Saturday, November 16, 2013

ADLs Are Where the Repetitions Are

Rebecca Dutton
Home After a  Stroke
November 3, 2013

Barb's last post expressed how I feel about exercise.  Barb said exercises "console survivors that they are working as hard as they can when they are not."  The reality is that rewiring the brain requires thousands of repetitions (reps).  Barb wonders if therapists do not tell clients that a few exercises are not enough because they do not want to discourage us or themselves.

Activities of Daily Living (ADLs) are one way to get thousands of reps. For example, twice a day I open my hand to grasp a tube of toothpaste so my sound hand can remove the cap.  In nine years I have opened my hand over 5000 times before brushing my teeth.  It takes 14 turns to prepare cereal with a sliced banana.  I've made this same breakfast for nine years so I have had to make over 45,000 turns.  Add making a sandwich for lunch and preparing a hot meal for dinner and the number of turns I've made in the kitchen are in the hundreds of thousands.

The distance I've walked at the grocery store is huge.  I step away from the shopping cart and bend down or reach up to get items I want. How far I walk away from my cart varies based on where I find a space to park my cart.  Detouring around people and other carts requires S-shaped curves that add more steps than walking in a straight line.  According to my pedometer I walk 2,000+ steps each time I visit the grocery store.  2,000 x 2 visits a week x nine years = 1,872,000 steps!

Shopping is also therapy for my hand.  I open my hemiplegic hand to let go of the cart and reach for items with my sound left hand.  My hemiplegic hand opens a 2nd time when I grab the cart to move on.  Finally, I open my hemiplegic hand to take it off the cart so my sound hand can empty the cart in the check-out lane and again to load food into my car.  Buy 30 items + empty cart + load car x open 2 times = 64.  64 x 2 visits a week x 9 years = I've opened my hand 59,904 times.

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