Physical Therapy for Paresis

Photo of a doctor examining a foot.
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Paresis refers to the condition of partial paralysis or weakness. Patients who suffer from spinal cord injury or a stroke often have paresis of an arm or leg. Irritation or pinching of a peripheral nerve may also cause paresis. Physical therapists work with patients with paresis to try to regain strength and improve neuromuscular recruitment of muscles in the affected limb.

Cause of Paresis

There are many different conditions that may cause paresis. These may include:

  • Spinal cord injury. A partial or incomplete spinal cord injury may cause partial weakness in one arm or leg. You may be able to move your body slightly, or some muscles may be functioning properly while others are weak.
  • Stroke. A cerebrovascular accident (CVA), also known as a stroke, may cause damage to one or several parts of your brain. This damage may result in paresis.
  • Pinched nerve in your back. Sometimes a pinched nerve in your spine can cause sciatica. One symptom you may feel is weakness or paresis in one or more muscles that are served by your sciatic nerve. This may cause dropped foot or weakness in your quadriceps muscles.
  • Cervical radiculopathy. This condition is caused by a pinched nerve in your neck and may cause paresis in your arm, wrist or hand.
  • Peripheral nerve injury. Sometimes, injury to one of your nerves as it courses down your leg or arm may cause paresis. Trauma or a blow to the nerve can impair its function, leading to weakness.
  • Decreased neuromuscular recruitment after injury or surgery. After an injury or surgery, your muscles around the injured or surgical site may become inhibited and not function properly.

    If you have any condition that causes difficulty moving your arm or leg, hand, or shoulder, you may be suffering from paresis. You must check in with your doctor to get evaluate and to start on the right treatment for you.

    Physical Therapy Treatments 

    Your physical therapist can be an excellent resource if you have paresis. First, he or she can help determine the cause of your paresis and work to minimize the effects of your condition. The goal of PT for paresis is to help you restore normal nerve and muscle function so you can move around safely.

    Modalities like neuromuscular electrical stimulation (NMES) may be used to help improve muscle function. The electrical stimulation artificially contracts your muscles to improve the way they function. While the electricity is contracting your muscle, you may work with it by trying to contract your muscle.

    Bracing may be used, either temporarily or permanently, to help support a joint and muscles affected by paresis. A brace like an ankle foot orthosis (AFO) is often used for foot drop to elevate your toes off the ground in the event of anterior tibial weakness. Your PT can help determine the best brace for you and your specific condition.

    Managing Permanent Paresis

    Sometimes, your paresis may be permanent. The damage to your nerve is too great, and your partial paralysis remains despite best efforts to improve muscle function. So what do you do now?

    Your PT can help you maximize your mobility if you have permanent paresis. If weakness in your lower leg is present, you may use an ankle foot orthosis (AFO) to help support your ankle. A shoulder sling may be used for paresis of your shoulder to help support the joint.

    Safety, when walking and moving around, is important and your physical therapist can recommend an assistive device that is appropriate for you to use to maintain safe ambulation. Your physical therapist can teach you how to use the device properly.

    Most importantly, if you have paresis, movement and exercise can be essential to maintaining full mobility and strength. Even if a portion of a muscle group is not functioning properly, working to keep the muscle function you do have can help you enjoy maximum mobility.

    A Word From Verywell

    Paresis can limit your ability to move around safely and enjoy normal work and recreational activities. Working with your PT may be an effective way to treat any paresis you may have. When paresis, or partial paralysis strikes, check in with your doctor and then visit your PT to get working on restoring maximum function and mobility.

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    Article Sources

    • Makino, M., Takami, A., & Oda, A. (2017). Comparison of forward walking and backward walking in stroke hemiplegia patients focusing on the paretic side. Journal of physical therapy science29(2), 187-190.