Myths About Stroke Recovery

I am saddened to think that stroke recovery is sometimes trapped in an outdated and dogmatic approach to help people with their stroke recovery. But the sad truth is unless you are one of the very fortunate ones, either geographically to be located next to a cutting edge stroke rehabilitation facility or the monetary means to afford such treatment, you are stuck with the stock standard cookie cutter approach to stroke treatment. And there is a good chance that it is stuck in the past.

Myths surrounding stroke recovery may be perpetuated by a number of factors. It seems that once something has been printed in a newspaper or magazine it is taken as gospel. Many of the belief surrounding the brain have been around for a long time and despite new research dispelling the myth, it takes a long time for this to filter into mainstream belief systems. This can clearly be seen with all the out dated beliefs in the exercise and fitness world. This article will discuss three main myths surrounding stroke recovery. Firstly that the brain is set in stone and cannot change. Secondly that there is only a small window of opportunity for stroke recovery to happen. And the last myth is that there are not better and more effective ways to perform stroke rehabilitation.

One of the worst perpetuated myths is that the brain is set in stone and cannot change. The brain is capable of change all the time and at any age. While certainly when we are older the brain may not be as responsive as when we are younger, it is still capable of improving and changing. We can see real world examples of the brain changing whenever we learn or improve on a new skill. Things like learning a new language or sport are great examples. The brain controls everything we do and when we see improvements in our coordination like in sports there must be improvements in the brain to bring about those changes. The science of the brain has disproved this repeatedly, the brain can change and this is the basis of stroke rehabilitation.

It is still said that stroke recovery has a small window of opportunity in which recovery can happen. And while there may be some credit to the fact that it may be easier to recover when stroke rehabilitation is performed closer to the time of a stroke, it has been shown that the brain is always capable of change. The degree and ease of that change of course changes with age. It is much easier to learn things when we are younger but it does not mean it is impossible to change the brain or learn things when we are older. The same holds true for after a stroke, the brain is always capable of changing and improving and regaining function. And while there certainly may be limitation and restoring full functional capacity may not be possible, I always feel people can improve on their current state.

Lastly the belief that there are not better and more efficient ways to do stroke recovery is continually perpetuated. Most stroke patients are not up to date on how the brain works, how stroke recovery works and the best techniques for stroke rehabilitation. In fact most practitioners are not probably up to date on this information. And it is a real pity, because in the last decade there have been tremendous advances in brain research and subsequently in stroke recovery but it will take a while until these techniques and methods reach the masses. So unless you happen to be one of the lucky ones, you are probably being short changed in your stroke recovery efforts.

Unfortunately there are many myths surrounding stroke recovery. I hope this article has helped to educate and open your mind up to the truth about your stroke rehabilitation and how you should be approaching it. At times stroke rehab can be a very daunting task, filled with too much science, jargon and technique that may be difficult to understand. I have made it my goal to try and make available the best stroke recovery techniques to stroke survivors, their family members, care givers and health care practitioners.

Neuroplasticity, The Ability of the Brain to Change

The 1990s was declared “The Decade of the Brain”. During this period scientists made many interesting discoveries. Research led to an improved understanding of many brain processes such as memory and emotions. Imaging was used to help identify areas of the brain involved in certain functions such as remembering a face to playing a computer game.

One discovery is rewriting the textbooks. It is the realisation that the brain at any age is not ‘set in stone’, but a malleable, “plastic” organ. A flood of discoveries shows the brain continually reorganises itself. It’s called “neuroplasticity.” And it means that you create your brain from the input you get.

Neuroplasticity basically means the brain is able to change and adapt. For example a part of the brain may, from birth, have been designated “the region where sensations on the right pinkie finger register.” But experiences can rezone the brain. We have all learnt a new skill or refined and improved an old skill. Those changes in learning or improving a skill require changes in the nervous system. If we continually activate certain areas of the nervous system (make them work) or certain pathways of communication, the nervous system is smart and it notes the increased use of the pathway and starts taking steps towards making that pathway more efficient. Good example of people’s nervous systems which have been refined to extraordinary levels are people like musicians or sports people. In musicians the area of the brain responsible for processing sound is so finely tuned that they can pick out an off note out of a whole orchestra of instruments. Or what about the gymnast whose co-ordination and balance is so precise that she can do a summersault and land on one leg on a thin beam.

The idea of neuroplasticity really emphasises the impact that our environmental influences have on shaping our nervous system, for the good or the bad. I often say to my patients that genetics load the gun but environment pulls the trigger. This basically means that we have an appreciation that our inherited genetics may predispose us to head down a certain neurological path, but the final destination is largely determined by our environmental influences. Our environmental influences basically involve our lifestyle factors. Contrast the expected brain health of an elderly person who eats well, regularly does cross-words, Sudoku, has a good social network and exercises regularly versus an individual who eats a poor diet, does not do mental or physical exercise and is not socially active. You do not have to be a neuroscientist to know who would have a healthier brain. Do not underestimate your lifestyle habits and the activities or things you do repetitively and the influence they can have on your brain and nervous system.

Neuro-rehab or rehabilitation of the nervous system is built on the concept of neuroplasticity. The brain is like a muscle and the more you use it, the stronger it grows. Neuroplasticity is the reason why people who have suffered a stroke are able to make recoveries or improvements in some or all of their functioning. The brain and nervous system are highly adaptable. Therapies like constraint induced therapy, which involves forcing the stroke survivor to use their affected hand, can be successful because of neuroplasticity. Performing an activity that originally involves the use of damaged areas of the brain forces the brain and nervous system to adapt, and to find a new way of executing the activity. Repetition with the goal to exercise and not exhaust is the key, especially in neuro-rehabilitation related to stroke recovery.