Varying degrees of paralysis*, loss of stamina and spasticity after a traumatic brain injury (TBI) can impair mobility and function and impede independence during daily living activities. Studies show those with severe traumatic brain injury (TBI) can continue to show functional recovery, even in chronic phase, with a neurorecovery program.
“In the injured central nervous system (CNS), exercise can facilitate functional recovery by harnessing the intrinsic capacity of the intact nervous system that uses brain-derived neurotrophic factor (BDNF) dependent synaptic plasticity. Especially in the hippocampus, exercise has been shown to effectuate synaptic plasticity and to enhance learning through the action of BDNF… Exercise should be considered as an important tool capable of improving overall neural health and cognitive ability and particularly as a regimen that can sustain cognitive function throughout one’s lifetime.”
- Department of Neurosurgery and Physiological Science,
and Brain Injury Research Center, UCLA School of Medicine
*Depending on the needs of the client and the severity of paralysis, the CORE Program Focus Areas for persons with spinal cord injuries (SCI) may be utilized.
CORE Program Focus Areas
Functional Electrical Stimulation (FES)
Those with reduced strength, mobility and function in either the upper or lower extremities due to a traumatic brain injury (TBI) can benefit in numerous ways from a functional electrical stimulation (FES) program. The science behind functional electrical stimulation (FES) is based on the concept that the nervous system requires an optimal level of patterned activity in order to simply maintain itself, as well as to maximize response of regeneration after injury. Functional electrical stimulation (FES) is effective at providing a high level of sensory motor input into the central nervous system (CNS).
Studies (link to http://www.luzimarteixeira.com.br/wp-content/uploads/2010/01/fes-induced-neural-changes-and-recovery-after-stroke.pdf ) related to the use of functional electrical stimulation in those with brain injuries, stroke and/or hemiparesis have shown the following benefits:
- Improved motor function
- Improved shoulder and limb outcomes
- Reduction of spasticity
- Reduction of tone
fRange of Motion/Flexibility Training
The ability to move freely to and from places is often taken for granted. For the individual who has sustained a traumatic brain injury, maintaining flexibility is important when seeking to avoid pressure sores, pain or injury. In doing so, joint contractures are prevented and the integrity of the joint maintained.
The name ‘CORE’ literally comes from our repeated mantra that a strong core is essential. The core is what stabilizes the entire neuromusculoskeletal system. Clients with traumatic brain injury, in particular, benefit from balance and proprioception exercises. This involves purposely creating instability, which forces the body to react and therefore strengthens the supporting muscles and reinforces the neural component. Balance training can help increase function, reduce reaction times to prevent injury and increase positional awareness.
Postural CorrectionIn addition to balance training, posture is also important to stabilizing the neuromusculoskeletal system. Poor posture, often a result of sitting in a wheelchair, sets up and exacerbates muscle imbalances, causing pain and fatigue. Core strengthening exercises and proper postural alignment will be utilized during every aspect of the CORE treatment program for injured clients to allow for an optimal workout and to increase function and safety while decreasing pain.
Whole Body Vibration TrainingWhole body vibration (WBV) training is implemented through the use of a vibrating platform on which static poses are held or dynamic exercises are performed. Whole body vibration (WBV) training stimulates muscle spindle fibers, creating a reflexive signal to the spinal cord causing muscles to contract or relax, regardless of injury. It is essentially a way to exercise without the need for incredible endurance, which benefits some of our quadriplegic clients who may fatigue at a quicker rate.The reported effects of whole body vibration (WBV) training within the neurorehabilitation field led the the Miami Project to Cure Paralysis at the University of Miami to conduct a pilot study that concluded whole body vibration (WBV) training improves walking function in individuals with traumatic brain injury.More and more studies are looking at whole body vibration, its’ cellular effects and what clinical conditions best respond to this type of therapy. Studies have already shown whole body vibration can increase balance and mobility, increase bone density, increase range of motion and increase plyometric muscle strength, as well as reduce postural sway.
Muscular Strength and Endurance Training
CORE incorporates muscular strength and endurance training into every program for a traumatic brain injury client to promote functional gains, build muscle mass and increase independence, which also improves the overall quality of life.
Cardiovascular conditioning, regardless of injury, is essential to maintaining a healthy heart muscle and to having the endurance to meet daily activity needs. CORE incorporates interval training for an effective and efficient aerobic workout.