Technology in Rehabilitation - Part 1
I have come across a few situations where individuals with CNS impairments were looking at specific technologies to help them with their recovery. Technology is changing every aspect of our Lives and will also change our approaches to neurological rehabilitation.
No matter how this post may come across, here are my basic thoughts about using technology with client first and then I will elaborate.
1) I am for things that are proven to work, that are cost effective, that are useable, and that will enable people to engage more fully in their Lives.
2) I am not for things that haven’t been proven, cost a lot of money, are too cumbersome to use, and can not guarantee some degree of efficacy. Yes everyone is different and sometimes it is hard to say how one device may affect individuals differently, but there should be some sense of validity to the technological intervention.
I have had several clients invest or look to invest in various technologies. From smaller items such as special gloves and electro therapeutic devices to larger devices such as specialized bikes both stationary and over-ground and exoskeletons. Everyone had their reasons for their interest. What I was so happy about in these cases was that there was no loss of control over their recovery or their lives. The technology was a tool to allow for a goal. They all checked out options and spoke with various people about their thoughts to gain more information. The individual clients were in control and researching a way to pursue their self-determined rehabilitation choices.
Where I run into problems with technology in rehabilitation is when clients become desperate to escape their situation and look to things that don’t have the scientific and/or legislative backing to support their goals. This is precisely when one starts to give away their personal control and power over their rehabilitation.
I have seen companies try to sell their therapies to clients who had conditions that were not part of the federally approved protocol/treatment program with no ability to promise any improvements and a complete absolution of any risks or negative outcomes. I have seen clients spend many thousands of dollars to travel for and participate in procedures that ended up only draining their bank accounts with nothing to show for it. I have even seen worse where there were serious health complications and deteriorations in function and ability because a client needed to try something, using their belief in its effectiveness over the approved scientific purposes that were in place at that time.
Belief is powerful. The placebo effect is real. But when we are undergoing surgery or using a powerful technological tool, there is also the physical reality of what is being done, so the research should at least demonstrate that it is safe before starting therapy, let alone be able to suggest potential benefits.
The aim of rehab is to improve things. Sometimes this is slow. It usually is, I’m sorry to say. For rehabbers, we will say someone is recovering quickly when they change over months. For the individual, this progress seems glacial. It is a current fact of neuroplasticity that it takes time. That may change with the technological advances that are coming.
Your quality of Life is really important. To be able to find quality, as best as you can, within your situation is a skill... a practice so to speak. Finding gratitude and acceptance are a part of rehabilitation. You are here and starting the recovery process. Starting recovery means that you made it through a very difficult situation and are now stable enough to look forward to the future. This sense of hopeful optimism is a huge part of neuroplasticity – see blog post #2 for more information.
One must be comfortable with where they are in order to move forward. Looking for a quick fix through technology will not yield healing, as healing is not just improvements in body, but also a state of mind. There is neurophysiologic evidence to demonstrate this.
We need look no further than the parasympathetic nervous system: the rest and digest system. It is what turns on when we can stop, un-panic, let go, to take a deep breath, and take in nutrients. You can bet this system is active during healing! It is how you start feeling comfortable and relaxed. It is there when your shoulders drop and the stress is gone. It is there when you pet your dog for a while, or hold your sleeping child. For all conditions we see in the clinic, increasing parasympathetic activation is a key piece to getting the CNS primed for change and ready to send out those important neuro-chemicals and neuro-transmitters – the workers who make neuroplasticity possible.
Feeling at one’s wits end and feeling powerless in their recovery is not the way to activate this powerful system. We are all looking for a magic bullet and a quick fix. These bullets will come. But they aren’t here yet, for client consumption, in a meaningful and functional way. What is available to you right now, however, besides the current therapies, current technologies, and current medications, is your attitude, your mindset, your determination and your hard work. There is something there that can be a powerful ally in your recovery. It is the best technology that has been created thus far – it is you.
My hope is that the amazing research being done with epidural stimulators, exoskeletons, deep brain stimulation, and a whole host of other ideas will transform the lives of those with neurological impairments. I just caution that only looking without to some technology to save oneself and to escape one’s current situation negates one’s personal power in their recovery. We all have the capability to determine our quality of Life.
I will end with a short story of a client of mine. (I will not include any identifying information, including gender.)
This person went through a lot. And when I say a lot, I mean it. I know any clients reading this have also gone through a lot, but this person had it rough, since their 20s. A head up from a doctor early in Life made them aware that there would be an issue in their brain at some point. This person kept going, kept learning, working, and eventually married and had a child. Multiple surgeries later, they were no longer working yet still mobile. One of the complications from the multiple brain surgeries was the potential for a stroke. One day outside their house, this happened. Now, multiple brain surgeries and one stroke later, they are essentially blind, immobile, and dependent for almost everything. I write this quick history not to ask for your pity for them, but so that the next few lines can serve to inspire all of us to appreciate the Life we have.
Unexpectedly, this person self describes as truly happy, well recovered, and the luckiest person alive. When asked why, they respond with a list of all that they are grateful for, all the Love they have in their Life, all the Life they have Lived. We can find joy and peace in our quality of Life in the most unlikely of places sometimes, if only we are open to seeing it.