Mr and Mrs E's story - Persistence

This case study is an interesting and positive story of the application of Tailwind with an individual affected by a severe stroke.  As you will see, the story has a few twists and turns before reaching a positive outcome.  On initial examination Mr E had some forward movement available as suggested in the“self-test” for product suitability. However, it was marginal as much of the shoulder movement available was across the body rather than forward and backward.

When Tailwind was set up for him he could manage just an inch or two of forward movement of the handles but needed assistance from his partner.

For one week they used Tailwind each day for 30 minutes as directed.

When I called them to see how they were progressing Mrs E reported that the arm below the elbow felt "lighter" but the arm from shoulder to elbow seemed "stiffer".  His pattern of movement tended to be trying to force the handles medially (toward the midline of the body) rather than forward.

Mrs E was concerned about this stiffening of the arm.  She had followed the instructions on the DVD and user manual precisely and believed the height of table to be OK

We advised that it is unlikely that one exercise (i.e., the Tailwind) will cause increases in tone or stiffness, but a therapist might want to work with the patient on stretching and passive range of motion guidance.

We also said that control sometimes decreases, and patients move in "synergies." The most common upper extremity synergy being elbow flexion/shoulder adduction/shoulderinternal rotation presenting as medial pressure against the handle (this is part of the Tailwind's appeal, as it helps "guide" patients to move outside of those synergies, and begin to isolate movements as the handle moves forward away from the patient).

This brings on external rotation at the shoulder and elbow extension to slide further up the rails. We advised that the medial movement this user was experiencing was not unusual, and that Mr E may be able to overcome it with additional practice and and some stretching.

6th October 2009

Derek Jones came to our home with the tailwind. My husband Ed had a very severe stroke in October 2007 and we had worked very hard trying to get arm movement for 2 years.

Ed left hospital with no feeling or movement in his arm, in fact a private neuro physiotherapist had told us she had only known 4 people regain movement in their arm after such a severe stroke in 17 years.

After a year he had managed to regain some movement after hard daily exercises and able to make a fist and lift his up arm two inches and swing his arm across his waist to his other arm.

We had no other progress for almost a year despite working very hard.

I saw the tailwind advertised and was impressed with the trials and Derek bought it to our home.

We were both excited to start.

In the beginning Ed had some trouble being able to push and pull the handle as quite quickly his arm began to tighten at the elbow.

Derek was very helpful and gave us very important advice and information.

Through his information we resolved the problem, which was a collapsed muscle in his back and was affecting his arm. We found the chest and back muscles badly needed some help and following Derek's advice for me to stretch Ed's arm right out at an angle on the tailwind helped stretch the chest and back muscles and with the help of a battery massager which I have used on all his muscles the muscle in his back got stronger and it is getting stronger every day.

19th November 2009 - 8 weeks later Ed has lifted his arm into the air whilst lying down on the bed and with very little support, can move his arm in all directions. We are so thrilled to be getting somewhere at last and we have been confident from the start.

Ed can use the tailwind now he can push and pull the handle to number 7 and back but his arm does sometimes stiffen at the elbow and a few stretches and he carries on.

The problem was with us I think was because the company recommends that you should be able to swing your arm 3 inches and Ed could not and we got the tailwind prematurely, but it was through the tailwind that he was able to - how lucky was that!