Brain Injury Rewiring for Loved Ones Carolyn Dolen, Idyll Arbor Page 1 of 7

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  Dr. Arango-Lasprilla is currently a research assistant professor in the Department of PM&R at Virginia Commonwealth University. Dr. Arango-Lasprilla is also the cultural competency coordinator for the National Institute on Disability and Rehabilitation Research's (NIDRR) Traumatic Brain Injury Model Systems and co-director for the NIDRR-funded Advanced Rehabilitation Research Training Program. This is BrainLine's exclusive interview with Dr. Arango-Lasprilla recorded on June 5th, 2008. Transcript of the video here.
• Dr. Juan Carlos Arango-Lasprilla Talks About Cultural Differences in Caregiving
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  BrainLine's webcast "Caregiving and TBI: What You Need to Know" offers ideas and strategies for people caring for a loved one with TBI. Produced by BrainLine.org. View this video in a webcast format. Transcript of this video.
  
• Caregiving and TBI: What You Need to Know
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  Transcript of this video.
• Changes in Family Roles After Traumatic Brain Injury
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  Learn why educating the whole family about TBI is important.
• The Role of Family-Centered Care
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  On April 24, 2009, BrainLine had the opportunity to sit down with Dr. Kreutzer and Dr. Stejskal to talk about their work with people with traumatic brain injury and their families. Produced by Victoria Tilney McDonough and Brian King. Transcript of this video.
• BrainLine Talks with Dr. Jeffrey Kreutzer and Dr. Taryn Stejskal About What Happens to a Family After Brain Injury
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  Produced by Victoria Tilney McDonough and Brian King. This neuropsychologist shares his experience and advice about culture, ethnicity, and brain injury rehab. Transcript of this video.
• Dr. Tedd Judd Talks About Brain Injury and Setting Family Centered Goals

Chapter 10 - Physical Rewiring: Healing His Body with Exercise

The only thing that ever sat its way to success was a hen.
— Sarah Brown

Brain Injury Rewiring for Survivors strongly urges your survivor to get active and play to enjoy life and create new brain cells. Here we further explore the mental and physical benefits of exercise. Did you know that survivors who exercise far surpass those who don’t? We discover why and how physical activity helps survivors to recover and look at typical physical problems and places that offer help. This chapter covers:

• Benefits of exercise, including recent research.
• Recovery process — typical problems and common deficits.
• Before he starts — preparation, goals, motivation.
• Helpful equipment.
• Programs to improve his movement.
• Accessible gardening.

Introduction

You will probably hear something like this from your survivor: “Yeah, right, physical recovery — I don’t think so! Heal my injured body myself? It’s not gonna happen. My body is so damaged there’s nothing left to recover. It’s hopeless. Nothing I can do will bring it back.”

Encourage him to try. Encourage him to adapt the “Use it or lose it” motto and say, “Use it to lose it!” Lose what? How about his disability? If he argues that nothing can take that away, you can say, “You’re right. However, if you exercise, you’ll be less disabled — isn’t that better than the way things are now?”

There are several ways he can achieve this goal. Besides exercise, muscle-stimulating devices and Constraint-Induced therapy (see Chapter 7) also strengthen affected limbs.

How much can he recover?

Nobody knows, but he can recover function — if he works at it. Recent research studies of brain plasticity continue to uncover promising new information about the three Rs of rewiring: activity reorganizes neural circuits and networks, replaces cells and chemical messengers, and regrows axons, dendrites, and synaptic connections (Dobkin, 2000).

Exercise Benefits for Everyone

Physical Benefits

To help convince your survivor to exercise, remind him that exercise increases physical capacity and ability to perform activities of daily living (ADLs), enhances his immune system, and helps to reverse and control risk factors for heart disease and stroke — high blood pressure, high cholesterol, obesity, high triglycerides, low HDL (“good cholesterol”). Exercise can also prevent or reverse bone loss, help people achieve and maintain healthy body fat levels, prevent or delay serious complications of diabetes, reduce need for insulin, and reduce the risk of colon and breast cancer. Importantly for those with arthritis, it improves endurance, strengthens muscles, and increases joint flexibility and range of motion (CDC, 1999; Elrick, 1996).

Mental Benefits

These are as important as physical benefits. They include elevated mood, reduced depression and anxiety, increased feelings of well-being, improved ability to handle stress, improved self-image, and intellectual function (CDC, 1999; Elrick, 1996).

Enhances memory. Middle-aged adults who improved their fitness by 15% through cycling also raised their scores on a memory test. Other studies confirmed that cyclists over the age of 55 demonstrate better recall than their sedentary counterparts (Strickland, 1994).

Delays diseases of aging. Your survivor’s injury instantly aged him. He’s not a candidate for Alzheimer’s disease just yet — if he exercises. Exercise can protect him from developing this debilitating brain disease — or at least stay healthy longer. What’s the evidence? How about four decades of data on nearly 400 people who engaged in life-long physical activity? (Smith, 1998).

Increases creativity. “Cardio” workouts that elevate the heart rate release chemicals like endorphins, epinephrine, and norepinephrine that promote a positive mood and may also enhance creative thinking. How? Researchers speculate that these opiate-like chemicals release inhibitions which then promote stream-of-consciousness thinking — the ability to think freely and creatively.

Discuss what happens if he doesn’t exercise. An inactive lifestyle decreases cardiorespiratory fitness, impairs circulation to the lower extremities, and can lead to osteoporosis — all of which can increase his daily dependence on others, decrease social interaction, and lead to more disability! Inactivity also leads to lower self-concept, depression, and diminished intellectual functioning (Gordon et al., 1998; Elrick, 1996).

If you need still more reasons to convince your survivor to get off the couch, this next study ought to do the trick.

Exercise Benefits for Survivors

To explore exercise benefits, 240 survivors were recruited from various communities in New York. The group of 64 exercisers and 176 non-exercisers were nearly 70% male, ages 18-65, and on the average injured about 10 years earlier. To determine if effects of exercise were different for those with and without disabilities, two non-disabled comparison groups of 66 exercisers and 73 non-exercisers were also included in the study (Gordon et al., 1998).

Exercisers swam, jogged, or bicycled an average of 30 minutes per session, three times a week for six months. While some of the differences between exercisers and non-exercisers were sharper than expected, one finding was a surprise:exercisers were survivors of more severe brain injuriesasmeasured by loss of consciousness. Here are the results:

Overall health. Non-exercisers reported 23 symptoms of health problems significantly more frequently than exercisers. Nearly 35% experienced difficulty in handling personal care versus 8% of exercisers.

Improved physical health. Forty percent of the non-exercisers reported blurred vision compared to 14% of exercisers. Similar numbers were found for waking up and staying awake. Inactive survivors also showed other negative effects — decreased lung capacity and decreased ability to work.

From Brain Injury Rewiring for Loved Ones by Carolyn E. Dolen, published by Idyll Arbor, Inc. © Carolyn E. Dolen, 2010. Used with permission. www.idyllarbor.com.

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