Summary

We consider how a number of interventions that would normally interfere with function have paradoxically improved symptoms in patients with neurological conditions. These include distorting reality, constraining patients' ability to perform everyday tasks, impeding vision, temporarily disabling healthy brain tissue, and distracting patients from the task at hand. We argue that the effects of these diverse interventions can be understood within a general framework of brain function that emphasizes competition for limited capacity resources. We discuss how this competition can be biased to produce rehabilitation benefits.

Introduction

Neurorehabilitation refers to any intervention that aims to reduce impairment caused by brain injury, disease or developmental abnormality. It also refers to techniques that help compensate for such impairments or that facilitate adjustment (Wilson,1996). Much that is effective in rehabilitation is far from paradoxical. People relearn and improve through practice, encouragement and the setting of incremental, achievable goals (e.g. Wilson et al., 2009). Where full restoration of a function is not possible, as is often the case, compensatory aids such as diaries and communication devices can facilitate independence (Kime, 2006; Kapur and Wilson, 2009). Patients and families can gain comfort, perspective and realistic hope from discussion with professionals and other patients.

In line with the focus of this book, here we concentrate on particular interventions that under normal circumstances may be considered deleterious or contrary to perceived wisdom, but which have been shown to reduce or offset impairment in people with brain injuries.