I want to expand on this thought a bit more:
1. The focus, the inner attention, has to be on the process of learning the action, not the desired action itself.There are several studies out there that shows how important this is and how we can use this during treatment:
Lorimer Moseley for example has done it again - a study published in Pain, January 2008 in CRPS shows that there is a big difference in how attention influences treatment.
It's been known for some time now that attention is the driving force behind cortical plasticity - the same stimulus is able to produce two different outcomes - depending on how much attention is directed towards the stimulus.
Stimulus discrimination (paying attention to what and where a stimulus is applied) - changes the cortex in a completely different way than simple passive tactile stimulation.
The process of attention is crucial in treating chronic pain; unfortunately the mental processes behind it are as yet poorly understood and there is a lot of controversy about even defining this mental capacity.
For us - PT's and others who work with patients we can focus on making the tasks we give the patient meaningful, functional and fun - that should be more than enough for now. ;-)
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