Mar 22, 2018Retrain the Brain
Following an injury, the brain undergoes changes in the way it processes information. Therefore, during rehab, the brain must be accounted for just as much as the impaired limb or tissue.
As I described in this Training & Conditioning article, recent research may have found a way to “reset” the brain to improve range of motion, increase confidence in the injured joint, and avoid reinjury. The key is including the brain in rehab and intervention efforts.
When retraining the brain following injury, it can help to follow a sensory-visual progression. Below is a sample model to follow. (Note: The training load, sets, and reps are to be determined clinically by patient progress.)
EXERCISE 1:
Balance Training
• Visual-motor progressions: Stroboscopic glasses, eyes closed, virtual reality.
• Sensory-motor progressions: Add an unstable surface, such as a roller, rocker, or Bosu ball, then add perturbations directly to the unstable surface (shake or tap the rocker or Bosu ball).
Key Feedback
• Return to neutral position if balance is lost.
• Keep knees slightly bent with knees pointed at forward markers.
• Stay relaxed during unstable surface perturbations, and try to respond with reflex contractions.
EXERCISE 2:
Functional Training
• Visual-motor progressions: Add in-air or on-ground targets to encourage external focus during training. Add unanticipated direction changes or stroboscopic glasses.
• Sensory-motor progressions: Add unstable landing surfaces, or add a dual cognitive task.
Key Feedback
• Relax between perturbations.
• Don’t tighten up.
• Respond with equal force.
