I once had a patient who fortunately had a mild stroke, but unfortunately he got it during the period of covid when hospitals were closed. At that time, there was/couldn't be a physiotherapist, so he developed a joint contracture (narrowing of range of motion) in his knee, which maybe no one will ever stretch for him, maybe only the surgeon...
Later, a physiotherapist came to him, who only passively stretched his leg, he was making good progress with it, but he couldn't stretch it out for him either. He told her she would never be able to walk again. Then this physiotherapist could no longer take care of the patient, so the family looked for a new physiotherapist. I was recommended to them, which is how I got to this person.
For the first time, I also stretched his legs, and then I checked how much muscle strength he had. It was quite strong, so I strengthened it, because no matter how much we stretch a joint (and with it the muscle, or vice versa), if there is no muscle control over it, we only create an unstable segment (in this case, a space joint)...
Tom (Toma Balchin, founder of ARNI) said at the training that ARNI is a way of thinking! We have to look at and work with the stakeholders differently.
That happened here too. I didn't do big things with him, there were no big ARNI or big physio exercises, I simply said that if he won't be able to walk with these contracted legs, at least he should be able to turn sideways on his own, sit up in bed, sit over a wheelchair, etc... Finally we got there, that he walks with these contracted legs. With a walking frame, but it works.
And that's a big word.
The big thing is that he learns to turn to his side with a new technique, so that he can see and feel that he is not tied to the bed, he can move his hands and feet! Not like before the stroke, but he knows and uses it!
