Wednesday, March 25, 2015

Brain + Comfort Zone = No Gain

The key to recovery is challenge. Heck, the key to learning anything new is challenge. (For stroke survivors movements that need to be re-learned are "new.")

So how much challenge is needed? Let's put it this way, one of the treatments used to improve quality and speed of walking that seems very promising is called "speed dependent treadmill training." How challenging is it? Check this out…

The survivor gets on a treadmill and harnessed to the ceiling with a strap around their chest, just under their arms. The strap doesn't do anything – it's just a safety belt so if they fall, they don't fall- if you fall oh. (heh heh- still got it!)

The speed of the treadmill is turned up until either the therapist or the stroke survivor freaks out. Trust me, I'm only nominally paraphrasing here.

The "freak out" speed is considered the survivor's top speed. The survivors then rests for about five minutes. Then he gets back on the treadmill, harnessed again, and the speed of the treadmill is brought to half of his top speed for two or three minutes – as a warm-up.

The speed of the treadmill is then increased to their top speed. If they can handle their top speed for 10 seconds, the speed of the treadmill is increased 10%. If they can handle that, there speed is increased another 10%. If they stumble it comes down 10%. But if they can then handle that for 10 seconds it increases 10%.

For this treatment, if speeds are plotted on a graph it looks kind of like the stock market – you have peaks and valleys but your speed is quicker at the end then at the beginning.

Think about that. The level of challenge is increased so much that it's defined by the person stumbling. This is where the brain operates. A safe brain does not grow. The brain has to be brought way outside it's comfort zone or doesn't change. True for anyone trying to learn anything. True for stroke survivors.


Tamara said...

I'm not sure I agree on this one. I'm stuck now in fight or flight for about 6 years. This shuts off the natural ability the body has to heal itself. If I feel safe, for instance if I take mental support on someone by holding their coat with 2 fingers, I'm fine, my painful spasms are gone and I can walk more than an hour.

Peter G Levine said...



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