Tuesday, April 7, 2009

The Feel of Recovery

Here is an article I wrote. It describes, theoretically at least, how to get sensation back after stroke. Turns out, nothing new under the sun. Getting back sensation is the same as getting back movement. Repeated attempts at feeling drives the brain to be better at feeling.

There are 2 ways of retraining feeling: active and passive. Passive seems to be more for tactile stuff, active is more for proprioception (the feel of movement).

But movement and sensation double back on each other. Movement affects sensation because if you can't move the brain stops listening for movement. And if you can't feel, your movement goes haywire.


Dean said...

I liked the book, Sensory Re-Education of the Hand after Stroke by Yekutiel Margar. I seemed to be the only documentation I could find on sensory recovery

Peter G Levine said...

Dean: I haven't read that. But I'm convinced that motor and sensory should not be viewed as seperate. they are 2 parts of a whole. thanks for the comment!

Julia said...

I read this book. It's excellent. I don't understand why sensory retraining isn't started with patients on day 1 when movement may be difficult or impossible. More precious subacute recovery time wasted. The only sensory retraining I've ever had is what I've done myself. I've even been told by some OT luminaries and their acolytes (Glenn Gillen at Columbia) that sensation isn't important, just "function". Well, earth to Glenn - no sensation, no function.

Peter G Levine said...

Remember... manged care does not pay for recovery of sensation, only recovery of movement. So therapists are reluctant to focus on that for which they will not be paid.

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