Saturday, September 1, 2012

My theory on motor recovery - stroke rehab

I put this out there with no professional background, borrowed from Cassalita and my original OT on eccentric vs. concentric contractions.Most therapists focus on functional recovery because that's what they are paid for. From some questions directed to me, a lot of survivors have a specific movement they want to recover - not necessarily functional. And no one is giving them any help in planning out how to recover that.  And as Steven Wolf says, 'Stroke patients need to rely more on their own problem solving to regain mobility', Prerequisites are a decent muscle anatomy or body-building book or anatomy software that shows the complete range of movement of the muscles you are interested in. My example is the bicep.
1. First you need to see where you have some control. straighten your arm out, see if you can exert force at any point in the contraction phase, this might entail having someone lift your arm up bit by bit to see if you have some muscle control at any point, try this standing and lying down. That determines if you have some concentric contractions. Then get the lower arm to 90 degrees to your body and try to lower it. You may need someone to pull on your hand to tell if you can resist. That determines if you have eccentric contractions.
2. If you have control at any point, start there and move it back and forth, thousands to millions of times.
3. If that doesn't produce anything it's time to go to the dead brain recovery options - these are not really proven yet and some can be quite dangerous(videos and mirrors)
    a. Mental imagery
    b. Passive movement
    c. Mirror therapy
    d. Thermal therapy
    e. Action observation
4. If 3 works go back and repeat 1 and 2.

Remember, this is not for personal use, ask your doctors and therapists for validation first.

If your doctor or therapist has given you something better, please post it, it must be worth a lot since it is not public information.

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