The NOGGINS AND NEURONS Podcast
NOGGINS & NEURONS: How Lucky Am I?

NOGGINS & NEURONS: How Lucky Am I?

January 17, 2022

In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Deb updates listeners about current happenings and future plans. She:

  • Shares upsetting news impacting all of us. Pete passed away on January 8, 2022 after a brief illness.
  • Sends love and well wishes from Noggins & Neurons to Pete’s family, friends and colleagues
  • Tell’s everyone that Pete wishes for the podcast to continue, that she assured him she will do all she can to move things forward and notifies the audience that plans for upcoming episodes are in in place
  • Acknowledges the need for the Noggins & Neurons community to process and heal our own grief. Speaks to the healing power of stories and provides avenues for listeners to share their Pete stories with each other:
  • Thanks the Noggins & Neurons community for bringing themselves to the world.

I send all of you much love and appreciation for supporting the podcast. I look forward to hearing from you and continuing this journey together.

As always, we want to hear from you! Please email us at NogginsAndNeurons@gmail.com

LINKS TO OTHER IMPORTANT INFORMATION:

Questions and Comments about the podcast?

 

Donate to The Noggins And Neurons Podcast with PayPal:

  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

Pete’s blog and book Stronger After Stroke

Debra's Website:

Music by scottholmesmusic.com

Tech Talk with Doro & Lynette from The Neuro Hub

Tech Talk with Doro & Lynette from The Neuro Hub

January 7, 2022

Learn more about low, medium and high tech OT interventions used by The Neuro Hub in stroke recovery.

OVERVIEW

Doro: That was the neat thing. This one client that had this really big change did nothing else. She just did her little exercises at home…

Lynette: Right

Doro: But no therapy with us or in other facilities. Nothing.

Lynette: She did her basic home program, just to maintain what she already had what she had already been doing…umm…but yeah, it really made a huge impact for her.

Deb: Was this a home program that she already had received prior to coming to you?

Lynette: Yes. She had been doing this home program for a while. Even with us, when we doing OT with her prior to doing BCI, she was doing this home program.

Deb: Hmmm

Doro (Dorothee) Zuleger, OTR/L, CBIS, CSRS, DRS and Lynette Diaz, COTA/L, CSRS, from The Neuro Hub, Orlando/Altamonte Springs, FL join Noggins And Neurons for another enlightening conversation. In this episode we talk about:

  • The Low Tech Interventions they use, including the Upper Extremity Ranger, Saebo Glove and paddle board
  • The Neofect Suite and how incorporating gaming elicits meaning and competition to promote interest as a Medium level technology intervention
  • The RecoverIx Brain-Computer Interface, a High tech intervention – Doro and Lynette cover everything, from how to set it up, get started and client requirements to outcomes; this is one way to get the required (high) number of reps per session
  • Home programs are not recommended during BCI treatment
  • Allowing clients to use the RecoverIx system when not recommended by the company – clinical reasoning and knowing when to push the boundaries
  • Neuroplastic change and success for clients with severe impairments
  • Spasticity reduction, inability to move, participate in Box and Blocks Test and low scores on the Fugl-Myer
  • Business and clinical impact of introducing the BCI
  • Therapy Intensives at The Neuro Hub, fundamentals for recovery and client results

We hope you find this episode useful and that it increases your understanding of technology in stroke recovery.

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com. 

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

Science Direct Brain Computer Interface

The Stroop Color and Word Test

Cho, W., Sabathiel, N., Ortner, R., Lechner, A., Irimia, D. C., Allison, B. Z., Edlinger, G., & Guger, C. (2016). Paired Associative Stimulation Using Brain-Computer Interfaces for Stroke Rehabilitation: A Pilot StudyEuropean journal of translational myology26(3), 6132. https://doi.org/10.4081/ejtm.2016.6132

Kim, T., Kim, S., & Lee, B. (2016). Effects of Action Observational Training Plus Brain-Computer Interface-Based Functional Electrical Stimulation on Paretic Arm Motor Recovery in Patient with Stroke: A Randomized Controlled Trial. Occupational therapy international23(1), 39–47. https://doi.org/10.1002/oti.1403

Motor Imagery Practice and Cognitive Processes

Neofect

Saebo

Upper Extremity Ranger

The Neuro Hub

Recoverix

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com
New Grad Q’s & Seasoned Practitioner Insights

New Grad Q’s & Seasoned Practitioner Insights

December 24, 2021

QR_Google_iTunes_Spotify_and_Websiteacguv.jpgPete and Deb share their insights and opinions on new OT grad, Adrian's, questions and other topics.

Neurodevelopmental Treatment Association

Neuro-Ifrah Organization

PNF & Virtual Reality

Effect of Proprioceptive Neuromuscular Facilitation in Functional Recovery of Patient’s with Stroke – A Review

Effect of task specific training with proprioceptive neuromuscular facilitation on stroke survivors

Join the Noggins And Neurons Facebook Group

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com.

Questions and Comments about the podcast?

Donate to The Noggins & Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app (appears as Creative Concepts OT - add the note NEURONS under donation amount)  

          CCOT_N_N_qrcodeawxh5.png

Update: Noggins & Neurons Happenings

Update: Noggins & Neurons Happenings

December 11, 2021

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

UPDATE TOPICS: Deb, Pete, the FACES App & what's next

Access the FACES Intervention App:

Google

Apple - Search for FACES Intervention in the app store

Join the Noggins And Neurons Facebook Group

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com.

Questions and Comments about the podcast?

Donate to The Noggins & Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app (appears as Creative Concepts OT - add the note NEURONS under donation amount)  

          CCOT_N_N_qrcodeawxh5.png

Bradford C. Berk, MD, PhD: Surviving & Recovering p̄ SCI, CVA, TBI

Bradford C. Berk, MD, PhD: Surviving & Recovering p̄ SCI, CVA, TBI

December 11, 2021

Bradford C. Berk, MD, PhD: Surviving & Recovering p̄ SCI, CVA, TBI

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins & Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

OVERVIEW:

Dr. Berk: So, I think devices offer a really improved approach to neurologic problems and they don’t need to be taken every day like a pill, so compliance is 100% and up until now we really haven’t had many devices in the field. But I think going forward we will…

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete talks with Bradford C. Berk, MD, PhD. About his experience professional and personal experiences. They cover many topics, including:

  • Dr. Berk’s book, “Getting Your Brain and Body Back: Everything You Need to Know after Spinal Cord Injury, Stroke, or Traumatic Brain Injury,” enlightenment and sins that writers commit.
  • Depression and anxiety following acute neurological injury, behavior, and insight.
  • Rehab and recovery and what the literature tells us about best treatments. Limitations, straightforward questions and finding answers.
  • Research is clunky, people’s perceptions cause conflicts and the importance of having a solid clinical practice.
  • Everyone receives V.I.P. care at the hospital Dr. Berk was a patient at. Clinician insecurities show up when taking care of people with credentials.
  • The Neuro Restoration Institute focuses on restoring function and neuroplasticity for recovery. Using energy wisely and prioritizing recovery to optimize function.
  • Standing, walking, body functions, spinal cord pathways and complete vs incomplete spinal cord injuries.
  • Central Pattern Generators can be used to aid in recovery.
  • The role of medical devices in healthcare.
  • Berk’s lived experience and how it shapes his medical practice. Patient/family centered care – the importance of attention, compassion and interpersonal relationships for recovery!
  • Progressive neurodegenerative diseases, research and hope as good medicine.
  • Physiology, depression, psychological states, being able to interpret body sensations and helping people who struggle with interoception.
  • The future of recovery - devices, smart devices, electronics and adapting for success.

Whoever you are and whatever your place in life, we hope you find this interesting conversation beneficial!

Dr. Bradford C Berk's book: Getting Your Brain and Body Back: Everything You Need to Know after Spinal Cord Injury, Stroke, or Traumatic Brain Injury

 

Dr. Berk's...

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com.

Questions and Comments about the podcast?

Donate to The Noggins & Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com
Heim, Drake, & Millar: Cerebellar Ataxia, PART 2

Heim, Drake, & Millar: Cerebellar Ataxia, PART 2

November 7, 2021

Heim, Drake, & Millar: Cerebellar Ataxia, PART 2

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins & Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

OVERVIEW:

Stephen: Even as simple as cracking an egg, I cannot do it one handed, I can’t do it 2-handed any more…so, I got on Amazon and if you put in 1-handed, a whole list of items comes up and I got an egg cracker that I can put the egg in and crack it with one hand. It’s a device, a lot of people, including some very close to me have said, ‘Oh that’s just lazy.’ Like I just say, google home so I can control my lights and or set an alarm with just using my voice and you know, I hear ‘Oh get up and turn your lights off or turn your light off…’ Well that is not easy for me to do and I’m not being lazy, I’m being efficient and that is how I have structured everything from the bathroom, from driving…efficiency.

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb continue our conversation with physical therapists Jennifer Millar and Meredith Drake from Johns Hopkins Ataxia Center in Baltimore, MD, and cerebellar stroke survivor Stephen Heim. We learn more:

  • Balance Weighted Torso Training – which uses a weighted vest to improve balance. While Stephen doesn’t think it’s a miracle cure, he did feel more stable with the vest on. Jennifer and Meredith explain it in more detail, also reminding us that limb weights are not effective in treating ataxia. Motiontherapeutics.com
  • Dysmetria, driving, vehicle modifications and driving rehab – Stephen describes his compensatory strategies for safe driving. The more he drives, the better he gets. Stephen reports he is able to listen to music and podcasts while he drives but he is not able to talk. Texas work force division assists with payment for some vehicle modifications.
  • Challenges with executive functions following stroke, despite testing showing no deficits. Stephen describes his real-world experience with cognitive functions and strategies he uses to compensate and make it successfully through the days.
  • Basic home tips and tricks are available on the ataxia.org website for a treasure trove of energy conservation techniques for people with ataxia. Using one-handed items and voice activation devices to conserve energy, stay safe and give oneself the space to progress towards other life goals following stroke – it’s not laziness and we need to stop telling people they’re lazy when in fact, they’re open minded towards creating a better life for themselves.
  • Cognition tends to still be missed, is perhaps incorrectly assessed, and remains under addressed following stroke! This includes gait speed. Community level gait speed within clinic testing but wearable tracking devices show significantly slower gait speeds once people leave therapy and clinical inability to accurately capture real-world cognitive functioning. Loss of automaticity has a negative impact on ease of function. 
  • Practice vs compensation for people who’ve experienced a cerebellar stroke compared with those who have a neurodegenerative disease.
  • Exercise programs, adaptive training at a local gym, using a pool to improve ambulation and locating a neuro therapy practice to establish a safe home exercise program, making a lifetime commitment to oneself and tracking progress.
  • The importance of a debrief for increasing life success following stroke. Know yourself and know your limits – take the time you need and don’t be afraid to adapt the way you do things.

We hope you find value in Part 2 of our engaging conversation!

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com.

Questions and Comments about the podcast?

Donate to The Noggins & Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com
Heim, Drake, & Millar: Cerebellar Ataxia, PART 1

Heim, Drake, & Millar: Cerebellar Ataxia, PART 1

November 4, 2021

Heim, Drake, & Millar: Cerebellar Ataxia, PART 1

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins & Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

OVERVIEW:

Meredith: The brain stimulation program that we’re doing at Hopkins is we’re applying transcranial direct current stimulation to people who’ve had multiple types of brain injuries. The most common population that we see are strokes. The concept of this non-invasive brain stimulation is that it promotes neuroplasticity and so we combine it with intensive therapies. You come every day for 3 weeks and we’re trying to do this really intensive therapy plus the non-invasive brain stimulation so we’re hoping it’s like a double whammy of neuroplasticity and that we’re really trying to get the brain to get excited…excite those cortical tissues and get them to start re-organizing and healing themselves.

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb talk with physical therapists Jennifer Millar and Meredith Drake from Johns Hopkins Ataxia Center in Baltimore, MD, and cerebellar stroke survivor Stephen Heim. We uncovered the following:

  • Cerebellum is latin for “little brain.” It coordinates coordination. The cerebellum is where movement coordination and motor learning mostly occurs. The role of the cerebellum is to predict and smooth out our movements in response to sensory stimuli. It is a complicated structure.
  • An impaired cerebellum is very debilitating to the body. Damage impacts motor learning and motor planning, which means traditional therapy is ineffective.
  • The cerebellum works ipsilaterally with the other brain structures to produce movement.
  • Dual task engagement is not effective for people with cerebellar damage. Using a new device such as a rolling walker adds another aspect to a task. Walking and talking should not occur together.
  • Parkinson’s treatment principles do not merge well with interventions to treat cerebellar ataxia.
  • Therapy for cerebellar ataxa focuses on balance, dynamic challenges and weight shifting rather than strength training. Most people with cerebellar ataxia have good strength. Practice and repetition are key for recovery. Tai Chi, yoga and swimming are effective interventions for ataxia.
  • Dysmetria is a challenge for Stephen, whether he under shoots or overcorrects – he still has trouble. He finds it annoying despite knowing the challenge exists. He uses a wheelchair for mobility and finds this conserves energy.
  • We learned compensatory strategies and devices that may help with dysmetria and ambulation when ataxia is present.
  • The origin of the Johns Hopkins Ataxia center and services provided. The brain stimulation program promotes neuroplasticity with intensive therapy…It doesn’t cure but does advance outcomes beyond those that occur without using brain stimulation as an intervention.

We hope you find value in Part 1 of our conversation!

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com.

Questions and Comments about the podcast?

Donate to The Noggins & Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com
Jennica & Suzanne from Trio Rehab: PART III

Jennica & Suzanne from Trio Rehab: PART III

October 30, 2021

Jennica & Suzanne from Trio Rehab: PART III

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins & Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb talk with Jennica Colvin and Suzanne McCrum from Trio Rehabilitation in Texas. We learned about private clinic ownership and more. Topics we covered include:

  • Jennica encourages listeners to follow their dreams
  • Brain primers, intervention, affordable interventions and getting started with home programs to facilitate success
  • Re-establishing brain control over the flexors, stress balls and stretching
  • Using the right questions and proper education to clients and caregivers
  • Slings, cost, subluxation, learned non-use, pain and balance
  • Subluxation, e-stim, markers and videos
  • Sleep after stroke, home assessments and intervention
  • Paying attention to prevent falls and learning floor transfers
  • Using video recording to facilitate physical & cognitive rehab
  • The role of music in aphasia recovery
  • Vestibular rehab, stroke and Benign Paroxysmal Positional Vertigo

We cover a lot of ground across 3 episodes with Jennica and Suzanne. We hope you find value in our conversation!

Trio Rehabilitation & Wellness Solutions (website)

Trio Rehabilitation & Wellness Solutions (Facebook Page)

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com.

Questions and Comments about the podcast?

Donate to The Noggins & Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com
Jennica & Suzanne from Trio Rehab: PART II

Jennica & Suzanne from Trio Rehab: PART II

October 29, 2021

Jennica & Suzanne from Trio Rehab: PART II

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins & Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb talk with Jennica Colvin and Suzanne McCrum from Trio Rehabilitation in Texas. We learned about private clinic ownership and more. Topics we covered include:

  • How Suzanne uses treadmill training following stroke
  • Practitioner opinions on using the terms good limb and bad limb
  • Addressing depression following stroke, awareness, and rapport as part of a recovery plan
  • Expectations, goal setting, programs that support client success and outcomes
  • Hiring good people, gut instincts and getting out of their way
  • Constraint Induced Therapy for the lower extremity and equipment cost
  • Guns, guitars and valued activities into motor practice and vision recovery
  • Efficiency for successful practice
  • Making the switch from paper to electronics for record keeping

Trio Rehabilitation & Wellness Solutions (website)

Trio Rehabilitation & Wellness Solutions (Facebook Page)

The Geriatric Depression Scale (GDS)

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com.

Questions and Comments about the podcast?

Donate to The Noggins & Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com
Jennica & Suzanne from Trio Rehab: PART I

Jennica & Suzanne from Trio Rehab: PART I

October 25, 2021

Jennica & Suzanne from Trio Rehab: PART I

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins And Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

OVERVIEW: Pete, Deb, Jennica and Suzanne get to know each other

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb talk with Jennica Colvin and Suzanne McCrum from Trio Rehabilitation in Texas. We learned about private clinic ownership and more. Topics we covered include:

  • The evolution of Trio Rehab
  • Reasons for starting a private practice and why people want to work in a private practice clinic
  • 1:1 treatment model, meeting people where they are, eclectic interventions and recovery
  • Seasoned therapists, learning and mentorship for practitioner growth
  • How having children promotes practitioner development
  • Trial and error and willingness to try for client success
  • Learning, motor learning and practice to make progress
  • Stroke, cognition, client & family interviews, assessments, fatigue and intervention

Trio Rehabilitation & Wellness Solutions (website)

Trio Rehabilitation & Wellness Solutions (Facebook Page)

Canadian Occupational Performance Model (COPM)

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com.

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com
Jus‘ a lil‘ bit o‘ Everything

Jus‘ a lil‘ bit o‘ Everything

October 22, 2021

Jus' a lil' bit o' Everything

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins And Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

OVERVIEW: Pete and Deb chat about Pete’s Blog, music and brain recovery

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb talk about Pete’s Blog, Facebook groups, and

  • Listening to music can help with aphasia
  • The challenges of the unknown for survivors, families and care providers immediately following traumatic brain injury
  • Facebook groups that clinicians, survivors and caregivers might find helpful
  • Unlearning as part of practitioner growth to create space updated practice evidence and tapping into students for learning, creating and setting up new programs
  • Explicit communication from family and friends and the challenges that come along with learning better ways to communicate

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com.

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com.

Vocal Music Listening Helps Recover Language

Noggins & Neurons

approved Facebook groups

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

Emotions After Brain Injury: The Recap

Emotions After Brain Injury: The Recap

October 20, 2021

Emotions After Brain Injury: The Recap

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins And Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

OVERVIEW: Pete and Deb chit chat

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb talk about what we learned about from Drs. Zupan and Neumann. We covered:

  • The new FACES app release information and understanding who should use the app, which is recommended for academic & clinical use. This bothers Pete and Deb sheds a little light on the need for some training. All is not lost!
  • Several quotes from the podcast:
    • Dr. Zupan talking about initial recovery experiences following brain injury, missing the opportunity to notice and address deficits in emotions, subsequent problems that appear and the need for a better discharge plan
    • Cognition, emotions, prioritizing intervention, lack of physician knowledge around TBI symptoms, and the need for a better system in the U. S. at least
    • Inability or difficulty identifying emotions, physiological responses and learning to identify emotions following brain injury
    • Facial recognition training, facial expression software, micro-expressions and watching movies
  • Addressing the higher level cognitive/emotion skills at the onset of brain injury as a means of lower-level skills healing
  • Negative attribution when assessing the emotions of others, family dynamics and stress around meeting the needs of all

In two previous episodes Emotion Perception After TBI/Stroke w/ Drs. Zupan & Neumann announced to the world on our show that they'll have a new free app out soon to help folks conquer Alexithymia. Here is some more info on that app:

The FACES app is an App version of  the facial affect recognition intervention that we tested and has the highest strongest level of evidence for treating facial affect recognition deficits after TBI. I think we talked about it on your program, but if you think it would help, you  could include some version of the below info.  That said, anyone will be able to download the app, it’s just not intended to be self-delivered.  Hope this helps!

The FACES App: 

  • What is it?:  It is a therapeutic program consists of exercises intended to help teach individuals who have problems with emotion perception to better recognize others’ emotions--- to be able to identify and relate to happy, sad, angry, and fearful facial expressions in others. This is an evidence-based approach (Neumann et al, 2015) and has been deemed a practice standard (Cicerone et al 2019) for treating emotion perception deficits in individuals with neurological disorders.

Neumann, D., Babbage, D., Zupan, B. and Willer, B. (2015). A Randomized controlled trial of emotion recognition training after traumatic brain injury. Journal of Head Trauma Rehabilitation. 30 (3): E12-E23 May/ June 2015 doi:10.3109/02699052.2014.901560

Cicerone, K. D., Goldin, Y., Ganci, K., Rosenbaum, A., Wethe, J. V., Langenbahn, D. M., Malec, J. F., Bergquist, T. F., Kingsley, K., & Nagele, D. (2019). Evidence-based cognitive rehabilitation: systematic review of the literature from 2009 through 2014. Archives of physical medicine and rehabilitation, 100(8), 1515-1533.

  • Who is it for?: Clinicians treating individuals with neurological disorders who have emotion perception deficits
  • Intended Delivery Method: This intervention was created as a clinical tool for therapists and healthcare professionals to use as a resource when treating patients who have emotion perception problems.  It is not intended for patients to use on their own or to be delivered by a care-partner or family member, as that approach has not been tested or validated by research.

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com.

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com
Emotion Perception After TBI/Stroke w/ Drs. Zupan & Neumann PART 2

Emotion Perception After TBI/Stroke w/ Drs. Zupan & Neumann PART 2

October 12, 2021

Emotion Perception After TBI/Stroke w/ Drs. Zupan & Neumann PART 2

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins And Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

OVERVIEW

  1. ZUPAN: I think as therapists if you’re really looking for something tangible to use just grab a movie or a tv show and, you know, stop and pause at various scenes. I think that would be a really useful task that you could get that more, I always say ecologically valid, but that more everyday way, I mean, it’s still acting but it’s a better example of how we use and express emotion and the way we need to use all of the cues that are around us to interpret not just one thing. So I think that’s a really good thing that therapists could look to do.

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified continues the conversation with Dawn and Barb. Here’s some of what we covered…

  • What we did during our recording break – yes! We take a break, even when we have guests on the show…
  • Speech therapy schools Pete’s daughter can investigate
  • Emotional inappropriateness as emotional difficulty and the misperception that it’s a cognitive problem. Alexithymia is as aspect of emotion regulation, emotional processing that requires cognition – awareness, evaluation and understanding of emotions that helps to regulate them.
  • Cognitive & emotional empathy, recognizing emotionally neutrality and negative attribution bias
  • Eye tracking and facial recognition
  • The value of authentic peer feedback over that of therapists who wear their professional hats and learning to receiving negative and positive feedback
  • Autism research and crossover to brain injury recovery strategies
  • Lack of feeling ability following brain injury and the impact of training on relationships
  • Survivor misdiagnosis of mental illness by physicians who don’t understand brain injury
  • Look at social emotional communication when survivors feel like something is wrong and are unable to get a diagnosis
  • Correlation of alexithymia and substance use
  • Logic + reason + emotion for optimal decision making
  • Decreased smell, the prefrontal cortex and the connection to empathy and social monitoring

We hope you found value in part 2 of our conversation about emotion regulation with Drs. Zupan and Neumann.

As always, we want to hear your top takeaways! Please email us at NogginsAndNeurons@gmail.com.

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

Obex Technologies are a UK software team working with Dr Dawn Neumann and her colleagues to develop a mobile version of the original Facial Affect Recognition intervention, which will be named FACES in the App stores.  FACES is scheduled for public release in App stores late 2021, where it will be free to download for clinical and academic use.

Facial Affect Recognition Task

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com

 

Emotion Perception After TBI/Stroke w/ Drs. Zupan & Neumann

Emotion Perception After TBI/Stroke w/ Drs. Zupan & Neumann

October 10, 2021

Emotion Perception After TBI/Stroke w/ Drs. Zupan & Neumann

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins And Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

  1. NEUMANN: And every time something was brought up, you know, we would show them this picture, his face would be as flat as can be but his physiological responses, his arousal of responses were really strong every time he saw one of these emotion stimuli. And it was amazing because just looking at his face there was nothing there. And he doesn’t think anything is there. You know I had asked him, “What would you do if your wife divorced you?” And he said as flat as he, you know, just straight faced as he could possibly be, “Well she’s got to do what she has to do.” Yet, this massive spike so you could tell he had this emotional response. And so it made me think that like these people who have this blunted affect, I think that it’s just unlocking something. There’s something there that we have to get through. We have, it’s a barrier that we have to get through and help them learn there’s a threshold. And it’s, this threshold has become so high in some of these individuals that we’ve got to lower this threshold and their ability to tackle when something’s going on. And kind of unlock some of these physiological responses and so that’s what led me to kind of develop the intervention that we have for teaching people with brain injury to gain insight into their emotions, detect these physiological responses, connect physiological responses with an emotional label and what they’re feeling and then being able to communicate and express those things. And then, so, if this neural plasticity, I believe that it’s there. I believe that as long as these, you know, these connections aren’t fully and completely destructed. You know, you can revive some of these and strengthen some of these connections.
  2. ZUPAN: What happens is when people first have a brain injury, there’s often so many things that they need help with, right? And so you’re focusing on let’s get them back to eating, let’s get them back to walking, let’s get them the skills they need to go back to work or to their life. And so this whole emotion, empathy, social cognition side of things kind of gets forgotten about or, in some cases, isn’t recognized as a problem, because when you’re in a hospital or rehab situation, everything’s structured and everything’s happening with a specific purpose or reason so sometimes those interactional problems don’t show up but also people are, um, too busy being focused on other things. So then these people go home and they no longer have this regular therapy and everyone thinks they’re ready to go…you know they’ve the skills they need to be fairly successful and it all falls to pieces…And that’s because, if you’re not responding or interacting emotionally and using social communication the way people expect, then that creates huge problems…

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified, we chat at length with Dr. Barbara Zupan and Dr. Dawn Neumann about emotion perception following traumatic brain injury/stroke. Topics covered include:

  • Alexithymia (the inability to recognize emotions from vocal, facial and body movement cues) and the problems experienced by the survivor and those they interact with as a result.
  • Pete’s sleuthing skills, how Dawn and Barbara started working together and other important members of their research team
  • Alexithymia, no words for emotions, neuroplasticity and treating the problem in brain injury survivors
  • Role of neuro imaging in emotion recovery
  • Interoception is key for detecting physiological responses and identifying emotions
  • Interventions to improve communication for partners and survivors and who can and should facilitate them…from SLP’s, Neuropsychologists and OT’s to trained support workers
  • Social cognition treatment, apps, training and intervention delivery. The intervention Dawn and Barbara developed will be available via app later this year! Stay tuned…
  • The value of explicit communication and managing emotional responses on the part of caregivers and loved ones

As always, we want to hear your top takeaways! Email us!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

Facial Affect Recognition Task

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com

 

Brain Injury Vision Recovery Recap

Brain Injury Vision Recovery Recap

October 4, 2021

Brain Injury Vision Recovery Recap

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins And Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

OVERVIEW - Conversation: Pete and Deb joke about Pete’s microphone being on the floor and his pre-podcast snacking. We also talk a bit about equipment design and fabrication because Deb’s friend and OT colleague designed a new piece of adaptive equipment. Pete shared his experience around production based on the arm skate he designed. It’s a fun and interesting conversation!  

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified recaps our thoughts and perspectives on the conversation we had with vision expert, Dr. Mary Warren. In this episode Pete and Deb talk about:

  • The OTA students’ love for Pete and the PTA students quick grasp of neuro concepts
  • Deb’s AOTA proposal acceptance for the national conference in spring ’22 and Pete’s talk withdrawal from ACRM
  • Noggins And Neurons podcast and Facebook stats
  • Pete’s reminder that practitioners have an inside track to what the research shows works and practice-based intervention
  • Stupid questions, feeling stupid and professional relationships
  • The negative impact of missing vision deficits, how to pick them up sooner and appropriate intervention strategies
  • Quick screen to determine if a visual field cut is present
  • Optometrist vs Ophthalmologist clarification
  • biVABA vision assessment, how to locate it, YouTube video demo and more
  • Vision interventions to implement now
  • Pete explains ABAB experiment design
  • Dr. Mary Warren conversation snippets followed by Deb and Pete thoughts

We love talking about what we learned in the Vision episodes with Dr. Warren. Review certainly helps us grow in our roles as clinicians and educators; Pete and I hope you find benefit too!

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

Brain Injury Visual Assessment Battery for Adults (Demo)

Brain Injury Visual Assessment Battery for Adults (biVABA)

visABILITIES REHAB SERVICES, INC. Continuing Education

A Hierarchical Model for Evaluation and Treatment of Visual Perceptual Dysfunction in Adult Acquired Brain Injury, Part 1

A Hierarchical Model for Evaluation and Treatment of Visual Perceptual Dysfunction in Adult Acquired Brain Injury, Part 2

 

Low Vision Rehabilitation Graduate Certificate program at University of Alabama at Birmingham

Chapter 24: Evaluation and Treatment of Visual Deficits After Brain Injury. (2018). In Pedretti’s Occupational Therapy Practice Skills for Physical Dysfunction (pp. 594–630). Elsevier.

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com
Mary Warren: Vision and Brain Injury. Part II

Mary Warren: Vision and Brain Injury. Part II

September 27, 2021

Mary Warren: Vision and Brain Injury. Part II

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins And Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

DEB: So sometimes when we’re working with someone who needs extra time, we might think it’s because of a motor problem, we might think it’s because of fatigue and maybe even memory, but it could be because they’re not visually taking in their environment properly.

 

  1. WARREN: Yeah. That’s exactly it. That’s why it’s important to screen right? Because if I have that client and I’m first seeing them and I screen for their acuity and I screen for their contrast and I look at whether they can move their eyes together and I look at their visual attention...If I do that basic screening and get a sense of what are their strengths in using their visual system and what are their weaknesses, then I can further assess their performance in an ADL or something else and I can help start to distinguish, you know, is this vision or is it something else? If it’s vision one of the ways I can test it is just by making whatever they’re doing more visible to them. I can add task lamp to spotlight it, I can simplify it, I can get rid of all the pattern that’s around it, whatever I need to do, if I can create it and make it more visible and then watch how their behavior changes.

 

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified is Part II of our conversation with vision expert, Dr. Mary Warren. In this episode we learn about:

 

  • Three common environmental barriers that add visual stress in home environments are too much pattern, incorrect lighting and not enough contrast
  • Warren’s belief that people improve following brain injury when they can successfully engage in their occupations again (The premise of occupational therapy practice), stimulating neuroplasticity and avoiding depression
  • Behaviors that mask vision deficits - looking at the feet and head positions when walking as signs of vision deficits
  • How cognition and vision are intertwined. Signs that look like frontal lobe injury (decreased initiation, increased time to complete a task and indecisiveness) could indicate a vision problem
  • The Brain Injury Visual Assessment Battery for Adults (biVABA) for assessing vision following stroke and brain injury. It aligns with the visual perceptual hierarchy, determines strengths and weaknesses of vision and guides intervention using the strengths to compensate for weaknesses
  • Warren’s continuing education course on vision
  • Warren’s perspective on how OT services are judged by the clients we serve
  • Low Vision Rehabilitation Graduate Certificate program was started by Dr. Mary Warren with Beth Barstow, PhD, OTR/L, SCLV, FAOTA
  • Vision declines but visual attention doesn’t have to! Engaging in activities that require reactivity can help improve visual attention, memory and driving in older adults
  • Visual deficits associated with vestibular system impairments and where to look for help
  • The question that helped Dr. Warren establish the most important professional relationship of her career

We hope you feel as inspired as we do after listening to this episode on vision.

As always, we want to hear your top takeaways!

 

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

Brain Injury Visual Assessment Battery for Adults (biVABA)

visABILITIES REHAB SERVICES, INC. Continuing Education

A Hierarchical Model for Evaluation and Treatment of Visual Perceptual Dysfunction in Adult Acquired Brain Injury, Part 1

A Hierarchical Model for Evaluation and Treatment of Visual Perceptual Dysfunction in Adult Acquired Brain Injury, Part 2

visAbilities

Low Vision Rehabilitation Graduate Certificate program at University of Alabama at Birmingham

Chapter 24: Evaluation and Treatment of Visual Deficits After Brain Injury. (2018). In Pedretti’s Occupational Therapy Practice Skills for Physical Dysfunction (pp. 594–630). Elsevier.

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com

 

Mary Warren: Vision and Brain Injury. Part I

Mary Warren: Vision and Brain Injury. Part I

September 26, 2021

Mary Warren: Vision and Brain Injury. Part I 

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins And Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

  1. WARREN: They are very concerned about falling and running into something. If you have a hemianopia you’re going to have some collusions right off the bat. And they walk very slowly or they do a thing where they stare straight ahead and just walk towards a target and hope they make it. These are dangerous types of things and you can’t get away with them when you’re in dynamic environments; they don’t keep you safe. So the person tends to avoid dynamic environments and won’t go outside the house then, because of the way they’re moving. So we...the big culprit for that....I gues that takes me off in a different direction that’s a very interesting thing that the brain does is that when we’re scanning our environment, when we’re finding things, we don’t go from object to object to build a visual scene. Instead what our frontal lobes do is they sample the visual scene and then they perceptually complete it based on past experience with this environment and expectations of what you should see and by doing that the frontal lobes allow us to process information very rapidly and move through environments that are very dynamic, like driving environments. What was discovered about hemianopia and the first research was published in the 1960’s, is that person’s with hemianopia where fifty percent of their vision is missing, actually exercise perceptual completion. So when you first experience a hemianopia, even though you’re missing fifty percent of your vision, you feel like you see everything. You have a completed visual field in front of you, you don’t have a border that tells you exactly where you have vision and where you don’t have vision. There’s no black curtain there, there’s nothing to tell you when you are getting into your blind field or how far you should go into the blind field.

 

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified is Part I of our conversation with vision expert, Dr. Mary Warren. In this episode we learn about:

 

  • Warren’s professional path into vision - vision and driving rehab, brain injury recovery, her development of the Visual Perceptual Hierarchy
  • Statistical information about vision deficits following stroke or brain injury:
    • 50-90% experience ocular motor problems
    • 50-70% experience difficulty using the eyes together
    • Visual field changes – about 50%
    • Acuity – 25%
    • Visual attention (neglect) – 70% (immediately following right middle cerebral artery stroke
  • Vision impairment and hidden disability
  • Vision impairment may cause changes in motor and cognitive behavior, masking vision as the underlying problem
  • The difference between neglect and hemianopia and gaze preference as an early sign of neglect
  • Vision deficits that respond to rehab, perspectives of ophthalmology and optometry and evidence for interventions
  • The difference between restorative and compensatory measures in vision recovery following stroke and brain injury
  • Client who has hemianopia can have recovery success (driving, reading, overall quality of life) IF they get the right therapeutic interventions (and it doesn’t require a lot)
  • Common problems experienced by people with hemianopia include reading and mobility challenges due to decreased field of view. Therapy can help. Without therapeutic intervention people often:
    • Quit reading due to difficulty finding the words, slowness and fatigue
    • Stop leaving the house because dynamic environments become frightening
  • Dynavision and other light boards to help improve vision and cognition deficits
  • Free vision training programs for people with hemianopia

We hope you feel as inspired as we do after listening to this episode on vision.

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

DREX Durham Reading & Exploration Training

A Hierarchical Model for Evaluation and Treatment of Visual Perceptual Dysfunction in Adult Acquired Brain Injury, Part 1

A Hierarchical Model for Evaluation and Treatment of Visual Perceptual Dysfunction in Adult Acquired Brain Injury, Part 2

visAbilities

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

  • Music by scottholmesmusic.com

 

Listener Q‘s & Decoding Teasell

Listener Q‘s & Decoding Teasell

September 22, 2021

Listener Q's & Decoding Teasell

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins And Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

DEB: An easy question for you to answer from JE. She is wondering, ‘Is there ever a time when spasticity turns itself off?’

 

PETE: Yes, there is a time when it turns off and that’s when they’re sleeping. Then that had implications for things like a splint that you can’t get on when they’re awake, you might be able to get it on when they’re asleep. So, my wife...this was another joke I used to tell in my talks. So my wife would say ‘yeah, I know about the splinting (Pete whispering) and sometimes I would sneak into their room and I’d be very quiet and I wouldn’t want to wake ‘em and then I would put the splint...’ and she’s a PT so it was probably something on the lower extremity...um...a boot or something. ‘And then I would sneak out.’ (Normal voice) But that’s not ethical right? So I’m like maybe I should report you to the state board, Ila! But no, I think as long as you ask permission first and every clinician that I told that joke to they’d go just ask first and you’re good. So you can do it if they’re sleeping, and truly, if you want to get a real perspective on the amount of spasticity that  they have, then it’s good to do something like the Modified Ashworth, which is a test of spasticity, while they’re sleeping because that’ll give you a true baseline. The other thing is if you’re confused about whether something is contracture or spasticity then, if it’s contracture, when they’re sleeping, it’ll still be evident as much as it ever was, whereas if you let them fall asleep and you can move it, then you know it’s just a whole lot of spasticity. Because sometimes it’s hard to tell the difference between a 4 on the Ashworth, which is, you know, can’t move it, and true contracture but that is a way of sort of the differential diagnosis of that.

 

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified, Pete & Deb share more thoughts about our conversation with Dr. Robert Teasell and Marcus Saikaley as well as listener questions. In this episode we talk about:

  • Rehab light for stroke survivors in the US
  • Client transitions throughout the rehab process, continuity of care through and a warm hand off
  • Best assessment tools to objectively measure upper extremity coordination
    • Box and Blocks test - grasp/release
    • Fugl-Meyer - finger to nose/dysmetria – liked by Dr. Teasell and done the most by Pete
    • Nine Hole Peg Test - manual dexterity
    • Action Research Arm Test – assesses specific changes in limb function
    • Jebsen Hand Function Test (JHFT) – functional hand motor skills
    • Wolf Motor Function Test (WMFT) -
    • Arm Motor Ability Test – Pete dislikes but Doro seems to know about it
  • Repetitive Transcranial Magnetic Stimulation is a primer. It’s nonpainful and very expensive. Direct Electrical Stimulation to the brain is a primer and requires surgery.
  • Less expensive brain primers cost little and are easy to use.
  • Times when spasticity turns itself off, the Modified Ashworth Scale and telling the difference between spasticity (Modified Ashworth score of 4) and contracture.
  • Brain Primers and focus on function – challenges for OT practitioners related to occupation-based interventions and making a plan for using primers to facilitate success.
  • Primer interventions appropriate for survivor home use. They might be boring but they work!
    • Bilateral Arm & Leg Training – intact limb helps improve affected limb movement
    • Mental Practice – use ready-made recordings and create client-centered recordings. Good to do just prior to engaging in mirror therapy.
    • Action Observation – at home upper extremity examples include watching another person obtain items for setting the table. Make videos of the person and watch repeatedly
    • Electromyography/biofeedback – using surface electrodes an EMG machine will show a muscle moving when it can’t be felt – even when it’s thought about. Can do repetitive practice before you’re able to move. Moves into a more expensive direction. Mental practice/mental imagery can be used instead – more trust is required but the same effect occurs.
  • Teasell suggests using 1 primer and 1 facilitator – for example, follow a primer with something such as strength training, trunk training or constraint-induced therapy.
  • Adding cognition may increase fatigue and rest is necessary.
  • Terms used in the EBRSR and what they mean. If an intervention beats standard of care:
    • 66% of the time or more they use the word may or can
    • 50-66% of the time they consider the evidence to be conflicting or mixed
    • Less than 50% of the time the term may not is used

As always, we want to hear your top takeaways...Please email us or post in the Noggins And Neurons Facebook group!

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

Pete & Deb Review Teasell‘s Insights

Pete & Deb Review Teasell‘s Insights

September 19, 2021

Pete & Deb Review Teasell's Insights

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins And Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

DEB: Dr. Teasell said that the reasons that therapists have for not doing these things...so they include not having enough time, being busy...and I understand all of this. I do, because I’ve been in those shoes...all of those reasons...he said that they’re legit. And I think that whatever our reasons are, whoever we are, I think they’re legit to a degree. I think that we need to start empowering ourselves to take some steps and try new things. I just think it’s important to have a culture of listening and kindness. Be compassionate with each other and then that way you’re going to advance your clinical outcomes, you’ll advance your practice setting. In trying to implement something new and doing new things, it’s become very apparent to me that we really are limited by our own weaknesses.

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified, Pete & Deb share thoughts about our conversation with Dr. Robert Teasell and Marcus Saikaley of the Evidence-Based Review of Stroke Rehabilitation (EBRSR). In this episode we talk about:

  • Our general feelings about the interview – Deb enjoyed being a part of the conversation and learning about opportunities. Pete was excited about the brain primers and moving beyond old school interventions.
  • Our thoughts on disability, the government, listening to patients, trust and advocacy.
  • Research, policy change, the brain and passion in practice.
  • The vast amount of stroke research and the three big messages:
    • Earlier is better (too much too soon can make infarct worse)
    • Intensity matters
    • Task specificity
  • Bobath strategies take longer to work.
  • Distrust among healthcare workers towards patients, being more trusting as a provider and collaborating.
  • Listener question: why therapists are afraid to try new things and push patients harder.
  • Opportunities to improve outcomes beyond standardized care using adjunct therapies are critical to the future-moving beyond cultural beliefs and sideways glances.
  • Pete’s tips for navigating change and stepping into leadership.
  • Therapist belief systems don’t belong in the clinic when they conflict with research.
  • Growth mindset, kindness and compassion belong in the clinic.
  • Certifications, creativity and translating the research in clinical practice.
  • Pete’s thoughts about why there is so much focus on the upper extremity.

As always, we want to hear your top takeaways...Please email us or post in the Noggins And Neurons Facebook group!

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

Debra's Website:

Stroke and TBI Recovery with Dr. Robert Teasell MD: Part II

Stroke and TBI Recovery with Dr. Robert Teasell MD: Part II

September 18, 2021

Stroke and TBI Recovery with Dr. Robert Teasell MD: Part II

QR_Google_iTunes_Spotify_and_Websiteacguv.jpg

Noggins And Neurons Facebook Group: CLICK HERE or scan below!

Facebook_N_N_QR_CODE7600u.jpg

  1. TEASELL: ...second of all, try and develop ways in which we can move things forward. You know? Not necessarily get to the you know, I say research is always about trying to get to the truth, and we’re far from it and our piece, hopefully, will get us a little closer to it, but it clearly isn’t going to be it. But I do think, you know, I think we all agree that we’re kind of at a point where we’re stuck, you know, and stroke rehab, there doesn’t seem to be a lot of movement forward clinically, you know, we’ve gotten really good at standardized care and even that’s starting to be eroded, you know what I mean, in some jurisdictions? And I think it’s time for us to really think about what do we pivot to next? Right? What do we add onto that to make it better, get people excited about stroke rehab again and sort of end that erosion of funding that is occurring in some centers and encourage more funding in other centers?

 

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified is Part II of our conversation with Dr. Robert Teasell and Marcus Saikaley of the Evidence-Based Review of Stroke Rehabilitation (EBRSR). In this episode we learn about:

  • Brain primers – what they are and the best ways to use them

    1. The vast number of randomized controlled trials on brain priming interventions that work: mirror therapy (75), bilateral arm training (66), virtual reality (99), EMG biofeedback (66)
  • What the words can, may and may not mean when interpreting research and how these terms are used in the EBRSR
  • Academic training, certifications, trainings and guidelines for implementing adjunct therapies in practice
  • The EBRSR spinoff projects:
    1. Spinal Cord Injury Evidence (SCIRE) – there are two components:
  • The spinal cord professional aspect for rehab professionals (similar to the EBRSR)
  • Spinal cord community – video information for patients
  1. Evidence-Based Review of Acquired Brain Injury (ERABI) – focus on cognition, mental health and community re-integration challenges following brain injury

    • Less evidence available compared to stroke
    • Research challenges due to the cognitive deficits experienced by brain injured people
  • Interventions that work for stroke recovery are not always translatable to Traumatic Brain Injury – the injuries are not the same stroke lesions tend to be more focal compared with TBI
  • The CORE Program consists of many research projects
  • The future, network meta-analysis as a tool for the future. Compares multiple treatments against each other with:
    1. direct evidence and can
    2. estimate indirect evidence (can make estimates for comparative effectiveness of two interventions which might not be compared in the literature)
  • The best interventions according to the Network Meta-Analysis are....
    1. Modified Constraint Induced Movement Therapy. Developed by yours truly, Pete Levine, and his colleague Dr. Steven Page
    2. Functional e-stim
    3. Theta burst stimulation
    4. Motor imagery
    5. Bilateral Arm Therapy
  • Research shows that primers work better than facilitators, but therapists seem to like facilitators more. Now it’s time to start using the treatments that work.
  • Adjunct treatments, standardized treatments, the future and improved care
  • Wondering how to help therapists use the research on interventions that work to maximize recovery
  • 85% of interventions that work are adjunct treatments we don’t use very often – we need to take advantage of them, especially the cheap ones.

We hope you feel as inspired as we do after listening to this episode on interventions that work and other resources.

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

Evidence-Based Review of Stroke Rehabilitation

Evidence-Based Review of Moderate-to-Severe Acquired Brain Injury

Spinal Cord Injury Research Evidence

Collaboration of Rehabilitation Research Evidence

Collaboration of Rehabilitation Research Evidence twitter

Dr. Teasell’s Google Scholar Page 

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with Venmo or PayPal:

  • Venmo @neurons
  • Use the PayPal app  (appears as Creative Concepts OT - add the note NEURONS under donation amount)

CCOT_N_N_qrcodeawxh5.png

Pete’s blog, book, Stronger After Stroke, and talks.

ACRM.jpg

Debra's Website:

Podbean App

Play this podcast on Podbean App