Topic: "Normal" therapy is all wrong! (Read 283 times)
katep Administrator; mom to OBPI sEMG user member is offline
Joined: Sept 2007 Gender: Female Posts: 144
"Normal" therapy is all wrong! « Thread Started on Sept 10, 2007, 9:51am »
That sounds extreme, doesn't it! But it really is, if you stop and think about it.
When your therapy is focussed on producing active movement, it is only going to "reward" and emphasize the muscles that are most able to produce movement. But the problem is, with OBPI (and maybe even traumatic injuries) the "strongest" muscles are not generally the ones that should be creating the movement. If the biceps were already strong enough to work all on their own without any additional "help"... you probably wouldn't be doing therapy, right? By trying only to induce movement that actually moves the arm, we actually teach compensation strategies instead of helping regain control and strength in previously paralyzed muscles. "Practice" doesn't make perfect; perfect practice makes perfect. When you practice the same thing over and over again, but do it wrong, it embeds the "wrong way" into your brain. You defeat yourself with all your efforts.
So the secret to BPI therapy is simple:
STOP making movement the goal!!
Instead, make activating (and then exercising) the desired muscles the goal. Through the use of biofeedback you can change your focus to specifically controlling and strengthening desired muscles, rather than just encouraging and strengthening inappropriate ones. In this way, you can deal with the source of the problem, which is that previously deinnervated muscles have to be strong enough for the brain to bother. Strengthen just those muscles - not everything else - by guiding yourself with sEMG-provided feedback.
Re: "Normal" therapy is all wrong! « Reply #1 on Sept 10, 2007, 2:03pm »
Kate The last time I was in PT the therapist said I should be doing ROM on my unaffected arm. He said that I was developing contractures because I kept my unaffected arm restricted to the length of my robpi arm. Most parent do not use both arms while doing therapy.
I have some thought about bilateral movements while using the Myotrac. I was thinking (that's dangerous) about the way infants move their arms. Babies move their arms bilaterally within their field of vision. Most babies grab bottles/toys and even their feet with both hand for a very long time. Just thinking out loud mind you... Most OBPI's never used both arms bilaterally nor did we see our arms function in a bilateral fashion within our field of vision. Each arm acts independently for OBPI. The injured arm is moved by someone else out of our field of vision. The unaffected arm moves as any normal infants would. That is another disconnect from the brain aside from the nerve damage. I assumed we were designed to move in a bilateral fashion and when we change that, we change the brain pattern and visual perception of our arms. Maybe we should encourage those using the Myotrac, to work bilaterally. I also think the children will gain better balance and eye hand coordination.
Ok... I know it's sound far fetched but so is the possibility of biofeedback bring new movement to an old lady.... LOL.
katep Administrator; mom to OBPI sEMG user member is offline
Joined: Sept 2007 Gender: Female Posts: 144
Re: "Normal" therapy is all wrong! « Reply #2 on Sept 10, 2007, 2:09pm »
Kath,
I think that is a very good point. I know that a few people who used the myotrac at Camp had a lot of success with trying to get their muscles to work when they thought about performing bilateral movements. And your comment that babies do everything two-handed at first is very insightful. A lot of work in front of a mirror and with both arms sounds like a very good idea.
Re: "Normal" therapy is all wrong! « Reply #3 on Sept 10, 2007, 4:35pm »
The bilateral movement is huge in getting back towards "normal" movement patterns. We are programed to function with juts the use of one arm so our other one takes on a role of protection and we dont use it in any bilateral motions. For the adults, go for a walk and take note to what your arms are doing I bet the majority of the adults, myself included hold their affected arm in at their stomach while hte unaffected arm swings naturally. You actually have to think about creating this "normal" movement pattern. Now for the parents, watch your kids, I bet they do the same thing! I saw every kid at camp do the holding of their affected arm at their stomach while the other arm swing naturally.
We dont get to learn the bilateral movements that are so important! Playing with another teen using the myotrac at camp she could not get her muscle to contract until I suggested doing the same motion with her unaffected arm. This is due to overflow. You can note over flow by simply taking a sheet of paper and two pencils, draw a design with your dominant hand and your non dominant will mirrow the design. When one side of your body is at rest, the other is more likely to be at rest...
Using bilateral movements would be a really good way to normalize brain patterns. Hope that makes sense! Amy
If you think you can, you can; If you think you can't, your right.
Go posterior deltoids go!
priscilla Parent of TBPI sEMG User member is offline
Joined: Jun 2008 Gender: Female Posts: 3
Re: "Normal" therapy is all wrong! « Reply #4 on Jun 27, 2008, 9:33pm »
Believe it or not, I have to agree with this. I didnt already know this but thank God James therapist did. Shes a good one, Im grateful fo that. In the beginning, after months of the waiting game after nerve grafting, we thought he was moving his arm, but he was compensating. It was depressing to hear that, but true.
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