Posts Tagged repetition

[BLOG POST] Repetition Improves Stroke Recovery Time – Saebo

In all stages of growth and development, repetition is key to successful long-term learning and information retention. Repetition is especially beneficial for stroke survivors who seek to regain motor function, strength, and coordination. Consistent repetition that re-establishes communication between the damaged parts of the brain and the body is crucial in stroke rehabilitation.

The brain is our most complex organ and scientists still don’t fully understand it, but we have extensive evidence of one amazing capability called “neuroplasticity.” Neuroplasticity is the brain’s ability to form new synapses, or connections between neurons, especially in response to a brain injury. The nervous system compensates for damage by reorganizing the neurons that remain intact. To form new connections, the involved neurons must be stimulated through consistent activity. Fully understanding this process—and why it works—motivates and clarifies the essential role of repetition in post-stroke rehabilitation.

Neuroplasticity Is The Ability To Heal

For our bodies to perform even the simplest tasks, networks of nerve cells, or neurons, must act in tandem to stimulate the correct parts of our bodies. However, when a stroke causes damage to an area of the brain, damaged neurons become unable to send out signals to the corresponding regions of the body. Although a stroke survivor may appear to have suffered damage to an area of the body—for example, the right arm and leg might be paralyzed—the issue actually stems from damage in the brain.

Amazingly, the brain compensates for these losses through various regenerative strategies. A common process, neuroplasticity, is something that the brain undergoes whenever we learn a new piece of information. As our environments and daily routines change throughout life, we create new synapses, or neural connections. During a healing process, the brain is even more engaged when building these new networks. Synaptic pathways are restructured to work around damaged neurons and may even relocate to entirely different areas of the brain.

Under the right circumstances, the brain can even create new neurons in a process known as neurogenesis. Any healing process requires a healthy body, to support the regeneration of cells, and neurogenesis is no different—the regenerating areas of the brain must be healthy, with the proper blood and oxygen supply, and must be activated consistently. Stroke survivors can encourage neurogenesis through frequent therapy, as well as at-home practice. Careful, diligent practice also ensures that new synapses and neurons do not lead to additional issues or symptoms.

Research has shown that stroke survivors who use repetition to promote neuroplasticity enjoy significant progress in their recovery. In one study, patients who initially struggled with grasp-and-release exercises demonstrated increased cortical reorganization after adhering to a repetitive rehabilitation regimen.

Visualize Progress And Challenge Yourself

We are only just beginning to discover the magnitude of the brain’s capabilities. Not only can the brain heal itself through proper support and repetitive exercises, but it can also respond positively to diligent and focused visualization of those same exercises. People who visualize a process can strengthen the involved synapses without performing the actual, physical motion. Visualization is a great introduction to rehabilitation for those who cannot physically complete the motions. In the early stages of regaining motor function or range-of-motion in an affected limb, it is important for stroke survivors to apply themselves to visualization with the same commitment as they would a physical exercise.

Ia 1995 study, synapses strengthened in participants who imagined completing a particular piano exercise. Even though they were not performing any physical motions, their brains still registered and retained the musical information. This principle is vital for those in the early stages of stroke recovery. Visualization bridges the gap between the motivational difficulties inherent to the early stages of rehabilitation and the more physically intense practices later on in recovery.

The transition between visualization and physical performance can be challenging. Supportive tools such as the SaeboMAS provide support to the affected limb while relieving stress from the joints and muscles involved in the exercise. By guiding the arm through its first physical motions, SaeboMAS helps the brain transition from visualization to independent task completion. Tools like SaeboMAS also encourage consistency in motion, a crucial factor when attempting such intensely repetitive action.

Once you master a repetitive action, it’s important to continue challenging yourself with an exercise routine. This is against human nature because once a task feels easy, we feel that we have succeeded; however, repetitions while on autopilot are far less beneficial than when the individual is actively focused on performing each repetition. It takes self-discipline to continue increasing the difficulty of an exercise but you can derive motivation from the support of a therapist, friends or family.

CIMT—or Constraint Induced Movement Therapy— allows for personal adjustments to the difficulty of an exercise. It’s common for those healing from motor function difficulties to avoid challenging the affected limb, overcompensating with the healthy limb to the point that the affected limb begins to deteriorate further due to non-use. Once the patient can comfortably rely on the affected limb, CIMT introduces “shaping” or “adaptive task practice”: the deconstruction of complex physical tasks into manageable steps that are added one at a time. This gradual addition of challenges deters the patient from switching to autopilot during long, repetitive sets.

A motivated and clear mindset is crucial, therefore the exercises themselves must follow a natural progression to become more challenging, while not being too frustrating. This balance comes from respecting each motion—no matter how small—as an important building block in the healing process. By remaining present in the repetitions, the brain picks up on more detailed messages from the body about what it needs. Any associated soreness or pain should be discussed with professionals to ensure that exercises are promoting healing and not inadvertently causing further damage.

Practice With Purpose

As mindfulness increases, it will become clearer which exercises are right for each particular day, depending on how the body feels. By honoring your body as your guide, you will improve your motivation and the physical progression of neuroplasticity. However, sensing what is best for the body is a tricky practice. Harder tasks may challenge a wider variety of neural networks, speeding up the healing process even when the exercise itself feels less successful.

Overall, it’s better to challenge the brain by moving beyond repetition that no longer inspires further improvement. Start small by mastering simpler tasks and skills, then immediately move on to slightly harder versions of those actions. Always maintain the same level of consistency, but with added restraint or weight. Without added challenges, the progress made through rehabilitation can be lost. It may help to view this healing process as a long-term, ongoing journey with the goal of fully rebuilding and re-strengthening connections that would otherwise be lost.

Canadian psychologist Dr. Donald Hebb claimed that “neurons that fire together, wire together,” in his 1949 book, “The Organization of Behavior.” Long before today’s societal focus on mindfulness, Dr. Hebb recognized the occurrence of neurological regrowth when an activity or thought process is repeated diligently. This observation is pertinent to unlearning less helpful habits or thought patterns, as well. If someone in rehabilitation develops a bad habit, such as injuring a healthy limb through overuse, the brain can unlearn these habits through careful repetition.

Mindfulness Leads To Motivation

The benefits of mindfulness are open to all kinds of learning. Intentional focus during practice is the only way to ensure the brain is fully present and supported for neuroplasticity and neurogenesis. During visualization, each movement should be imagined with extreme specificity as well; awareness that is too unspecific can lead to apathy and lack of concentration. Visualization can be motivating, pushing the person in rehabilitation past the plateau stage—a dispiriting time in the process in which progress stalls. Overall, the trick is to keep exercises from becoming routine. When each day is different or challenging in a new way, the brain stays engaged in ways more conducive to synaptic rehabilitation.

You Need To Move

The most important mantra for post-stroke recovery is to keep moving. Once an intention or goal has been set, consistent movement is the key to warding off muscular atrophy. As mentioned earlier, even before physical movement is possible, exercises can be completed in the brain through visualization. Begin as soon as possible after the injury to take full advantage of early neurogenesis before entering the plateau phase. Whether visualizing or physically completing an action, repetition  is the most important factor in long-term recovery.

How Much Is Enough?

The question remains, how many repetitions are enough to regain full health during stroke rehabilitation? The number of repetitions required to establish a neural pathway depends on multiple factors:

  • the type of exercise
  • the area of the body
  • the current health of the muscles, nerves, and joints

Consistent, dedicated repetition is the most important priority. Without this, the brain cannot complete the rebuilding of the neurons, networks, and capabilities it lost during the stroke.

Quality of repetitions is just as important as quantity. Practice is helpful only while remaining mindful and fully present. Concentration also bolsters motivation, especially when progress plateaus.

Together, mindfulness and repetition move those in rehabilitation past initial discomfort more quickly by strengthening the affected muscles and neurons. We now know that visualization and drive have a psychosomatic effect, speeding up rehabilitation while the brain is most susceptible to healing. Visit the Saebo blog for more information about healing after a stroke.


All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.

via Repetition Improves Stroke Recovery Time | Saebo

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[WEB SITE] How a Stroke In The Right brain Affects The Body & How to Recover | Saebo

Guide to Recovering From a Right Brain Stroke

Two is stronger than one, and your brain is no exception to the adage. What many people may not realize is that your brain consists of two distinct parts that work together as one, much like your eyes or ears.

Essentially, each side of the brain—left and right—is responsible for carrying out specific tasks. An easy way to understand this concept is to imagine a photograph of a loved one or friend. Immediately, the right side of your brain will see that it’s a person in a kind of setting (visual). But the left side of the brain will be the one to associate that person and place with a specific memory (analytical). You may have heard people say that they’re more “left-brained” or “right-brained”; they are identifying with the side of their brain, and its associated processes, that they feel is more dominant in their thinking. This symbiotic relationship is crucial to how everyone’s mind processes and stores information, so when either side of the brain is damaged by a stroke, there can be specific repercussions.

In most cases, a stroke occurs on one side of the brain. In this article, we examine the right brain in particular, its functions, and share what processes may be affected by a stroke.

What Does The Right Brain Control?

What Does The Right Brain Control?

When it comes to physical movement, the right side of the brain is responsible for carrying out functions for the left side of the body. The same is true for the opposite—the left side of the brain controls the right side of the body. Although we essentially live with crossed wires in our system, the same principles don’t necessarily apply when it comes to certain cognitive functions for each.

Specific duties performed by the right side consist of:

  • Spatial Reasoning
  • Musical Comprehension
  • Basic Object Recognition
  • Creative Abilities
  • Emotion
  • Imagination

Taking these things into consideration, it’s easy to see why any disruption to the right brain can be devastating. Unfortunately, a stroke can occur on either side of the brain depending on where the damage takes place. If you or a loved one has suffered from a right brain stroke, it’s important to be aware of what kinds of complications may arise.

Possible Effects Of Right Brain Stroke on Survivors

Suffering from a right brain stroke is certainly difficult to endure and overcome but, by increasing your awareness of what the potential side effects are, you can better prepare yourself for the road to recovery.

Potential Effects Of A Right Brain Stroke Consist Of:

  • Loss of Mobility and Control of the Left Side of the Body: Like what was mentioned above, damage to the right side of the brain can result in a loss of functionality in the left side of the body. This means that a stroke survivor can potentially lose the ability to move their left hand, arm, leg, foot, or left-side face muscles.
  • Unilateral Neglect: Mostly prominent in right-brain affected stroke patients, Unilateral Neglect (or Hemispatial Neglect) refers to an unawareness of objects to one side of the body or personal space. In severe cases, a side can be completely ignored when carrying out certain tasks and everyday functions.
  • Denial Syndrome or Anosognosia (Self-awareness): Due to various parts of the brain that remain unaffected after a stroke, stroke survivors will mentally believe that they are carrying out their physical functions in a normal fashion despite their actual inability to do so. These issues can also lead to a stroke survivor not wanting to undergo physical rehabilitation, which can put them at risk for further injury if left unresolved.
  • Emotional Indifference: A lack of emotion or change in emotional affect can be exhibited after a stroke, rendering the survivor to act as if nothing serious—physical or mental—needs to be addressed. This kind of indifference or unmotivated behavior can make initiation of or following through with the rehabilitation process difficult. Learn more about coping with emotional changes after stroke here.
  • Visual & Spatial Issues: Stroke survivors can experience a myriad of issues when it comes to visual and spatial comprehension. Primarily, a survivor will have trouble judging their location amid objects in their surroundings. This can manifest in difficulty feeding themselves, climbing up and down stairs, and changing clothes. Additionally, one may lose the ability to visually and mentally recall certain objects. A new rehab approach for retraining the brain in these areas is with the use of virtual reality. Learn how the SaeboVR can make recovery exercises fun!
  • Social Challenges: In many cases, a stroke survivor will have a difficult time recognizing certain social behaviors and cues. Things like body language, nonverbal communication, humor and sarcasm have the potential to go unnoticed.
  • Lack of Focus: One may not be able to give their full attention to a subject for extended periods of time. This inability can also surface if a stroke survivor is trying to follow directions, answer questions, or solve problems with basic reasoning practices (instinctual errors).
  • Loss of Hearing & Musicality: When considering the range of variables that make up one’s persona—emotions, actions, and mental processes—it’s important to realize that a person’s hearing and understanding is made of similar components. This means that a stroke survivor may have trouble picking up on certain sounds, which could result in miscommunication or an inability to appreciate the musicality of speech and tone altogether.

 

Treatments for Right Brain Stroke

Treatments for Right Brain Strokes

For any survivor to begin to see positive changes after a stroke, the rehabilitation process must start right away. Of course, the pathway to recuperation will be different for every individual, but the process that must always take effect in order to see results is something called neuroplasticity.

Neuroplasticity, in essence, refers to the regenerative properties of the brain—a re-establishment and rearrangement of neural connections. This means that the brain is essentially reprogramming itself in undamaged areas to support damaged ones, and the sooner this activity begins, the sooner one can recover.

Process of Dealing with Right Brain Stroke

To enhance this process, proper execution of rehabilitation exercises—both mental and physical—must be carried out on a regular basis. Over time, consistent and repetitive efforts will aid in constructing healthy neural connections, as well strengthening damaged ones.

In addition to consistency and repetition, there are rehabilitation exercise aids which can enhance the effectiveness of rehab exercises after stroke. These devices offer additional supports that allow the user to execute a wider range of exercises and adjust the difficulty for individualized results. For weakness in the arm or hand, the SaeboGloveSaeboFlexSaeboStretch, or SaeboMas can significantly increase the speed and effectiveness of rehabilitation.

Although the difficulties of life post-stroke can seem insurmountable, always remember that the brain and the heart are two of our most powerful organs. Given the right tools, patience, and support, you or a loved one can move forward on the path to recovery.

All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.

more —>  How a Stroke In The Right brain Affects The Body & How to Recover | Saebo

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[WEB SITE] Neuroplasticity: 10 Things Stroke Survivors Need to Know

Neuroplasticity is a big word getting a lot of buzz. It means the brain (“neuro”) can change (“plastic”). We hear a lot about it in stroke and brain injury rehab because it gives hope to survivors that their brains can heal, adapt, and rewire after they have been damaged. We also hear the word in advertisements for new treatments or programs. What exactly is neuroplasticity, and how does it work?

Intuitively, we know that we get better at the things we practice, and we are shaped by our experiences. Therapy for a damaged brain is essentially no different. The best therapies exploit how neuroplasticity works by using repetitive positive experiences to forge and strengthen pathways in the brain. To better understand how this works, we look to the research published by Kleim & Jones that outlines the 10 principles of experience-dependent neuroplasticity.

Neuroplasticity - What it Means for Stroke Survivors

1) Use it or lose it

The skills we don’t practice often get weaker.

2) Use it and improve it

The skills we practice get better.

3) Specificity

We must skillfully practice the exact tasks we want to improve.

4) Repetition matters

We must do a task over and over again once we’ve got it right to actually change the brain.

5) Intensity matters

More repetitions in a shorter time are necessary for creating new connections.

6) Time matters

Neuroplasticity is a process rather than a single event, with windows of opportunity opening for different skills at different times. In rehabilitation, starting earlier is usually better than starting later.

Recent research shows that even 5+ years post-stroke, people with aphasia made significant progress in language skills using Language Therapy daily.

7) Salience matters

To change the brain, the skill we’re practicing must have some meaning, relevance, or importance to us.

8) Age matters

Younger brains tend to change faster than older brains, but improvement is possible at any age.

9) Transference

Practicing one skill can result in improvement of a related skill.

10) Interference

Learning an “easier way” of doing something (i.e. a bad habit or compensation) may make it harder to learn the proper way.

 

Whether you’re learning a new skill or re-learning a lost one, it’s clear we must practice the thing we want to get better at. Unfortunately, many stroke survivors, recovering but not yet ready to return to work, sit at home alone between therapy sessions. They turn to TV to pass the time, despite being willing to do the exercises they need to improve their skills. Fortunately, there are new technologies (such as an app that helps you practice talking or a video game that guides you through meaningful movements) that can help provide intense, meaningful, and skilled stimulation that will change their brains for the better. Understanding how neuroplasticity works can help you evaluate which methods can truly help you reach your goal.

Regrettably, there are some people who are exploiting the term neuroplasticity to give brain injury survivors false hope that they can get better with unproven treatments that require little to no effort. If the therapy does not have you directly practicing the skill it claims to improve, please be cautious. There are no quick-fixes (remember: intensity and repetition matter), and there is no one-size-fits-all solution (remember: specificity and relevance matter). Anyone who tells you otherwise, using brain-brandingneuro-marketing, or brain-training terminology while charging you for a service or product, is banking on you not knowing the difference. But now you do.

 

Further Reading on Neuroplasticity:

 


Tactus Therapy apps are an affordable and accessible way to get some of the mental stimulation needed for recovery. You can personalize Language Therapy, Answering Therapy, and Conversation Therapy with your own questions or photos, helping you use repetition & personal relevance to your advantage.

Source: Neuroplasticity: 10 Things Stroke Survivors Need to Know

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[WEB SITE] Neuroplasticity: 10 Things Stroke Survivors Need to Know

Neuroplasticity is a big word getting a lot of buzz. It means the brain (“neuro”) can change (“plastic”). We hear a lot about it in stroke and brain injury rehab because it gives hope to survivors that their brains can heal, adapt, and rewire after they have been damaged. We also hear the word in advertisements for new treatments or programs. What exactly is neuroplasticity, and how does it work?Intuitively, we know that we get better at the things we practice, and we are shaped by our experiences. Therapy for a damaged brain is essentially no different. The best therapies exploit how neuroplasticity works by using repetitive positive experiences to forge and strengthen pathways in the brain. To better understand how this works, we look to the research published by Kleim & Jones that outlines the 10 principles of experience-dependent neuroplasticity.

1) Use it or lose it: The skills we don’t practice often get weaker.

2) Use it and improve it: The skills we practice get better.

3) Specificity: We must skillfully practice the exact tasks we want to improve.

4) Repetition matters: We must do a task over and over again once we’ve got it right to actually change the brain.

5) Intensity matters: More repetitions in a shorter time are necessary for creating new connections.

6) Time matters: Neuroplasticity is a process rather than a single event, with windows of opportunity opening for different skills at different times. In rehabilitation, starting earlier is usually better than starting later.Recent research shows that even 5+ years post-stroke, people with aphasia made significant progress in language skills using Language Therapy daily.

7) Salience matters: To change the brain, the skill we’re practicing must have some meaning, relevance, or importance to us.

8) Age matters: Younger brains tend to change faster than older brains, but improvement is possible at any age.

9) Transference: Practicing one skill can result in improvement of a related skill.

10) Interference: Learning an “easier way” of doing something (i.e. a bad habit or compensation) may make it harder to learn the proper way.

Whether you’re learning a new skill or re-learning a lost one, it’s clear we must practice the thing we want to get better at. Unfortunately, many stroke survivors, recovering but not yet ready to return to work, sit at home alone between therapy sessions. They turn to TV to pass the time, despite being willing to do the exercises they need to improve their skills. Fortunately, there are new technologies (such as an app that helps you practice talking or a video game that guides you through meaningful movements) that can help provide intense, meaningful, and skilled stimulation that will change their brains for the better. Understanding how neuroplasticity works can help you evaluate which methods can truly help you reach your goal.

Regrettably, there are some people who are exploiting the term neuroplasticity to give brain injury survivors false hope that they can get better with unproven treatments that require little to no effort. If the therapy does not have you directly practicing the skill it claims to improve, please be cautious. There are no quick-fixes (remember: intensity and repetition matter), and there is no one-size-fits-all solution (remember: specificity and relevance matter). Anyone who tells you otherwise, using brain-branding, neuro-marketing, or brain-training terminology while charging you for a service or product, is banking on you not knowing the difference. But now you do.

Source: Neuroplasticity: 10 Things Stroke Survivors Need to Know

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[ARTICLE] Things to Note in Stroke Rehabilitation – Full Text PDF

Abstract

Stroke results in impairment of motor, cognitive and sensory/perceptual functions. As such, activities of daily living (ADL) after stroke can be affected. These affectations can persist for a long time depending on the extent of the affectation in the brain and rehabilitation. In fact, stroke has lately been recognized as a long term condition. Thus, stroke rehabilitation requires intensive time. When stroke occurred, the brain capitalizes heavily on learning to recover function; and the best way to induce such learning is known to be through task specific training.

Effective stroke rehabilitation requires knowledge of the current available evidence base. However, to embrace the current available evidence, skills in information retrieval and critical appraisal of the literature are needed. Unfortunately, the skills of a say, entry level physiotherapists may not be adequate for them to be abreast of the evidence-based practice. Thus, there is a need to summarize the literature for such therapists to help them note some important issues in stroke rehabilitation.

Full Text PDF

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