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Think You Know How Many Reps It Takes to Achieve Neuroplasticity?

Henry Hoffman
Wednesday, May 11th, 2022


The damage inflicted by a stroke is unique to every patient, and so is the recovery process. It is not a one-size-fits-all proposition. The brain consists of 100 billion neurons and 200 trillion synapses. It’s nearly impossible to grasp the complexity and power of this amazing organ!

During a stroke, 32,000 neurons die every second, totaling around 1.2 billion for the entire event. That’s a lot, but consider the total neurons in the brain, it’s around one percent. That means 99 percent of the brain is still intact!

A variety of exercises and movements can be used to provide cues to the brain. Thanks to pioneers like Dr. Merzenich (https://lnkd.in/dR9zGCmx) , who conducted landmark studies in the 1980’s that confirmed the adult brain is not hard-wired, practitioners have an opportunity to “rewire the brain”.

 

How Can the Brain be Rewired?

Those cues direct the brain on how to adapt, creating new neural pathways that can overcome any brain damage and alleviate or compensate for physical and mental deficits.

This means they can work around the one percent that’s been impacted through neuroplasticity, which can be defined as the ability of the nervous system to change its activity in response to intrinsic or extrinsic stimuli by reorganizing its structure, functions, or connections after injuries, such as a stroke or traumatic brain injury (National Library of Medicine).

This “neuroplasticity” was considered impossible a few decades ago.

So, why do most traditional stroke therapies fail?

They abandon a stroke survivor before this rewiring (neuroplasticity) takes place. Traditional tests which determine if therapy is making an impact do not detect the subtle movements that indicate neuroplasticity is taking place.

Fortunately, Merzenich, and others, have offered the clinical community an amazing contribution.

As therapists, we must ask ourselves “What did I do during my skilled 45 minutes session to drive neuroplasticity for my patient today?” “Did I do enough?”

 

How Many Reps is Enough?

The average number of repetitions performed in a standard therapy session is 30. Yes, 30! We need at least 300-400 reps per session to begin rewiring the brain to provide meaningful outcomes.

Consider this: There are many studies that show the number of repetitions it takes to “master” a movement. A golf swing, throwing a baseball, ice skating, playing the piano, etc. These repetitions trigger the same rewiring of the brain and require thousands of repetitions.

Stroke survivors know that the journey to full recovery can be a long one. It is important to reiterate to them that repetition is key because their brain needs to constantly be reminded how to move a part of the body. With every reminder, connections are reinforced and the ability to successfully complete the action becomes more certain.

Each repetition leaves a footprint, a pathway for the next rep to build on and move further into neuroplasticity – the stage where the brain “remembers” the paths, or new wiring, allowing someone to get better, and keep getting better!

With all the exciting new therapy solutions available at our fingertips, now is the time to challenge ourselves to toss out conventional concepts, usually not backed by research (gasp!) and focus on new protocols, supported by science, that produce continuous and lasting results.

If you are a stroke survivor or a caregiver, ask your therapist about Dr. Merzenich’s research and read “Soft-Wired: How the New Science of Brain Plasticity Can Change Your Life”.

 

Conclusion

The longer the brain sits dormant before beginning rehabilitation or the longer a patient waits between rehabilitation sessions, the longer it will take for the brain to establish the necessary connections to drive body parts. The sooner after a stroke event a survivor begins strengthening their brain through neuroplastic exercises (such as performing repetitions or mirror therapy), the quicker they are able to begin reaping the benefits

Rewiring the brain takes effort and commitment, and it doesn’t happen overnight, but it does work, providing hope for stroke survivors who’ve been left behind. One rep at a time.


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 providers 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.

Neurotherapists: Stop shouldering the blame. It’s time to rethink electrode placement for treating subluxation.

Henry Hoffman
Thursday, April 28th, 2022


Shoulder subluxation, defined as a partial or incomplete dislocation that usually stems from changes in the mechanical integrity of the joint (muscles, tendons, ligaments) is a common issue with hemiplegic stroke survivors. There are several protocols for treating subluxation, such as electrical stimulation, but it’s often done improperly due to misconceptions about what’s considered “standard practice.” 

Studies suggest that the supraspinatus and posterior deltoid muscles are the primary muscles to target when using electrical stimulation. Contrary to popular belief, this may not be the case. This blog aims to revisit what we already know about subluxation and proximal migration and challenge traditional beliefs many of us have embraced throughout our careers. 

Let’s dive into when to use electrical stimulation and what the optimal muscles are for targeting. 

Read more…

Best Stroke Hand Recovery Exercises Using Pens

Henry Hoffman
Tuesday, March 29th, 2022


Strokes can be one of the leading causes of serious long-term disability. A stroke can lead to a reduction in mobility in more than half of stroke survivors from the age of 65 and older. Loss in hand function, strength, and dexterity can result from a stroke. These conditions and impairments are determined by the location and severity of the stroke. Today, there are many ways to regain hand function after a stroke or neurological injury.

Read more…

Foot Drop Treatment Using a Resistance Band

Henry Hoffman
Tuesday, October 12th, 2021


Want a quick fix to your foot drop problem?  This blog will share two techniques for helping lift your foot without using an ankle-foot orthosis (AFO).  These techniques are temporary and not meant as a long-term solution but are effective if done correctly. Please consult your physician or medical professional. They might have a better solution for you, like the SaeboStep.

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5 Easy Tests for Foot Drop

Henry Hoffman
Wednesday, September 22nd, 2021


5 Easy Test for Foot Drop

Think you suffer from foot drop after a stroke or neurological injury? In this post, we will cover five easy tests to identify foot drop. Foot drop is a common symptom of many neurological and orthopedic issues affecting the lower leg. Most commonly, the peroneal nerve is the affected culprit, causing the lack of ability to lift the foot or toes off the ground. This could lead to a person dragging their foot as they walk, increase the risk of tripping or falling while walking, or cause the person to alter their steppage gait. 

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Foot Drop Recovery: Definition, Causes, & Recovery Solutions

Henry Hoffman
Monday, August 16th, 2021


Foot drop, also known as drop foot, is the inability to raise the front part of the foot due to weakness or paralysis of the muscles that lift the foot (National Institute of Neurological Disorders). It can be a temporary or permanent situation, so address this as soon as you see any signs. Foot drop is not a disease but a symptom of an underlying muscular, neurological, or anatomical disorder. This blog will educate you on what foot drop is, common reasons that it occurs, and also possible treatment options.

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How to Treat Foot Drop with Electrical Stimulation

Henry Hoffman
Thursday, August 20th, 2020


foot drop treatment with estim

What is Foot Drop?

Foot drop, also known as dropped foot or drop foot, is the inability to raise the front part of the foot up toward the shin. This happens due to weakness or paralysis of the muscles that lift the foot (National Institute of Neurological Disorders).

Patients who suffer from foot drop often scuff their toes along the ground; they may also bend their knees to lift their foot higher than usual or swing their leg out to the side to avoid hitting their toes on the ground.

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A Guide to Electrical Stimulation Therapy for Stroke Patients

Henry Hoffman
Thursday, July 16th, 2020


In simple terms, electrical stimulation is the sending of electrical impulses to generate a muscle contraction. This is usually done via surface electrodes stuck to the skin over the target area. The muscle contraction may be very small to help with pain or sensation, or it may be large enough to produce a visible movement at a joint.

Following a stroke or other neurological injury, you may be left with muscle weakness or complete loss of movement (sometimes called hemiplegia). You may also experience a sudden inability to perform everyday tasks, sensory loss, pain, or a combination of these symptoms.

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Combining the SaeboStretch and SaeboStim Micro to Improve Hand Function After Stroke

Henry Hoffman
Tuesday, April 14th, 2020


Are you interested in combining other evidence-based products with your SaeboStretch?  If you have already purchased the SaeboStretch, or are thinking about purchasing it, this video will help explain why many of our Saebo Family members are boosting their hand recovery by combining the SaeboStretch and SaeboStim Micro.

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SaeboStim Micro Commonly Asked Questions [VIDEO]

Henry Hoffman
Thursday, April 2nd, 2020


SaeboStim Micro

Questions about the SaeboStim Micro?

Check out the video below to learn more about this popular sensory electrical stimulation device. In this video, Saebo’s Director of Clinical Services, Dr. Scott Thompson addresses some of the most frequently asked questions from our clients, including:

Why is my hand not moving when I put on the device?

When can I expect results?

Why can’t I feel the SaeboStim Micro at its highest setting?

Can I combine the SaeboStim Micro and the SaeboStretch?

 

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