I woke up this morning and thought "I want to get
on my bike on the trainer." Then I remembered what I had written earlier.
That I was going to work on the trainer each Monday. That meant I would have to
forgo today's workout. However, at breakfast Kathy read me the article entitled
"What is Neural Plasticity?" by Lucy Lazarony written on Jul 31 2014.
Here it is in its entirety (in italics) with some of
my sometimes snide side remarks:
Look at your rehab program in a whole new way by
understanding neural plasticity.
As a result of a stroke, connections in the brain,
also called neural pathways, may be damaged. And this damage may interrupt the
normal flow of signals within the brain and between the brain and other parts
of the body.
Neural plasticity occurs when a new neural pathway can
be established or an unused connection in the brain can be activated.
“Parts of the brain can re-connect or another part of
the brain can take over the function of the parts that are damaged,” explains
Dr. Richard Senelick, author of Living with Stroke: A Guide for Families. “It
takes practice.”
Practice Means Rehab
(and I would add "Rehab means
Practice" or do it over and over, again and again. But don't do it so
aggressively that it causes injury. Especially to the unaffected side. Been
there before.)
“What drives the brain to re-connect, what drives
other parts of the brain to take over the function, is deliberate practice.
Dose matters,” Senelick says. “The amount of repetition, the amount of therapy
drives the brain repair.”
When it comes to repairing damage after a stroke,
early rehab is key, Senelick says. (The
staff at UC Davis had me attempt to walk the third day after surgery. I was a
shoo-in for the Ministry of Silly Walks, but I was trying.)
“The earlier the better with rehab,” Senelick says.
“The key is what the family can do with a home program to continue with
repetitions so you’re getting enough therapy.” (I've even had members of my family build my things
to use at home that are used at PT.)
The Truth About Recovery Plateaus (The truth is: plateaus can be very depressing.)
Many stroke survivors may experience strong progress
early on in their physical and occupational therapy programs.
“Early on, people tend to make more progress and then
it slows down. It doesn’t mean they aren’t making progress. They have a slower
rate of progress,” Senelick says. “You need to be diligent.” (My mind is always working, making predictions, for
example: "if I'm this farm by now, by that month I should be able
to…" Sometimes I like what I see and sometimes I don't. And when I don't I
push harder, almost to the point of overdoing. Not a very good outcome. I have
come to the realization that I am a ham. I like to show off. And PT gives me
that opportunity. Also it adds additional physical recovery time. If you read
the previous posting, I talk about that.)
And because neural plasticity can take place for years
after a stroke, some stroke survivors will continue to see progress in their
recoveries several years after a stroke.
“There are parts that are dying that never re-grow and
parts that are damaged and by doing repetitive functional tasks it promotes
re-growth,” Senelick says.
He urges stroke survivors who have hit plateaus with
their current rehab program to be re-evaluated by a doctor or therapist. (I guess that's the reason my therapist sets goals and
does evaluations periodically.)
“It’s important to get evaluated to find out if you
have a reservoir of ability and if there is something else that can be done,”
Senelick advises.
To get off a rehab plateau, it may mean beginning more
aggressive types of therapy.
“Without therapy, people are self-limiting,” Senelick
says. “People don’t do things that are too hard unless they are forced to.”
So I guess I'm back on the bike today. Not because
it's hard or easy, but because I like being on the bike. Even if it's on the
trainer.
