Friday, May 23, 2008

Caveman Therapy

I’ve long believed that the amount of recovery after stroke is directly related to the amount of challenge. The more challenge, the more recovery. If you take yourself out of your “safety zone” that zone naturally expands. This happens no matter the endeavor. From stretching yourself as an artist or learning a new language, challenge = betterment (or at least the chance of betterment). Stroke survivors tend to decrease rather than increase the challenge. By using a growing number of assistive devices and energy saving strategies their safety zone contacts. I have this theory that when people had stroke in the distant past, they would actually recover more. This is from an Advance for PT/As article I wrote in 2006:

“It would be hard for our world to be a safer and easier place for survivors of stroke. And that just may be bad news. If a prehistoric tribe had decided to aid in the recovery of the stroke survivor, the "therapy" would have been ferocious by today's standards. The vise grip created between the survival of the tribe and the needs of the individual would have necessitated early rehabilitative intervention centering on mobility. For obvious reasons, the ability to walk in a hunter-gatherer tribe would have been of paramount significance to the individual and the tribe. Stroke survivors had to learn to feed themselves or starve, toilet or suffer bacterial disease, and ambulate or get left behind. Their "forced-use therapy," "gait training," and "ADL training," as well as the amount of energy they put into rehabilitation was dictated by one thing: survival." (Vol. 16 •Issue 9 • Page 35)

But I missed a key point: The flip-side of the equation is what the stroke survivor would say to the tribe. “Ugh-UG-Uh. Umph-duffKAAAAHH!”, which loosely translated means, “Get the hell out of my way because I know damned well what the stakes are!”

Friday, May 2, 2008

Relax and Recover?

This is a great study. It basically says that if a joint is moved passively (someone else moves it or you move it with your "good" hand) there will be neuroplastic (brain rewiring) change. This has big implications for folks who are low level and need to start moving. After there is enough brain rewiring, you may be able to rewire enough to begin moving the joint under its won power. This gives some credence to passive movement that therapists have been doing for decades, but has never been proven effective.

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