Over at the NeuroCollaborative, we had a discussion recently about our favorite neuro rehab articles. I wanted to share mine and several of the others mentioned as they were good too!
We’ll start the series with my favorite article! I like this article because it is so foundational to everything I do everyday. If you don’t get this article, you won’t get what I do. This article is required reading for each of my students.
First, the article defines neuroplasticity– the physiologic growth of brain cells when a person learns something– and why it is necessary after brain damage. Brain cells communicate in a network, like the internet you’re reading this on. The internet is a bunch of information stored on computers all over the world. When your computer joins the internet network, it has access to the information on that network. When brain cells die, individual computers or brain cells can’t get to the information on the network, because there are dead spots, a disconnect. Which is where you see the problems– a arm or leg doesn’t work, because it can’t connect onto the network. In order for it to reconnect to the network, new brain cells need to be grown via neuroplasticity.
So that’s where I come in. As a neuro therapist I provide treatment activities that encourage new brain cells to develop and guide them in developing in the correct way.
That’s why this article is so foundational and important. Without these principles, I’m not going to make any head way and I’m just wasting everyone’s time.
Without further ado,
Principles of Neuroplasticity
- Use It or Lose It– If you don’t use a brain area, it will be reabsorbed and reallocated to another purpose. This becomes important for patients when they can’t walk because one of their legs doesn’t work. That doesn’t mean the other one is incapable of moving and walking, so this is why I work not only the leg that was affected, but also the other leg– to make sure the good leg’s brain cells are still available for use when the bad leg is ready to try walking again.
- Use It and Improve It– You have to actually make those brain cells fire by moving yourself or thinking about moving in order to make those brain cells grow. This is why passive activities (with the exception of visualization activities) are not going to make brain cells grow.
- Specificity– If you want to learn how to play baseball, you don’t practice golf. Same thing in therapy. If you want to learn how to walk, you practice walking.
- Repetition Matters– And you don’t just practice walking once…. you practice a lot.
- Intensity Matters– You practice a lot, a lot. In fact, generally, the more you do the better.
- Time Matters– But you have to be careful to not do too much too soon. Too much too soon can actually kill the baby brain cells. This is where having a professional neuro therapist comes in handy to make sure you’re not actually doing damage in your excitement to do 1,000 reps of something in 5 minutes.
- Salience Matters– You have to pick activities that are meaningful and important to the person doing them. I like to describe rehab as a road trip: the patient is in the driver’s seat and the therapist is in the passenger seat with the map. The therapist knows where to go and how to get there, but if the patient doesn’t push the gas, we’re not going anywhere. So you have to pick somewhere to go that the patient wants to go to and ideally, with some good sights along the way to keep the patient motivated.
- Age Matters– As we age, the brain’s ability to grow new brain cells decreases. That’s just life.
- Transference– Let’s say you’re working on transfers– a person’s ability to stand up and sit down. We do a lot of different transfers during the day. I’m sitting on my couch right now, but I’ve sat on a rolling desk chair, a stool, a toilet, a car seat… who knows what else today. And although all those transfers are slightly different, the basics are all the same. So although practicing them all is ideal for specificity (see above), many of the skills practiced in one type will transfer to the others. That’s transference.
- Interference– BUT, maybe the skills in one of those transfers gets in the way of doing another successfully. For example, it’s kind of fun to just drop onto the couch when I sit to bounce a little. But if I did that on the rolling desk chair, I’d probably wind up on the floor. So those two transfer techniques might interfere with performing each other safely and successfully. It’s important to be aware of those interferences and train toward making those differences understood.
There you have it: your recipe for growing brain cells!