The Key to Stroke Recovery: Repetitions, Repetitions, Repetitions
By Alyssa Beebe Have you ever had to think about each step you take to be able to walk? Walking is something so natural to us, but could be one of the most challenging tasks for a stroke survivor. Survivors face a unique challenge: repairing and retraining their bodies, minds, and lives. When a person suffers a stroke, often the arm and leg on one side of the body become weak or paralyzed. This is because the motor control center in your brain has difficulty sending out signals to the arm and leg to tell them how to move. This limits a survivor’s capacity to implement basic everyday tasks like brushing teeth, drinking a cup of coffee, tying a shoe, putting on a jacket, and simply being able to balance.
However, this is where the power of neuroplasticity comes in. We can reorganize our brains through the use of a high-dose repetitive task practice program. Repeating a motion over and over again helps to entrench a new set of neural commands which helps the brain learn and perform motions. Think of it like learning a new skill – playing the piano or learning to ride a bicycle.
How many repetitions are needed?
Research suggests that 400-600 repetitions per day of challenging functional tasks are required to improve function (Nudo et al. 1996). High-dose rehabilitation protocols with extended training hours have been shown to induce structural as well as functional changes in neural networks (Kwakkel et al., 2015) and have been shown to increase cortical excitability. These neurophysiological changes then result in improved motor function.
How many repetitions do we get in inpatient rehab?
When a patient is admitted into inpatient therapy, they typically receive about 2 to 3 hours of therapy for 5 days a week. While this is potentially enough, patients are not there long enough to realize the full benefit. Since there is finite time in inpatient rehab, patients get discharged to outpatient rehab.
How many repetitions in outpatient rehab?
Once patients reach that “plateau” point and are independently mobile again, the outpatient rehabilitation process begins. Even though that’s the overall goal, survivors should continue with their physical therapy in outpatient facilities for as long as necessary. However, the average daily repetitions completed in traditional outpatient clinics is 32 (which is less than 10% of the recommended dose) (Lang et. al., 2009) – far below the hundreds required for neuroplasticity.
However, not all is lost. There is still strong evidence to suggest that stroke survivors can improve after being discharged from inpatient/outpatient rehab. But we need to do it correctly with a sufficient dose of rehab – depending on magnitude and difficulty. The brain may continue to change and improve if you work at it. Progress is possible years after stroke with focused exercises toward a specific goal. Thanks to research, we now know that plateaus are not permanent.
Solution
We know what the solution is, but it’s very costly and complicated to execute successfully. This is what Motus Nova has spent years developing. The Motus Hand or Foot devices are the only FDA Class I robotic devices that deliver quality rehabilitation to the home with no cap on the amount of hours of rehab. The truth is, therapy doesn’t stop at the hospital. You’ll never know how much recovery is possible unless you put in the work and never give up. The Motus hand is here to make it easier for you to get back to where you need to be.