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.