Sunday, January 24, 2016

Mental Practice in stroke

Stroke survivors, quick question...

In your dreams, have you had a stroke? 

Your answer is probably no

What if you were able to access that memory for your recovery?

You can.

Not everything that will help stroke survivors recovery is a therapy - per se. Some things you can do benefit your brain so much that they help recovery as well. An example is Mental Practice.

Mental practice - 
We've published on this one a lot. The idea is pretty simple - do what athletes and musicians do... Practice mentally. You get the idea, you sit back and imagine a movement, and then when you go to actually do the movement it's better. 

There are a few things that you should know if you want to undertake mental practice:
  • Mentally practice what you are actually practicing. For example, let's say you're working on walking in therapy. During that same set of weeks or months you would also do mental practice of walking when you are at rest. And that brings up another very important point... 
  • Only mentally practice what you're good at. The good news is, a stroke survivor trying to get back what they've lost, is already an expert at the moment that they're trying      to relearn. Consider walking. At one point in time, almost every stroke survivor walked perfectly fine. And if you ever ask a stroke survivor - in your dreams have you had a stroke? - they always tell you the same thing: no. The AFO may be in the corner as a metaphor for something awful— or the wheelchair may show up in the dream somewhere— but they were moving and walking and talking perfectly fine. That's what mental practice is all about— you try to get into that dream-like state— but while you're awake. Because while you're awake you'll be able to really focus on what you're trying to relearn unlike a dream, where you may or may not be able to control it. 
  • When you mentally practice something the muscles involved in actually doing that movement fire. And they fire in exactly the same order as if you were to actually do the movement. They just fire very minutely. Think about the muscle jerk that you might get during a dream as you're trying to run away from the monster . those are imagined movement manifested in physical movement. So, getting back to why you should only practice stuff you know well... If you mentally practice movements you don't know well, it will make your movements worse. 
But, again, the good news is that stroke survivors will be mentally practicing things that they used to do perfectly well.

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