Sensory re-training involves a broad range of techniques, including CIMT, sensory tricks, and tactile exercises.
By giving the hand new repetitive tasks to perform that involve fine motor control, changes are made in the sensory cortex. These changes are thought to reverse, or re-map, the areas in the brain that have caused the focal dystonia. As well as using sensory ‘tricks’ to lessen the symptoms of the dystonia whilst playing, there are a number of exercises where the patient can work away from the instrument altogether.
The use of devices such as latex gloves, or tape around the digits of the hand, has been noticed to lessen the effects of focal dystonia in certain cases. It is thought the brain is somehow tricked into thinking a different task is being performed, and hence a different area of the motor cortex is activated. These tricks, while giving positive signs that the condition is malleable, often have short lived effects and need to be used within a wider range of sensory retraining techniques.
The use of dominoes, buttons, small toys or figures, and even braille have been used to help patients fine-tune their tactile senses. Often blindfolded and using the opposite hand in conjunction with the affected one, patients are asked to identify or visualise the small details of these objects. The use of the unaffected hand is thought to help the dystonic hand ‘learn’ in the correct way.
The success of these techniques requires a high level of compliance. Nancy Byl recommends at least 1-2 hours a day for these activities.
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