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Stroke-Brain-MRI

Is Your Brain Really “Plastic”? – The Key to Stroke Recovery

Neuroplasticity is the brain’s ability to reorganize itself by forming new neural connections. This occurs through the changing of neurons, the organization of their networks, and their function via new experiences. Neuroplasticity is also called neural plasticity, brain plasticity, cortical plasticity, or cortical re-mapping.

You are experiencing neuroplasticity every time you learn something new, such as how to use a new computer program, a new line of music, a new app on your phone, or a new exercise in your workouts. Learning is neuroplasticity.

For brain injuries such as stroke, neuroplasticity takes on an even greater importance. Because the injury literally damaged or even destroyed neurons, we must harness neuroplasticity to build new neural connections to do regain or improve upon the resulting dysfunction. The cool thing is that other areas of the brain, those not normally associated with a given action, can assist if the stimulus is strong enough.

Why neuroplasticity matters for all brain injury survivors

The concept of neuroplasticity is very important and if you work with stroke survivors it is a concept you will want to explain at some level. Here are some points of why neuroplasticity is so important:

  • Neuroplasticity provides hope – Despite the fact that the concept of neuroplasticity has been around for several decades, it is still not widely understood in the public arena. When we explain neuroplasticity to our pain and brain injury clients, they often reply that knowing this gives them hope. Hope is especially important for a stroke survivor, in which the loss of a major motor function occurs so swiftly that it can seem to be a very daunting process to recover from.
  • We can target neuroplastic change – The great thing about learning a neuro-centric approach to training and exercise therapy is that the nervous system is very orderly and so we can be very targeted in our training to regain or improve dysfunctions.
  • Neurons that wire together, fire together – Understanding some basic neuroanatomy can go a long way. The bottom line is that areas of the brain that live close to one another can affect one another. Here is an easy example:

    • In the picture above, we see the sensory (purple) and motor (blue) cortices of the brain; if we had an issue with knee articulation, we could stimulate that area by moving the hip and/or ankle, which would “fire” into the knee area just by their proximity.
    • Here is a less obvious example: Also, notice how close the eyes and the hands are in the sensory and motor maps; you can help motor control of the hands by doing eye exercises.
  • You have lots of “backup disks” in the brain – A stroke can damage whole neuronal areas beyond repair. While this sounds daunting, it is still possible to regain function. One aspect of neuroplasticity is that other areas of the brain can actually take over to learn and perform tasks they are not normally associated with, given the right kind and amount of stimulus.

The concept of neuroplasticity and how to harness it is not only for stroke recovery, but also for general fitness, performance, and pain clients! Begin learning a neuro-centric approach to medical fitness and how to work with stroke survivors with our Stroke Recovery Fitness Specialist online course, available through the MedFit Classroom!


Dr. Grove Higgins is a chiropractor, rehabilitationist, soft tissue injury expert, researcher, anatomy instructor, biomechanist, human performance expert, speaker, and corporate health consultant. In 2015, Dr. Higgins cofounded Neuroathlete with Coach Patrick Marques (LTC, US Army Ret.) and Peter Hoversten. Neuroathlete’s goal is to more broadly deliver neurological training to a global audience.

Master Trainer Pat Marques served in the Active Duty Army for 20 years in the Infantry and Special Forces, including combat tours in Iraq. Upon retiring Pat decided to try and combine his two passions – soldiers and fitness. He was able to work with soldiers through adaptive physical training, helping them deal with amputations, chronic pain, PTS, and traumatic brain injury. Pat has completed over 600 hours of neurological training, becoming a Z-Health Master Trainer. He currently provides exercise therapy, movement reeducation, and strength and conditioning for all levels of clients at NeuroAthlete, from chronic pain sufferers to Olympic-level athletes. 

Female-Trainer-and-older-male-client

Trainer Challenge of Stroke

A stroke is an obvious turning point in most survivors’ lives. In a best-case scenario, it can be as minor as a mild concussion. At worst, it is a disabling brain injury that leaves the person incapable of caring for themselves—or even breathing on their own. In any case, stroke clients can provide a significant challenge to a trainer wanting to help them, once medical care and primary rehabilitation has plateaued. This is especially true considering the variety of experiences a survivor can have, following a stroke.

feet-under-blanket

Evolution of the Foot: How the Senses Shape the Foot

Everyone has had flat feet, and probably will again – and that’s normal!

While working in a biomechanics lab, part of my job was to read nearly 500 papers on childhood foot development. In doing so, I learned something extraordinary: we all had flat feet at one time and as we get older, we likely will again. This makes so much sense if you see the foot as a sensory organ and not just a mechanical part of the human machine.

Fat Flat Feet

Most babies have cute, pudgy, fat, flat feet!  As the child grows, the foot develops and an arch becomes more and more evident, keeping pace with the child’s physical abilities. Evolutionarily this makes sense.  Before birth we are water dwellers and do not need a well-developed vestibular system.

Only a few months after birth babies begin learning to roll, then crawl, eventually sit upright, and then “find their feet”. They begin to stand and squat and the vestibular system starts to adapt to gravity. Babies’ fat flat feet give them a broad surface to sense the effects of gravity, which allows the vestibular system to orient and develop.

As balance improves, the foot becomes stronger and the arch develops.  The effect is a decrease in the amount of sensory surface area dedicated to gravity, making baby less structurally stable but providing a biomechanical environment for increased speed and agility.  However, now the individual must rely on a very well developed and active vestibular system, supported by the mobile proprioceptive system of the foot joints.

The twilight of the arch

Understanding how and why the arch develops should then clarify the changes we experience as we grow older. The vestibular system slowly becomes less active and balance becomes more difficult. This leads to a natural decline of arch height as an attempt to increase proprioceptive input, like we needed when we were babies.

Gait tells us so much

The reality is, gait assessment is a window into your clients’ nervous system and, utilized properly, it informs how we help our clients improve, at every stage. Now that you know how the arches and vestibular system relate, help your clients rediscover their feet!

Coach Pat Marques & I will host a live webinar, focusing on gait assessment, for MedFit practitioners and trainers.

 


Dr. Grove Higgins is a chiropractor, rehabilitationist, soft tissue injury expert, researcher, anatomy instructor, biomechanist, human performance expert, speaker, and corporate health consultant. In 2015, Dr. Higgins cofounded Neuroathlete with Coach Patrick Marques (LTC, US Army Ret.) and Peter Hoversten. Neuroathlete’s goal is to more broadly deliver neurological training to a global audience.

Interesting studies and articles:

Does My Kid Need Arch Support: March 2020: Blog. (n.d.). Retrieved from https://www.vivobarefoot.com/nz/blog/march-2020/does-my-kid-need-arch-support

Gray, H., Carter, H. V., Pick, P. T., Holden, L., & Keen, W. W. (1887). Anatomy, descriptive and surgical / the drawings by H.V. Carter with additional drawings in later editions edited by T. Pickering Pick ; to which is added Landmarks, medical and surgical by Luther Holden with additions by William W. Keen. Philadelphia: Lea Brothers &.

Li, F., Harmer, P., Wilson, N. L., & Fisher, K. J. (2003). Health Benefits of Cobblestone-Mat Walking: Preliminary Findings. Journal of Aging and Physical Activity, 11(4), 487-501. doi:10.1123/japa.11.4.487

Rock Walking for Healthful & Graceful Aging. (2018, December 13). Retrieved from https://www.integrativehealthcare.org/mt/walking-on-rocks-benefits/

Tubbs, R. S., Mortazavi, M. M., Loukas, M., Dantoni, A. V., Shoja, M. M., & Cohen-Gadol, A. A. (2011). Cruveilhier plexus: An anatomical study and a potential cause of failed treatments for occipital neuralgia and muscular and facet denervation procedures. Journal of Neurosurgery, 115(5), 929-933. doi:10.3171/2011.5.jns102058

sneakers-walking-in-woods

Gait! Everything You Need to Know

Assessing and training clients is challenging but skilled observation can give you important clues about your clients’ condition and readiness—and they don’t need to say a thing! Many trainers, and even therapists and doctors, are missing one of the most valuable assessment tools and training modalities they have at their disposal: the client’s gait.