Comparison of amounts and types of practice during rehabilitation for traumatic brain injury and stroke

Abstract

Abstract-Patients with acquired neurological deficits may capitalize on cortical reorganization to recover functional skills that have been lost. Research in neuroplasticity proposes that a high number of repetitions may lead to cortical reorganization. The purposes of this study were to quantify the number and type of activities performed by patients with traumatic brain injury (TBI) and stroke in physical and occupational therapy sessions to determine whether (1) the number of repetitions approaches the numbers in neuroplasticity research, (2) there were differences based on patient diagnosis, and (3) patient or therapist characteristics affected the type or amount of activities performed. Forty-eight patient and forty provider subjects participated. One hundred seven therapy sessions were observed. Data from therapy sessions were counted and categorized. Neither patient group approached the total number of repetitions neuroplasticity research suggests may be required for neuroplastic change. Repetitions per session did not differ between groups. Subjects with TBI performed more repetitions per minute in three categories (total upper-limb repetitions, gait steps, and transfers) than subjects with stroke. Therapists with <1 year or >15 years of neurological therapy experience instructed patients in fewer functional repetitions per minute than did therapists with 5 to 15 years of experience.

Internal Memory Rehabilitation Strategies in the Context of Post-acute Brain Injury: A Pilot Study

“…Current neuroplasticity research appears to suggest that the brain has the ability to create and modify neural connections and, perhaps, allow the brain to compensate for areas of damage [14]. Based on these findings, the therapeutic goal would then be to facilitate improved skills through learning strategies and perhaps neural compensation [15].…”

“…In brief, there has been little research showing that memory can be improved through remediation-oriented therapies and hence external compensation approaches are commonly the treatment of choice. However, the recent advancements in neuroplasticity research have reinvigorated the quest for potentially clinically effective internal strategies.Current neuroplasticity research appears to suggest that the brain has the ability to create and modify neural connections and, perhaps, allow the brain to compensate for areas of damage [14]. Based on these findings, the therapeutic goal would then be to facilitate improved …”

Exercising the Tibialis Anterior Muscle of Children with Cerebral Palsy for Improved Neuroplasticity Using an Electrical Guitar

“…Advances within this area will be extremely important and helpful for people with brain injuries like cerebral palsy or stroke victims. Studies show that by doing 400 -600 repetitions a day exercise can lead to structural neurological changes [1][2] [3]. There is still a lot to discover regarding neuroplasticity and how to optimize and target specific areas and functionality of the brain.…”

Smart rehabilitation for the 21st century: The Tampa Smart Home for veterans with traumatic brain injury

“…Repeating environmental cues that trigger specific behaviors and cues to facilitate attention are crucial for therapeutic progress [6]. Growing neurophysiological evidence supports the contention that task-specific therapy involving repetition facilitates cortical reorganization or neuroplasticity [14][15][16][17][18][19][20][21][22]. Little disagreement exists that the therapies are effective and facilitate change in neuronal connections, but emphasis has shifted to the factors and patient characteristics that maximize clinical outcomes [23].…”