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A Patient’s Guide to Hand-Arm Bimanual Intensive Therapy for Stroke

One of the biggest challenges after suffering a stroke is losing your range of motion and control of your arms. Hand-arm bimanual intensive therapy (HABIT) is one way to regain the use of your hands and arms.

Paired with other forms of rehabilitation, HABIT can help you overcome the impairments caused by stroke.

This specialised rehabilitation method enhances coordination and strength in both arms. It also addresses common post-stroke challenges such as muscle weakness and limited mobility.

HABIT’s focus is mainly on bimanual activities (requiring the use of both hands). That’s how it gradually helps you regain independence and confidence in everyday tasks.

Let’s dig into how HABIT improves your quality of life and some practical techniques for your successful recovery.

Understanding Hand-Arm Bimanual Intensive Therapy (HABIT)

Hand-arm bimanual intensive therapy (HABIT) represents a dynamic shift in stroke rehabilitation. This method focuses on coordinating both hands to maximise recovery. Let’s breakdown the HABIT process into four key principles:

  1. Repetitive practice: You know what they say: “Practice makes perfect”. HABIT is based on repetitive movements that use both hands. This approach reinforces brain connections by engaging the dominant and non-dominant hands.
  2. Goal-oriented and personalised: HABIT exercises are not random. Each one is carefully tailored to your daily needs and personal recovery goals. This customisation ensures each activity contributes to functional improvement. Gradually, these exercises can help make your everyday tasks easier.
  3. Intensity: HABIT is intense and requires a high level of commitment. You must engage in frequent and dedicated practice if you want effective results. The regimen is designed to consistently and rigorously engage you in the rehabilitation process.
  4. Contrast with traditional therapy: Traditional therapies often focus on single-limb training. HABIT’s holistic approach incorporates the often-neglected “healthy” side. This inclusivity means a more balanced recovery. It can help prevent your over-reliance on one limb, which can lead to further physical imbalances.

HABIT is a comprehensive, intense, and highly personalised rehab option. Although different from traditional methods, it shows promising results for stroke survivors.

Why is Bimanual Therapy Crucial for Stroke Recovery?

Bimanual therapy is the cornerstone of modern stroke recovery. Let’s see how this therapy works and why it’s especially effective in the aftermath of a stroke:

1.   Rewiring the Brain

Bimanual therapy leverages the brain’s inherent capacity for neuroplasticity. This is the brain’s ability to reorganise itself by forming new neural connections. Engaging both hands in therapy stimulates this adaptability.

Symmetrical coordination often deteriorates after a stroke. Bringing it back is essential for restoring balanced control between both hands.

2.   Bilateral Engagement

Using both hands simultaneously requires physical and cognitive coordination. Hand-arm bimanual Intensive Therapy (HABIT) encourages the activation of both hemispheres of the brain.

That’s important for fostering balanced neural activity. Bilateral engagement is key for two reasons:

  • It enhances overall motor control and agility.
  • It is responsible for synchronising body movements.

3.   Functional Outcomes

The practical implications of bimanual therapy are profound. It better equips you for daily activities that require two-handed coordination. That’s because bimanual rehab improves coordination and control.

Performing simple bimanual activities such as cooking and dressing is a huge step towards regaining independence post-stroke. 

4.   Evidence-Based Results

Research further cements the effectiveness of bimanual therapy. It is proven to improve motor skills and hand dexterity among stroke survivors.

Studies like those published in Frontiers in Neurology highlight the importance of structured, intensive bimanual training in enhancing limb function. It’s also been credited with greater overall functional improvements in daily activities.

Bimanual therapy is a robust PT framework for stroke rehabilitation. We regularly provide this therapy to our stroke clients and have seen remarkable progress in them. Book an appointment with us today to see if HABIT can help you improve your quality of life after a stroke.

Key Components of HABIT Sessions

HABIT sessions are structured to maximise recovery through targeted, repetitive practice. Let’s delve into the core elements that make these sessions effective:

  1. Task-Specific training: HABIT uses exercises that mimic everyday tasks to enhance your practical application. For example, stacking blocks improves fine motor skills. Similarly, pouring water helps with grip and steady movements and folding laundry targets coordination and muscle strength.
  2. Practical tools: Sessions use readily available household items. That makes therapy easier to continue outside structured sessions. That’s how we seamlessly integrate your therapy sessions into your daily routine.
  3. Graded challenges: Adjusting task difficulty based on progress keeps exercises challenging yet achievable. We usually start tasks with larger, easy-to-handle objects and progress to smaller, more complex items as you improve.
  4. Feedback and motivation: Immediate feedback during sessions helps keep your spirits up while maintaining the correct technique. Constructive feedback also helps you understand your progress and stay engaged.
  5. Customised programs: Each session is tailored to your individual needs and goals. Customised programs mean your therapy targets your specific weakness. It’s also how we track progress, making adjustments as necessary to optimise recovery.

These components make HABIT sessions a comprehensive and adaptable framework for your stroke recovery.

Practical Tips for Implementing HABIT at Home

Implementing hand-arm bimanual intensive therapy (HABIT) at home can be challenging but well worth it. Here’s how to make it more effective and engaging:

  • Routine establishment: Consistency is key. Practice exercises daily at a set time to reinforce skills. Regular practice helps integrate therapy into your daily routine while keeping progress steady.
  • Use of technology: Leverage assistive apps and video guides to enhance your HABIT sessions. You can ask your physiotherapist at Clearcut physiotherapy to record exercises for you to watch and follow at home. Similarly, you can record your home exercises and show them to our therapist for feedback.
  • Family involvement: Involve family members in your exercises for added encouragement and accountability. Their support can boost morale and help you adhere to your rehabilitation goals.

By following these tips, you can create a conducive environment for effective HABIT at home.

Tracking Progress and Adjusting Goals in HABIT

For effective hand-arm bimanual intensive therapy at home, tracking progress and adjusting goals accordingly is crucial. It’s important to use specific metrics to assess functional improvements.

This can include timed tasks to evaluate speed and efficiency. Sometimes, we measure progress through your range of motion to see how joint flexibility improves over time.

It’s crucial to monitor your progress regularly. Ideally, we recommend weekly or bi-weekly assessments. This allows us to adjust your regimen’s intensity and variety of exercises, based on your current performance.

Regular reviews help us ensure continuous improvement and adaptation for your seamless recovery.

Image Alt Text	Patient testimonial for rehab at Clearcut Physiotherapy in London.

Your Next Steps

Therapy only works when you work it!

Like any rehabilitation method, hand-arm bimanual intensive therapy (HABIT) requires your dedication and patience to work. Remember, progress can be slow but that’s ok if it’s steady.

HABIT’s structured and repetitive approach to therapy will gradually help you build new brain connections and improve coordination. While staying hopeful is key, keeping realistic expectations is just as essential.

Another crucial component of recovery is having the right professional help by your side. Clearcut Physiotherapy offers you expert support throughout your post-stroke journey.

Our clinics in Eltham, Battersea, and Norbury offer expert guidance and customised programs on a flexible schedule.

Interested to see HABIT work its magic on you? Then take the next step towards a healthier you and book your appointment now.