I have just reached Levine’s chapter on spasticity. I am very glad to report that, while the stroke brought on many previously-unexperienced problems, spasticity was not one of them. However, many people, both here and at Bristol After-Stroke, suffer from this. Although it is rarely talked about, I see little improvement with others, but Levine seems to expect this to improve with the right choice of exercise, frequency and intention. In this sense it is just like other things such as sit-to-stand where practice eventually makes perfect.
I, on the other hand, suffer from intention tremors of the right arm, and this has presently destroyed any hope I had of returning to playing the violin in orchestra. Remediation is mentioned nowhere, apart from medical interventions such as implants or burning lesions into the brain. There’s also etanercept, but all of these carry an element of risk.
Spasticity is expected to improve with time with suitable exercises, while tremors are meant to get slowly worse with time. Yes, I have simplified what could be a bit more nuanced than this.
So how are they possibly related? Well, it seems to me that they share the common facts that (i) the muscles are fine, depite appearances to the contrary, and (ii) the brain is either sending incorrect signals to the muscles or none at all. These are big commonalities, and forms quite a substantial overlap, if it isn’t really a complete overlap. One of my questions is: am I right? If not, then how am I incorrect, and does anyone know about this? Does this apparently substantial overlap mean that, what works for spasticity will work for tremors also?
In the last 24 hours I have begun a programme of 5 times clenching the hand, 5 times spreading the fingers wide, 5 seconds of a resting-your-hand-on-a-keyboard pose with the wrist above the table and not touching it. If any tremors are felt, I immediately go back to clenching so that the tremors don’t have a chance to establish. This morning I managed 20 of these and 14 were without tremors. I was a bit surprised that I managed 14! This afternoon was 20/17 - seems to be an improvement? Perhaps in later days I’ll go to 10 seconds if this regime is seen to improve matters. Perhaps Levine’s experience that 80% of placebos still work will work for this too, so will the doing of something towards the overall objective work if done with the right intention?