Tuesday, November 1, 2011

Barking up the right tree.

Here's a made up story: I dropped my computer down the stairs the other day. Thankfully, it still turned on. But then the computer screen wouldn’t work! I shook the screen. I turned it on and off. I pushed all the buttons. All the screen said was NO INPUT SIGNAL. What should I do? Well anybody who's ever owned a computer knows that it has nothing to do with screen and has everything to do with the computer.

Stroke is an injury to the brain. Peripheral nerves and muscles (unless and until atrophy and/or muscle shortening sets in) are working just fine.   

But when it comes to stroke recovery "we" (including clinitians and survivors) focus on the affected parts of the body. We put an orthotic on it, stretch it, splint it, move it, measure it, worry about it...

We focus on the symptoms rather than the cause. We focus on the screen rather than the computer. We focus on the limb rather than the brain.

Symptoms, computer screens and limbs are easy. We can see them, touch them, and measure them.

But let's be clear. The basic paradigm shift presented by research is that it's not about the limb…it's about the brain. 

Good thing the brain responds to simple rules. What are those rules? Let me answer that question with questions. Take something that you learned in your life... anything. How did you learn it?  Did you offload the process of learning to someone else? Was that learning easy?  Did you wait for someone else to test you, or did you test yourself?

Will decides movement. Movement rewires brain. Brain controls limbs.
~

3 comments:

Jen said...

Your last statement seems to be exactly where we are with my husband and his stroke recovery. He's done all the "exercises" and he's made a lot of improvement. However, now that he's discharged from all of his therapy with the ever-present reminders to keep doing his exercises, it's still discouraging to know that just doing the exercises won't MAKE the brain reconnect to his body. Hopefully it will, but there is no guarantee. I will continue to read your blog as it seems you must be much further along than my husband. I look forward to finding any nuggets of wisdom you may have!

oc1dean said...

This is the reason why I think we need to totally get away from standard descriptions of effects of the stroke. I could present the same effects with a pea-sized infarct and a softball sized penumbra vs. a softball-sized infarct. The first will recover much faster and unless the therapists know this they will just be pushing therapies that make no sense. And until this occurs we will never get useful case studies.
Dean, pushing the boundaries again.

Elizabeth, John and Jack said...

The last part is what resonants best with me. I feel like my "will" has helped more than anything, and my unquivering belief that I would/will recover completly. Blah blah to the nay sayers. It's taking longer than I hoped but that's not the point. Will it with all you've got!!

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