The multidimensional impact of a stroke requires physical therapists to be flexible and versatile with their treatment approaches, yet they should also be strong in communicating the reality of the training that will be required of their stroke patients.
I tell my stroke patients that they must think of their rehab as preparing for the Olympics. Just as an athlete would use an expert coach to design and oversee an appropriate training protocol, the stroke survivor should team up with a PT that has developed an arsenal of therapy skill sets. The therapist also should have a working knowledge of the new research in training intensity and frequency as it relates to neuroplasticity. The PT should also be up to date on new EMG, FES and combined biofeedback and gaming technologies to maximize their patients home training program and to help provide enough stimulus and volume of work required to rewire the brain.
“Performing 2 sets of 10 reps once per day is not going to get you to the Olympics and it certainly is not going to prepare you for your return to the best possible outcome post stroke!”
David Dansereau, Stroke Survivor and Physical Therapist
Stroke researchers now know that the brain has a much greater capacity for change in response to imposed demands than earlier believed. This capacity for change is known as neuroplasticity. A good PT coach should understand that to induce neuroplastic changes and reorganize the brain post stroke they must intervene with intense, task-specific repetitions that require a challenge in rehabilitation much to the same level as an Olympian in training for a gold medal performance. Effective rehabilitation therefore involves constant practice and repetition to perfect post stroke performance, and the stroke survivor must understand the workout plan designed by their PT and be consistent with their home exercise regimen to maximize their return.
I am still researching for a follow-up on several new technologies available to stroke survivors and therapists for an upcoming post. A recent conversation I had with a stroke survivor at a Tedy’s Team meeting got me thinking of this topic of the way PT’s should coach their stroke patients. I wanted to comment here on why it is so important for stroke survivors to rethink the way they approach their rehabilitation.