These procedures aren't limited just to the leg. These procedures are available to the arm and hand. Typically the function of the arm and hand after a stroke is characterized by adduction and internal rotation of the shoulder. That is the arm is pulled into the side and turned in so the forearm is against the abdomen. At the same time the elbow is flexed, the wrist is flexed, protonated that is the hand turned down towards the floor and the fingers are clenched. Sometimes there's some degree of function, the patient is able to open. The fingers are extended the arm a little bit, but some of the muscles are interfering with that action. We can usually identify which muscles these are and find the branches to them and trim them back and eliminate this dysfunction. Sometimes the patient's arm and hand can be completely dysfunctional where there is no active motor control at all. When this is the case, often hygiene is a problem or even simple daily tasks such as getting clothes on the arm. When this is the case, we can relax these muscles are these nerves entirely to allow the arm to fall down to the side and a more relaxed position making place in clothes or washing the arm and cleaning the arm much more simple. When we find that the patient has some underlying motor control, they can clench the hand, they can flex at the elbow, yet other muscles are getting in the way, this is using an ideal candidate to find the dysfunctional muscles, trim them back and achieve much more normal function once again. So patient who had no ability to pick up a fork or bring a cup to their mouth, after these procedures, they often can regain that type of control.
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