Stroke survivors face a unique and difficult challenge: repairing and remodeling their bodies, minds, and lives. The process can often seem like mapping out a brand new course through totally uncharted waters.

Why Are Repetitive Motions Important After a Stroke?

In the beginning

Stroke survivors face a unique and difficult challenge: repairing and remodeling
their bodies, minds, and lives. The process can often seem like mapping out a
brand new course through totally uncharted waters. Survivors are charged with
figuring out how to do basic tasks like getting dressed, brushing teeth, and
using the restroom, while also focusing on standing up straight and not falling.
Often, all of these things must be done while using only one hand, because the
affected arm becomes weak and hard to control. Activities that once came
naturally and were programmed into habits are suddenly very challenging and
frustrating. The affected arm can become such a frustration that survivors may
start to only use their stronger arm to get things accomplished, even if that is
not normally their dominant arm.

There is good news, though!

Research has taught us a lot about how amazing our brains truly are. Now we know
that when we go through a neurological event (such as a stroke), we actually
have the ability to regrow and work around many of the connections in our brain.
We can actually repair and remodel our brains and bodies. We can remap our
brains to help us to function again. Another word for this is neuroplasticity
[https://www.neofect.com/us/blog/tips-for-unlocking-neuroplasticity-after-stroke-part-1] 
(1).



What does this mean for stroke recovery?

When a person suffers a stroke, he may notice that certain body parts are no
longer functioning correctly. Often the arm and leg on one side of the body
become weak or paralyzed. This is because the motor control center of the brain
has become “injured,” and with this injury, it now has difficulty sending out
strong signals to the arm and leg to tell them how to move. Essentially, the
brain needs help to get reorganized and get back to work controlling the rest of
the body.

When we talk about repairing and reorganizing our brains after a stroke, there
are two huge players in the game: time
[https://www.neofect.com/us/blog/how-to-quickly-recover-after-stroke] and brain
activity. Though we can’t control the time variable (exactly how long the
recovery process will take for each individual), we can definitely play a large
hand in the brain activity variable. The sooner we do this following a stroke,
the better, BUT, changes can still continue to take place months and even years
later. In fact, we now know that progressive motor practice is essential for
gains at any point after stroke onset (5). This is where high repetition comes
into play: our brains have an area where motor control, learning, and shaping
happens, and research shows that the more intensely and often we practice, the
more this part of the brain recovers, and the better we can get! (1). Tasks that
encourage repetitive practice using the arm can actually improve both strength
and activity (2).



What needs to happen next?

If the person is able to provide opportunities for the arm and leg to try to
move again, it is possible to reconnect some signals and also to form new
connections all around the injury to help the brain regain control. The key to
this is massed practice, or many, many, many repetitions. The more times the
body tries to move the arm or leg, the more opportunity for neuroplasticity. It
is noted that high numbers of repetitions are required to make an impactful and
lasting change in the brain (6). In other words, repeating a motion over and
over helps with learning and remembering that motion, because the signals from
our body parts become more connected to the brain.

Another important reason to repeatedly attempt to use the affected limb is to
prevent “learned nonuse.” When a person tends to use the stronger limb more
often because it’s easier and more efficient, the weaker limb starts to “forget”
what it is supposed to do, thereby becoming even weaker and less functional. In
fact, focusing on using only the non-affected side can actually hinder the brain
from recovering connections with the weak side (3). Instead, using the weaker
arm or leg many, many times can promote awareness of the limb, increased
strength, and overall functional use in the same ways - fixing old and making
new connections to the brain.



It has been shown that “high repetition” is most successful when hundreds of
repetitions of a particular movement happen during the day (6). Motor rehab
after a stroke helps promote reorganization of important areas of the brain that
control movements. Completing exercises set by your Occupational or Physical
Therapist help strengthen and retrain how your muscles work together to create
functional movements. Some types of activities and tools you may see during
therapy include Constraint Induced Movement Therapy (CIMT), Mirror Therapy,
neuromuscular electrical stimulation or Bioness, and massed task practice. All
of these have a component of high repetition to drive more significant change in
the brain and body. Engaging your affected arm in regular, routine
[https://www.neofect.com/us/blog/importance-of-setting-up-post-stroke-routine],
functional tasks is also very helpful -- the more that arm gets the opportunity
to do what it is meant to do, the greater the chance it has to recover.

Recovery Mode: ON!

It can certainly be challenging to carry over such a demanding high repetition
exercise program at home. It may be hard to find time in an already busy
schedule, or it may be hard to find motivation when your therapist is no longer
present to cheer you on. One of the best things you or your loved one can try to
do is to figure out what types of activities and strategies are the most
motivating and engaging, because that will help to stick to the plan and see
real results. In fact, the brain needs to be motivated, engaged in learning, and
paying good attention to the task in order to make real change happen (5).



Use of the NEOFECT Smart Glove and/or Smart Board can be added to your
repertoire to help keep you motivated and excited to work on these repetitions -
when you’re having fun, seeing visual responses to the movements you make, and
tracking your own progress, you may be more likely to stick with it, and enjoy
the process! While you are searching for more options for you or your loved one
to add to your stroke recovery toolkit, don’t forget to check out NEOFECT Home
Rehab Solutions, clinically proven to improve hand and arm function at home. To
learn more, call 888-623-8947 or email info@neofect.com. Here at Neofect, we are
here to support you on this journey.

References

 1. Nudo RJ. Adaptive plasticity in motor cortex: Implications for
    rehabilitation after brain injury. Journal of Rehabilitation Medicine, 2003;
    41: 7-10.
    
    
 2. De Sousa DG, et al. Interventions involving repetitive practice improve
    strength after stroke: a systematic review. Journal of Physiotherapy, 2018;
    64(4): 210-221.
    
    
 3. Allred, RP, et al. Use it and/or lose it -- Experience effects on brain
    remodeling across time after stroke. Frontiers in Human Neuroscience, 2014;
    8: Article ID 379.
    
    
 4. Duncan P, et al. Randomized clinical trial of therapeutic exercise in
    subacute stroke. Stroke, 2003; 34: 2173-2180.
    
    
 5. Dobkin, BH, and Dorsch, A. New Evidence for therapies in stroke
    rehabilitation. Current Atherosclerosis Reports, 2013; 15 (6): 331.
    
    
 6. Kimberley, TJ, et al. Comparison of amounts and types of practice during
    rehabilitation for traumatic brain injury and stroke. Journal of
    Rehabilitation Research and Development, 2010; 47 (9): 851-862.
    
    

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intended to be a substitute for professional medical advice, diagnosis, or
treatment. Always seek the advice of your physician or other qualified health
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Reliance on any information provided by the NEOFECT website is solely at your
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