Propioception; Can it be regained through PT?

[rendean]

Hi All,

I have been struggling with increasing weakness and and an increase in proprioception , especially my left side. I have knock over at least 6  liquid filled glass today and managed to pour a pan with bacon grease on the floor tonight. That doesn't include the numerous blows to my left outer foot and pinkie toe this weekend as I hit the couch leg or ran into other objects. Good news is , with the decreased sensation it doesn't hurt as bad as it should despite the bruising, etc. Bad news :it's becoming more frequent.

My question is , can the propprioception be improved theough PT and neuro plasticity or do I have to figure out a way around this handicap?

Thanks,
Ren

[supermum_ms]

Yes and yes, its magic lol, there is absolutely nothing special about it but it keeps a coffee hot enough to drink for upto an hour but by the second hour its getting luke warm. It has a large rubber grip around it which makes holding it easier. I've assumed the steel holds the heat or cold in, though its not like the travel mugs that seem to have a double or thermal layer to it, the water bottle is just one layer.

In the hot hot weather I often feeze a bit of water in the bottom and the cold drink stays cold for hours. Its an arcosteel brand but not sure if you have it over there. It's very handy because it fits every cup holder thingy i've put it in, car, boat, bike and as I said it just looks like i'm drinking water when often it holds my coffee so i dont spil it everywhere.

Cheers.......JJ

[Quixotic1]

Does the steel cup keep hot things hot and cold things cold?

How does it know the difference?

q

[supermum_ms]

I started using a stainless steel water bottle a couple of years ago, it's good for hot or cold drinks and it just looks like a normal water bottle so people dont realise i'm drinking coffee. I've also got a couple of stainless steel travel mugs, screw top lids but no handles, many times i've lobed them across a room and only a couple of drips have escaped, which is why i like to use them.

OT: Funny but last night i checked the lasagna cooking in the oven and i didn't use an oven mitt, didn't even notice until i was pushing the dish back in, I felt nothing, DH was really confused and checked to see if it was as hot as it should be, hmm it was to him lol. It gets a bit loopy when i can splash coffee on my foot, through layers of clothing and a leather shoe, the burning heat was so unexpected my brain couldn't register what was going on. Its either too much or not enough feelings lol!

I think adapting and practise is important to regain function, 30 odd years of working with brain injured children tends to open your eyes to the posibilities, though there is no garantee the work you put in will pay off or not. Hope is a powerful thing!

Cheers........JJ

[rendean]

Thanks for all the info, it is greatly appreciate, especially the fact that PT can help restore some of pathways lost. My PT extraordinaire will certainly add even more exercises to my regime with this new development.

I am a firm believer in neuroplasticity as my PT helped me regain the ability to tandem walk and learn to adapt to a permanent loss in proprioception when looking to my left. If I look left while walking, I go boom. I obviously avoid this situation but it is more difficult than one can imagine as it is a natural movement. With weeks of practice I learned to adapt and how to "step out" of  a potential fall position.  

As for the sippy cups...DV I think your theme should be "Princess" . There are many styles of Princess cups on the market and you can choose either pink or purple to suit your mood and/or ensemble on a particular day :-)

Lu, already use the pre-cooked stuff 99% of the time. This recipe was for candied bacon for a brunch menu, very yummy! Next time I'll just leave the cleaning of the bacon pan to someone else.

Another note regarding the cups. My entire family would need sippy cups. I knock their cups over as often as I knock mine over. I'm sure my 6'3'' foot husband does not want to use a sippy cup...he'll just have to keep his glass beyond my reach at any given moment.

And last but certainly not least, Quix. Thank you once again for providing an eloquent and informational answer. I have hope and desire to fix this newest mess just as I overcame the the falling issue. Thank you for providing the information necessary for me to be encouraged (which I was not) and keep up the fight.

Thanks to all!
Ren

[doublevision1]

you are not the first person to suggest sippy cups to me. I might just have to resort to that.  I'll make sure it's all pink and pretty, maybe a Cinderella theme.  Would make for an interesting and/or awkward moment at a staff meeting.

[Lulu54]

Ren,

The talk about proprioception and neuroplasticity has sure given me the refresher course in this topic.  I lose my left foot sense of place every once in a while, but it seems to be only temporary. Great explanations as usual from everyone.

As for the side effects of lost proprioception - May I suggest some of that pre-cooked bacon?  It saves the cleanup mess - get it at the warehouse clubs in bulk!  As for the cups, it is a little awkward at our age to be using a sippy cup but perhaps a travel mug that won't be as easy to spill?  I hate to think about these ways to work around our problems, but it sure is a lot easier than cleaning up the messes.

Just as Q has adapted to playing with her cats, we need to find ways to adapt to our deficits.  

Your neuro should be interested in hearing about your latest changes - keep in the loop, ok?

best, L

[Quixotic1]

I think what PT can do for those who are losing both proprioception and coordination is stimulation of the awareness of the other faculties that can help you compensate.

Proprioception is the awareness of limb position sense:  that is, How bent is my elbow?  How outstretched is the shoulder?  Is my knee bent or straight and is it under me or behind/in front of me?

Then there are the cerebellar functions of coordinating movement with target.  When I reach out, am I reaching with appropriate velocity?  and Am I truly reaching for what I aim at?  Do I stop before plowing into my latte?  Does my hand close around the target at the correct time (ie before I lift it up) and with the correct pressure?  This is mainly a problem of coordination.   But, you cannot have normal coordination if you can't tell where your arm is in space with normal proprioceptive signals.

Now, the loss of proprioception is from the loss of a specific sensory nerve, just like loss of regular or pain sensation, loss of hot/cold determination.

Proproprioception often is damaged right along with loss of vibratory sense.  

Just as any other sensory loss, proprioception may be regained with re-myelination.  So there is hope in that.  But, while it is gone, we may need to use other senses, like vision to fine tune our movements.  We have learn to move more slowly, using visual feedback, to land on our targets.

I believe that occupational therapy can be useful for this.

The same discussion goes for walking and overal movement of our bodies.  It takes training, but we can at least partially compensate for loss of proprioception and lack of coordination.  There PT could certainly help some, by practicing other ways of being able to monitor our movements.  It's just that we have spent our whole lives taking our movements for granted and it is a hard habit to help.

I'm shocked that a neuro wouldn't immediately think of rehab therapy to try to adjust to these problems.  Learning new techniques and practicing them over and over should improve our movments and allow for some re-routing of signals (neuroplasticity).

I have a similar problem, but it is only with the cerebellar coordination thing.  My proprioception is fine.  I can no longer throw objects, like toys for the kitties.  If I throw overhand, I can't get the signal to my hand to release at the right time.  I throw directly into the flow.  Kitties are not amused.  If I throw underhand I release late also and throw the toy into the ceiling or even back over my shoulder.  The cats walk away in disgust.  I have practiced and practiced with little improvment.  But, I have learned to "lob" things fairly well using an open hand.

Quix

[doublevision1]

this is a great question, Ren.  I don't have an answer but I do share this symptom with you.  Lately I have been smashing things left right and centre.  Fortunately no one was hurt and I had no attachment to these objects, though pretty soon I am going to need a whole new set of wine glasses.  Just the other day I was at a cafe with a friend having a very large latte in one of those tall take-out cups.  I got only a sip or two when I missed reaching for it and knocked the whole thing over.  24 ounces of latte all over the table and carpet, though miraculously not on me or my friend.  And the carpet was brown already, so that's good.  It's so frustrating and something you think you'd adapt to, but something you don't seem to be aware of until you drop/knock over/bang into things.  My neuro knows about this but offered no suggestion re: treatment.  His take seems to be that this is a hard symptom to treat and it'll either get better on it's own, or not.

[jensequitur]

I personally think that exercise in general helps with nerve connections.  However, proprioperception is a function of the spinal column.  Spinal column damage takes a long time to heal.  So it make be a year or more before you'll see some of that return - and that's if there isn't any further damage.

I would be really careful about banging into things.  Any injury to the foot will cause spasticity up the leg.  You can also really injure yourself and not realize this because you're numb - believe me, I know!  I walked around for a day with a broken toe before I realized it was broken, not just bruised.  Then the spasms in my calf started...

[rendean]

Thank you for your responses. I appreciate any and all thoughts sent my way.

No, I haven't talked to my neuro about this yet. I just saw him last week and it wasn't an issue but the hand and muscle jerking is starting to return. So once I video that , I will call him. I have PT on Wednesday and I was hoping to have her document this for me.

BTW, I still have a few brains left in my head...the bacon grease had cooled down before I even contemplated touching it. :-) I cooked the bacon in the oven and someone usually removes things form the oven for me per orders of  my PT. No knives either due to documented decreased sensation (monofilament testing)  in my left hand and some cuts already that I didn't notice until the food turned red.

Thanks again,
Ren

[michelleric]

(((Ren))),

I have no idea to your question but am sending you a big hug and tell you I am thinking of you. Perhaps stop cooking bacon at the moment. That grease is scary if it got on you. You dont need any more injuries.

BIG hugs to you my friend,
Michelle

[tonyad]

  I am sorry to hear that you are not doing so well.
I am also sorry that I do not have much input on proprioception (did I spell that right?)
From what I do know about it, It has got to be hard to try and deal with.

   Got you in thought and Prayer.......I am guessing that you have informed your Neuro about this right? Be careful around glass and any other sharp items.

Take Care,
~Tonya

[rendean]

I don't think I've ever heard of a behavioral optometrist. What an interesting concept!! I will have to explore this option as well.

Thank you for your input!!

Warmly,
Ren

[supermum_ms]

Hey Ren,

Well my family are getting use to bridging the gap or be faced with their dinner in their lap lol sorry your getting clumsier due to propprioception issues too. I still am a strong believer in neuro plasticity and i do think i'm not as bad as I was but could still use some tweeking, i've been thinking of seeing the behavioural optomitrist my son use to go to.

I cant with honesty, say if the behavioural optomitrist exercises was, what made the difference to his sports/sight issues but he went from not being able to catch a ball etc to being able to, also helped heaps with his balance, so I sort of think it did do something to change how his brain perceived distance. I'm not sure if PT would incorporate enough to change sight-brain but I'd expect it would help with the figuring a way around it.

Cheers......JJ