Neuroplasiticty is so hot right now. Everywhere I look in health magazines and on online forums there is that word in big glittering lights. It is trending in every sense of the word. It definitely warrants a wiki search, but for a person post brain injury this word is so much more than an interesting definition. This word is HOPE.
For me as an occupational therapist, a person’s understanding of and belief in Neuroplasticity, determines the course of recovery. The idea that brains are more like muscles and sponges than impermeable organs is revolutionary. We know brains change as we develop, but neuroplasticity argues that it is always changing. It is a relatively new concept it was first coined in 1890 by William James in the Journal of Psychology. In the 1960s a bunch of research was performed that propelled us forward, but in terms of adult brain rehabilitation Michael Merzenich has had the most profound impact on our understanding of the brain. In 2004, he gave a Ted Talk and described the brain as plastic and argues that it remains plastic from “the cradle to the grave.” If your heart isn’t beating a little bit faster right now, you do not get it. With this understanding, the possibility for recovery or for the brain to rewire itself is endless. Chills, Right?
This is HUGE. This is the brain science revolution. If you thought woodstock was fun, adjust your spectacles and hang on to your ipads. Things are getting mind blowing. Neuroscience is POPPIN and it is all GOOD news. It is an incredible time to be working within the world of brain injury. People who would have been left to compensate at home and lose the function of their limbs, eyes, and postural control are returning to skiing and writing dissertations. I see neuroplasticity working everyday in my job. It explains why the avid athlete who focuses on exercises with ferocity in the clinic, but goes home to the couch and an occasional squeeze of a stress ball, doesn’t fair as well, as a grandmother, who insists on cleaning her home and being the best baker at the church bake sale. I have one middle aged carpenter whose hand made incredible progress, because he just kept tinkering. It looked awkward and weird when he tried to screw his first bolt and he had trouble coordinating that first swing of a hammer, but over time it returned to second nature.
The brain responds to what we present it with. If you can embrace the clumsy awkwardness and get creative with your activity, you WILL progress. It’s science! One of my favorite soapbox type lectures that I give to my poor unsuspecting clients is about activity dependent neuroplasticity. This is what I have been blabbing about based on Dr. Merzenicks research in the early 2000s and the pioneering work of Dr. Rita in the 60s. It asserts that if you repeat an activity new neural pathways will generate. This explains ambidextrous people and why persons who become blind have a heightened sense of touch and hearing. It also explains why persons with huge cell death and damage to the brain can recover several years post brain injury, because this plasticity business never turns off.
The thing that I am constantly honking on my loudspeaker about is creating opportunities for yourself. The person who does their hand putty exercises, but never brushes their teeth with their affected hand is doing themselves a disservice. Even if the toothpaste is going everywhere and you can barely make it to your mouth you are working on something and you are ALLOWING your brain to create a new neural pathway. It is not easy. I see the barriers. I see spasticity, weakness, poor balance, poor vision, and I know it feels impossible. The insanely good news is that it IS possible. The bad news is that it IS hard. There are no quick fixes in neuro rehab, but there are millions and billions of opportunities to heal.
It takes 10,000 attempts to build mastery of a motor skill in a typically developing brain. If you brush your teeth 2xs a day for a year that is 730 opportunities, but those movements of the wrist and forearm occur in many other activities. If you added three more wrist activities such as washing your face, putting on lotion with your affected hand, and combing our hair, you can add about 1000 more opportunities for cell growth or rewiring per year. That is 10 minutes of your day. Imagine if you were conscious of this for several hours a day?!
I live in wine country in the central coast of California and I heard something that made me think of Brain Injury survivors. A family friend was telling me how summer rain is bad for the wine industry. In her words “grapes that are challenged and struggle produce better wines. They are more complex.” I immediately thought of my patients. The struggle it not being in the hospital and almost dying, though that is intensely difficult. The real challenge is being home by yourself and dealing with the day to day and doing the uncomfortable thing. It is this struggle that makes you a complex good wine. The old cheesy adage “if at first, you don’t succeed” turns out to be scientifically sound. “Try. try. again.”