CT Using mirror therapy idea with MS client, excepts my hands instead of a mirror

[rkathryn]

Not sure where to put this one, I'm sure a moderator will put it in the right place.

I have a client with MS, he can still get around okay and even drive. The left leg has been numb for some time and the left arm gets feeling in it that comes and goes. (I know and he's still driving?!)

For today's session, I tried and experiment with him. I told him about mirror therapy and that I would try and apply that in the massage. I asked him to pay attention to the massage on his right limb and then I would perform the exact same strokes/speed on the opposite limb. I worked his right leg/foot and then the left leg/foot second, following the same idea with the upper body-- the right side first.

After working the left leg and foot, he exclaimed that he could actually feel what I was doing to his foot. To be honest, I tried it first without telling him about the mirror therapy until after working his legs. I explained it after he expressed surprise that he could feel my touch on his left foot and leg.

We'll see what happens when I see him for his next session.

My thinking is that with mirror therapy, the brain is fooled into thinking a limb can function better. Since we can imagine we are playing tennis and the parts of our brain involved in that action light up, I wondered if the same thing couldn't be done with touch. Of course, he has MS, so maybe the most would be he feels his leg and foot a little more than usual for his daily activities, but I wouldn't expect the symptoms to disappear.

But I wondered what you (somasimplers) thought about that?

[Randy Dixon]

It will be interesting to follow. It depends if his numbness is due to the demylenation processs or a lesion or if it is has something to do in the cortical processing. It is possible that he believes he is feeling sensory changes in his left leg even though he really isn't, it is also possible that what you are doing is changing something in the way the signals are processed.

I think it is an interesting case study regarding the relative inputs of the left and right sides of the neuromatrix. It may be something like the opposite of phantom limb pain.

[Diane]

Interesting idea Rajam.
An input is an input. Somatosensory or visual.
Visual processing uses way more of the brain than somatosensory, but all input is funnelled through premotor, motor and autonomic output parts of the brain, kind of the same way, according to Mayo Clinic Medical Neurosciences 5th ed. (see picture bottom of this book review).

[joebrence9]

Great idea Rajam. I currently am treating a patient with MS who had a childhood history of CRPS and her daughter now has CRPS. I ran recognize on her and she has significantly diminished laterality ratings both L and R. I suspect the premotor cortex is heavily involved and maybe a correlation between the conditions (MS is difficulty to diagnose and criterion are rather vague---maybe it could be a form of central sensization?)

[zimney3pt]

It would be curious if they have any right/left judgement differences.

[zendogg]

For what it is worth, I worked on a woman who had significant pain in one of her feet and non-volitional movement of the foot that was incredibly annoying. If I remember it was caused by a nicking a nerve from a LB disc surgery. Numerous neurology appointments and therapy did pretty much nothing for her. I tried a bunch of stuff that didn't do much. Then on a total whim I thought of touching her opposite foot. INSTANTLY the other foot stopped moving around. Just stroking and paying attention to it even diminished the pain notably. I told her to use that as her therapy and for the most part she could reduce bad flare ups by self applying touch to the opposite foot. Who knows, could be on the same page??