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  1. #71
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    Quote Originally Posted by jfsully View Post
    If the left side is weak from the stroke, for recovery you have to get other parts of your brain to do the work of the stroked part. The way to do this: use your left side, A LOT.

    Assuming you are right-handed, it is common for people with strokes on the right side of the brain to be less aware or even unaware of deficits on the left side of the body. It’s a pretty interesting phenomenon known as “neglect,” but if it happens to you it’s less interesting and more of a challenge.

    Keep up with the regular barbell lifts, don’t be tempted to do dumbbell work on the “good” side. Make that left side figure out how to work under the barbell. This is maybe one time when doing some work in front of a mirror would be helpful. Do barbell curls in front of the mirror next to the bodybuilders!

    And use the left side more than you have to. Brush your teeth and shave with your left hand. Use your left hand to wipe your ... you get the idea.

    You’ve already overcome some steep odds, no reason to think that won’t continue. Please continue to report back here. We’re all pulling for you and also inspired by you.
    The left side is doing much better. I have been doing some dumbell rows and curls. I just use a lighter weight for the left side.

  2. #72
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    Quote Originally Posted by Paulbfast View Post
    The left side is doing much better. I have been doing some dumbell rows and curls. I just use a lighter weight for the left side.
    This is really just a hunch based on working with people after strokes in a medical setting, not training them: I would favor bilateral movements, like barbell rows and curls. Dumbbells for assistance are fine, but don't fall for the temptation of going too easy on the left side. If the weight is a little lighter, make sure the volume is at least keeping up with the right.

  3. #73
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    Quote Originally Posted by jfsully View Post
    This is really just a hunch based on working with people after strokes in a medical setting, not training them: I would favor bilateral movements, like barbell rows and curls. Dumbbells for assistance are fine, but don't fall for the temptation of going too easy on the left side. If the weight is a little lighter, make sure the volume is at least keeping up with the right.
    In the clinical rehabilitation setting, you are exactly right Dr. JFSully. I highly encourage bilateral exercise and shy away from increased volume work with the weaker side. This is a particular setting when a Smith Machine is of some utility. Working bilaterally will help maximize the contralateral Repeated Bout Effect of training / crossover effect. With neurological injuries, it is rehabilitation dogma to shy away from higher volume as it is thought that increased oxidative stress can cause neuronal apoptosis.....but, please understand, I am not a neurological clinical specialist. I'm a bone and joint and sports medicine dude, so I am only parroting what my professors taught.

  4. #74
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    THANKS! I have been wondering the best approach.

  5. #75
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    I had a great workout on Sat - bench press, goblet squats to below parallel and deadlifts. Deadlifts were much better than before. Left arm did some work and the bar stayed on legs.

  6. #76
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    Quote Originally Posted by Will Morris View Post
    With neurological injuries, it is rehabilitation dogma to shy away from higher volume as it is thought that increased oxidative stress can cause neuronal apoptosis.....but, please understand, I am not a neurological clinical specialist. I'm a bone and joint and sports medicine dude, so I am only parroting what my professors taught.
    Ok, i am not a rehab doc or trainer, but from the Neuro side this makes sense for Peripheral nerve injuries. In a stroke, the nerves damaged are in the brain, far from the anaerobically stressed muscles and local nerves. Brain perfusion will increase readily on demand, whereas contractile muscles and their local nerves may struggle. And we want increased perfusion in the brain around the strokes area, for neuroplasticity to do its thing.

    In the stroke recovery setting, my observation has been that patients who are diligent and consistently push the envelope (within reason) do better than those who think of themselves as brittle and treat themselves gingerly. I am sure you see the same thing.

    So I would not shy away from volume in this setting.

    Also....Paul, you’re kicking ass!

  7. #77
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    Quote Originally Posted by jfsully View Post
    Ok, i am not a rehab doc or trainer, but from the Neuro side this makes sense for Peripheral nerve injuries. In a stroke, the nerves damaged are in the brain, far from the anaerobically stressed muscles and local nerves. Brain perfusion will increase readily on demand, whereas contractile muscles and their local nerves may struggle. And we want increased perfusion in the brain around the strokes area, for neuroplasticity to do its thing.

    In the stroke recovery setting, my observation has been that patients who are diligent and consistently push the envelope (within reason) do better than those who think of themselves as brittle and treat themselves gingerly. I am sure you see the same thing.

    So I would not shy away from volume in this setting.

    Also....Paul, you’re kicking ass!
    Fair points, Dr. JFSully. In this setting, would you prioritize strength or volume?

  8. #78
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    I have wondered about intensity vs volume also. Today a new PR 190 lbs on the leg press. It is a machine and does not use plates so easier for me to use - just move the pin and no need to get up and round up the correct plate. The left leg is doing well, but the left arm is still not behaving! I did some "deadlifts" in the smith machine and some db rows too.

  9. #79
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    Quote Originally Posted by Will Morris View Post
    Fair points, Dr. JFSully. In this setting, would you prioritize strength or volume?
    Depends on your goals, and I would defer to your coach on this. We know that doctors in general will tell you to do high volume, low intensity, because they don't really understand strength training and don't want you to get crushed under a barbell at their instruction.

    My point is that you should not avoid or reduce volume just because you've had a stroke. In general I think that older trainees avoid volume more than strictly necessary. (I consider myself an old lifter at 48, and I have made more progress with deadlift doing 5x5 in the 70-80% range than I would have thought possible.)

    I would stick with whatever programming you have. I assume you are varying intensity and volume, so keep it up as long as it's working. Also, any assistance work should be bilateral work: e.g. barbell rows or curls instead of dumbbells, because we want to teach your left side that it is expected to perform the same as your right side. If you are diligent with dumbbells you can accomplish this, but working both sides together should have more benefits for stroke recovery, in my view, and I would recommend against exclusively using dumbbells for assistance work.

  10. #80
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    THANKS!

    I did squats yesterday with a "safety bar". It felt good to put some weight on my back! I think it was 173 lbs. And yes they were to depth. I did some deadlifts too.

    Feeding port is healing nicely. Just looks like an extra bellybutton.

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