I want you to imagine that you have just completed ankle surgery to fix torn ligaments. Think about the next steps which typically include casting, weight bearing, and a period of physical therapy. Physical therapy you will be doing exercises that are specific to that joint to provide stability to it. This includes strengthening the muscles around it, to provide the support you need to return to the highest level of function possible. Each injury is different and your ability to recover will dictate the length of therapy which can take weeks or months, and to what level of function you return.
Old Concept, New Application
Now I want you to take the same concept of ankle rehabilitation and think about injuries that occur to the brain in the form of concussion, traumatic brain injury, stroke, and neurodegenerative diseases to name a few. What is the current plan for a patient suffering from these ailments? Depending on how progressive of a medical team you have it will range from rest, acceptance, occupational therapy, and experimental therapy. It is very difficult to have any of those issues and not have a plan.
What if there is a way to make the brain healthier? You are not going to replace neurons that have been permanently damaged as a result of stroke or traumatic brain injury, but what if you can make the remaining ones more efficient. In other injuries there is no visible injury on imaging, but the function of those areas are impacted. Would it not make since to improve functioning of the brain in the same way you would of a muscle or ligament injury?
Is there Hope?
Each part of the brain is responsible for specific functions. When an area is impacted you will see a decrease in the function of that area. A great example is when a stroke causes impaired motor function. Movement is controlled by a few areas but primarily the frontal lobe and cerebellum. When you have the patient perform motor tasks to try and improve function what you are really doing is trying to get the brain to function more appropriately. The ability of the brain to learn is called plasticity. When individuals make progress through focused rehab techniques this shows the brain can function better.
There are many rehab strategies that can be implemented. It can be divided into peripheral and central. Central would be therapies such as transcranial magnet stimulation or implanting a stimulation device. Peripheral mechanisms utilize the musculoskeletal and sensory systems as they are controlled by the nervous system. This can include different movement patters, oculomotor, sensory stimulation, and balance therapy to name a few. Finding a clinician that understands the functional workings of the brain allows them to assess which parts are not functioning optimally while using appropriate rehab techniques to improve function.
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