skill sets of the doctor. 

[charliebadenhop]

I guess there is nothing that works 100% on everything, but the acupuncturist I talked to who did the work on my friend, claims it is a fairly straightforward process.

[Speedo1968]

My friend who has practiced acupuncture for some time on humans, including on myself during / after a TIA, also treated a dog that had had a stroke.    It's condition was so bad ( not eating / drinking, unable to sit / stand / walk ) that the vet had recommended that it be put to sleep.    The owner, as one may / can understand, did not want to do this.    The owner asked her sister ( the acupuncturist ) if she would try to treat the dog.    It was the first time that she had given acupuncture to any animal.     After the first treatment the dog could drink, continuing daily treatment the dog was able to eat; 2 weeks later the dog could stand, walk and now is able to climb stairs.  My friend, the acupuncturist, although aware from studies that animals could be treated was amazed, and very very happy at the dogs quick recovery.    She has now been asked by a local vet if she would treat further patients, should they be presented to the surgery.

 

Of course responses to acupuncture may / will be different depending on the damage the patient - human or animal - may have suffered. The responses may be quick or take time, or even require treatment every few months.

Without trying one will never know.