The NOGGINS AND NEURONS Podcast
Brain Computer Interface with Occupational Therapist Lauren Souders

Brain Computer Interface with Occupational Therapist Lauren Souders

September 24, 2022

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excerpt of the information that was submitted and reviewed by the FDA: "10 Summary of Clinical Performance Testing

The Neurolutions System has been evaluated in 40 subjects across three separate clinical studies (described below), all of which evaluated use of the Neurolutions system in chronic stroke survivors.  All three studies were designed to determine the feasibility of recording electroencephalogram (EEG) signals from the affected and/or unaffected brain hemispheres, and to use the signals to control a computer to facilitate movement of a robotic hand orthosis (Handpiece).  The results of the studies have been analyzed to determine if the Neurolutions System can be used to positively impact rehabilitation. These three studies were open-label studies whereby a literature meta-analysis assessing usual care as well as minimal clinically important difference (MCID) benchmarks were utilized for comparison of device effectiveness in lieu of randomized control data.

Results of testing demonstrate that following 12-weeks of use of the Neurolutions System, chronic stroke survivors showed increases in the mean change from their baseline scores on the primary outcome measure for the three respective studies. Ten of the total 40 subjects were assessed utilizing the Action Research Arm Test (ARAT) as the primary outcome measure and the mean scores exceeded the Minimal Clinically Important Difference (MCID) of 5.7 points.  In the two other studies, 30 of the total 40 subjects were assessed utilizing the Fugl-Meyer Upper Extremity (UEFM) assessment as the primary outcome measure. For 66.7% of these 30 subjects, mean scores exceeded the MCID of 5.25 points.  UEFM data were collected in 30 subjects from studies.

Results of Pooled Analysis: The results from 30 subjects across two studies may be validly pooled because the studies have the same primary endpoint and were conducted under nearly identical protocols (including inclusion/exclusion criteria and treatment regimen) and investigated the same version of the device in a very similar patient population (as evidenced by a comparison of the demographic data).  Moreover, the primary endpoint, change in UEFM, was compared at the same timepoint, and the studies were weighted relative to their size.  Based on the foregoing, a pooled analysis for UEFM, including all 30 subjects from the two studies, resulted in a mean change at 12-weeks of 7.77 points (SD of 5.041, two-sided, one-sample t-test, p-value < .0001), which exceeds the Minimal Clinically Important difference (MCID) of +5.25 points reported in the literature. 

Across the two pooled clinical studies, 100% (30/30) of the subjects demonstrated improvement on the primary outcome measure, UEFM. A total of 66.7% of these subjects exceeded the minimal clinical important difference (MCID). The MCID is the change in a treatment outcome as measured by a trained clinician and regarded as important and clinically meaningful to health professionals and patients.[1],[2],[3],[4]  The remaining 33.3% of the subjects, although demonstrating improvement, did not achieve the MCID.

For a cohort of 12 patients who participated in, durability data was assessed at 6-months following completion of their 12-week study visit. Durability assessment of the primary and secondary outcome measures revealed these subjects maintained their level of improved functional and motor performance. This demonstrates that the motor improvements achieved with the Neurolutions System therapy were maintained at 6-months following the last device use. However, as durability testing has not been completed beyond 6-months, persistence of benefits beyond 6-months post device use are currently unknown.

The results of these clinical studies support the feasibility of recording EEG signals from the affected and unaffected hemisphere and demonstrate that a computer can use these signals to control the motor output of a robotic handpiece (orthosis). Results of testing demonstrate that movement of the affected fingers, through the use of the Neurolutions System, can positively impact rehabilitation of the affected arm in individuals who suffer from chronic (≥ 6 months post-stroke) upper extremity hemiparesis resulting from stroke."

Website Items: 

 

 

Publications of Interest: 

IpsiHand in the Media:

RESOURCES:

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!   Guest Request Form

MUSIC: “Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

PT Michelle: Survivor Success Story

PT Michelle: Survivor Success Story

September 1, 2022

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EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, "PT Michelle: Survivor Success Story," with Michelle Sawtelle, we talked about: Deb and Michelle chat about Michelle’s experience around having a stroke. She shares details around the evolution of the stroke, her recovery journey and returning to family and work life. Other topics that came up include:

  • Inflammation, nutrition and overall health
  • Wahl’s Protocol – one example of decreasing inflammation through food
  • Who you are after stroke
  • The gluteus maximus

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

 

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!   Guest Request Form

MUSIC: “Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

 

 

Another Noggin in the mix - Welcome Doro!

Another Noggin in the mix - Welcome Doro!

August 23, 2022

The title says it all! Noggins And Neurons has a plan and it feels so good...Thanks for sticking with us 😊

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

If you enjoy listening, please share with others who you think would benefit. Also, consider donating to NOGGINS & NEURONS. You can do this is 2 ways:

  1. Donate to Noggins And Neurons and get an Allstar Pete Trading Card
  2. 2. Using your PayPal app

RESOURCES:

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!   Guest Request Form

MUSIC: “Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

Strategies for Successful Medication Management: Part 2

Strategies for Successful Medication Management: Part 2

July 15, 2022

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EPISODE TITLE:  Strategies for Successful Medication Management: Part 2

OVERVIEW: Occupational Therapy provides the distinct value of being able to look at clients holistically to best collaborate with individuals on THEIR goals and needs, rather than viewing them solely as their diagnosis.

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified Medication Management: Part II, with Tracy Bentley-Root, Anna Kotansky, and Haleigh Bjorkman, we talked about:

  • Utilizing the evaluation process to address physical, cognitive and visual (and so much more!) components of medication management from the START of client care.
  • Analyzing the environment and context to determine possible barriers to medication management.
  • Empowering and motivating individuals can reduce caregiver fatigue and increase an individual’s participation in medication management.
  • Modifications for medication management, such as low- and high-tech assistive device examples
  • How to tailor specific low- and high-tech assistive devices to best meet client needs (variations for each example)

SUMMATION STATEMENT: It is imperative to look at what an individual used to do, and now WANTS to be able to do, before suggesting modifications to their medication management routine. Taking a strength-based approach and providing suggestions that best fit an individual’s needs is key to ensure consistent medication adherence. There are various low-cost devices that can assist an individual in the areas they need it most, whether it be cognitive, physical, visual, or other deficits.

As always, we want to hear your top takeaways!

Please email us at:  NogginsAndNeurons@gmail.com.

If you enjoy listening, please share with others who you think would benefit. Also, consider donating to NOGGINS & NEURONS. You can do this is 2 ways:

  1. Donate to Noggins And Neurons and get an Allstar Pete Trading Card
  2. Using your PayPal app

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LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

Check out the free app, Mango Health at: https://www.mangohealth.com/

For a list of some examples of low- and high-tech assistive devices, check out: https://mainecite.org/wp-content/uploads/2017/01/MedicationManagPicts.pdf

PurrFect Opener: https://www.elderstore.com/purrfect-opener-the-easy-open-pill-extractor.aspx

For some examples of different pill boxes, check out: https://www.epill.com/organizer.html

Articles discussed during the podcast:

Siebert, C., Schwartz, J., & Kannenberg, K. (2017). Occupational therapy’s role in medication management. American Journal of Occupational Therapy71, 1–20. https://doi-org.dyc.idm.oclc.org/10.5014/ajot.2017.716S02

Appalasamy, J. R., Joseph, J. P., Ramaiah, S. S., Quek, K. F., Zain, A. Z. M., & Tha, K. K. (2020). Exploring stroke survivors’ self-efficacy in understanding and taking medication and determining associated factors: a cross-sectional study in a neurology clinic in Malaysia. Patient Preference and Adherence, 1463c. https://doi-org.dyc.idm.oclc.org/10.2147/PPA.S215271

Polenick, C. A., Stanz, S. D., Leggett, A. N., Maust, D. T., Hodgson, N. A., & Kales, H. C. (2020). Stressors and resources related to medication management: Associations with spousal caregivers’ role overload. Gerontologist60(1), 165–173. https://doi-org.dyc.idm.oclc.org/10.1093/geront/gny130

Appalasamy, J. R., Tha, K. K., Quek, K. F., Ramaiah, S. S., Joseph, J. P., & Md Zain, A. Z. (2018). The effectiveness of culturally tailored video narratives on medication understanding and use self-efficacy among stroke patients: a randomized controlled trial study protocol. Medicine97(22), e10876. https://doi-org.dyc.idm.oclc.org/10.1097/MD.0000000000010876

Kollerup, M. G., Curtis, T., & Schantz Laursen, B. (2018). Visiting nurses’ posthospital medication management in home health care: An ethnographic study. Scandinavian Journal of Caring Sciences32(1), 222–232. https://doi-org.dyc.idm.oclc.org/10.1111/scs.12451

Connect with Anna: https://www.linkedin.com/in/anna-kotansky-7005b11a6/

Connect with Haleigh: https://www.linkedin.com/in/haleighbjorkman/

RESOURCES:

Deb's OT Resources:

Pete's Resources:

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!   Guest Request Form

MUSIC:

“Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

Strategies for Successful Medication Management: Part 1

Strategies for Successful Medication Management: Part 1

June 21, 2022

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EPISODE TITLE: Medication Management Part 1

OVERVIEW:

Haleigh: “I think it is important too, to see what patients actually value doing within medication management and then starting from there.” This episode is a conversation between two OTRs and two soon-to-be new grad OTs. The topic of conversation is about medication management and how to adapt this occupation for patients.

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Medication Management Part 1 with Tracy Bentley Root, Haleigh Bjorkman, and Anna Kotansky, we talked about:

  • What is Medication Management?
  • What are common burdens related to medication management?
  • How are caregivers affected by the burdens of medication management?
  • What is Occupational Therapy’s role in medication management?

Summation statement:

The job of medication management can be extremely stressful for both the patient and the caregivers. Health professionals, such as nurses and occupational therapists, have an important role in the health care system to assist caregivers with the many responsibilities within medication management. In this episode, we acknowledge the challenges of medication management and discuss how occupational therapy practitioners have such an important role in reducing the stress for patients and caregivers. Tune into the second part of this podcast with Tracy, Haleigh, and Anna to learn more about techniques and assistive technology devices that can assist with medication management.

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

https://www.heart.org/en/

Articles discussed during the podcast:

Siebert, C., Schwartz, J., & Kannenberg, K. (2017). Occupational therapy’s role in medication management. American Journal of Occupational Therapy71, 1–20. https://doi-org.dyc.idm.oclc.org/10.5014/ajot.2017.716S02

Appalasamy, J. R., Joseph, J. P., Ramaiah, S. S., Quek, K. F., Zain, A. Z. M., & Tha, K. K. (2020). Exploring stroke survivors’ self-efficacy in understanding and taking medication and determining associated factors: a cross-sectional study in a neurology clinic in Malaysia. Patient Preference and Adherence, 1463c. https://doi-org.dyc.idm.oclc.org/10.2147/PPA.S215271

Polenick, C. A., Stanz, S. D., Leggett, A. N., Maust, D. T., Hodgson, N. A., & Kales, H. C. (2020). Stressors and resources related to medication management: Associations with spousal caregivers’ role overload. Gerontologist60(1), 165–173. https://doi-org.dyc.idm.oclc.org/10.1093/geront/gny130

Appalasamy, J. R., Tha, K. K., Quek, K. F., Ramaiah, S. S., Joseph, J. P., & Md Zain, A. Z. (2018). The effectiveness of culturally tailored video narratives on medication understanding and use self-efficacy among stroke patients: a randomized controlled trial study protocol. Medicine97(22), e10876. https://doi-org.dyc.idm.oclc.org/10.1097/MD.0000000000010876

Kollerup, M. G., Curtis, T., & Schantz Laursen, B. (2018). Visiting nurses’ posthospital medication management in home health care: An ethnographic study. Scandinavian Journal of Caring Sciences32(1), 222–232. https://doi-org.dyc.idm.oclc.org/10.1111/scs.12451

Connect with Anna: https://www.linkedin.com/in/anna-kotansky-7005b11a6/

Connect with Haleigh: https://www.linkedin.com/in/haleighbjorkman/

As always, we want to hear from you! Questions and Comments about the podcast: NogginsAndNeurons@gmail.com

If you enjoy listening, please share with others who you think would benefit. Also, consider donating to NOGGINS & NEURONS. You can do this is 2 ways:

  1. Donate to Noggins And Neurons and get an Allstar Pete Trading Card
  2. Using your PayPal app

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RESOURCES:

Deb's OT Resources:

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!   Guest Request Form

MUSIC:

“Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

Beyond Tired: Post Stroke Fatigue Part 2

Beyond Tired: Post Stroke Fatigue Part 2

June 1, 2022

OVERVIEW

Alyssa: Finding that purpose, that meaning as to why… And I think once together we figure out why it’s almost motivation to better that aspect…

Tracy: So many things have changed now that they’ve had their neurological event.. Meet the new routine as opposed to going back the old way because the old way isn’t working any longer.. Increasing their awareness of what their body needs now could be very beneficial…

Debra: And their [caregivers] lives are different now too… we can’t just keep adding things onto a caregiver but making something more meaningful.. And so when is everyone functioning their best

Sarah: The whole chemical makeup of the brain is changing constantly.. What is actually happening and there are a few different reasons why post stroke fatigue is happening…

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified: Post-Stroke Fatigue, with occupational therapist and educator Tracy Bentley-Root, and occupational therapy students Alyssa Brockmann and Sarah Battaglia, we talked about:

  • Continuation of journaling to determine patterns contributing to fatigue. Bringing a diary to an occupational therapist or a practitioner to identify triggers and develop a treatment plan to compensate or design a body map to enhance functioning. Introduce new routines, as opposed to old routines as after a neurological event, the past remains in the past and a new beginning is present. Discussion on caregiver responsibility and adapting to new roles and routines. Energy conservation and other interventions are discussed throughout the podcast to target survivors, caregivers, practitioners, researchers, and students.

  • Fatigue is subjective and perceivable, and the effort used to produce movement and involuntary behaviors is seemingly more difficult due to the high threshold of neuron excitability. Sarah addresses the why and how related to post-stroke fatigue from a neurological level and elaborates on how the brain is constantly changing before, during and after a stroke takes place. Research surrounding the excitability of neurons has been emerging and states after a stroke the neurons within the brain have to work much harder to fire. This not only is hard work and utilizes a high amount of energy for the body, but the brain also is working double time to process the receiving input to produce movement, thoughts, and unconscious bodily functions.

Summary: The aspect of bringing awareness to how one is feeling and collaboratively developing a treatment plan that includes the survivor and caregiver can be pertinent to recovery. Understanding the why and how from a neurological level may assist in awareness.

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

Factors associated with post-stroke depression and fatigue: lesion location and coping styles

Managing post-stroke fatigue: A qualitative study to explore multifaceted clinical perspectives

Occupational Therapy - Energy Conservation Booklet Patient Information Leaflet

Post-stroke fatigue: a deficit in corticomotor excitability?

Post-stroke fatigue: a review on prevalence, correlates, measurement, and management

Poststroke Fatigue | Stroke

Review article Lack of content overlap and essential dimensions – A review of measures used for post-stroke fatigue

Social Support as a Predictor of Community Participation After Stroke

As always, we want to hear your top takeaways!

Questions and Comments about the podcast: NogginsAndNeurons@gmail.com

DONATE TO NOGGINS & NEURONS:

Donate to Noggins And Neurons and get an Allstar Pete Trading Card

Using your PayPal app:

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RESOURCES:

Deb's OT Resources:

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!   Guest Request Form

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MUSIC:

“Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

Beyond Tired: Post Stroke Fatigue Part 1

Beyond Tired: Post Stroke Fatigue Part 1

May 17, 2022

OVERVIEW:

Tracy: My understanding is that not a lot of people understand post-stroke fatigue. Are we mislabeling it? Are we saying it’s more of a cognitive problem? Are we saying it’s more of a muscle strength problem? I’m just wondering if we’re mislabeling it…especially when we’re talking about it down the road. I’m really hung up on these individuals who are functioning well…so these are the individuals who no longer qualify for home care services, and have really graduated beyond outpatient, but they’re still not able to get back to their role as an employee…back to those desired occupations they want to get to…because of the post-stroke fatigue.

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified: Post-Stroke Fatigue, with occupational therapist and educator Tracy Bentley-Root, and occupational therapy students Alyssa Brockmann and Sarah Battaglia, we talked about:

  • Post-stroke fatigue (PSF) - General symptoms, occupational impacts, timeline, recovery process, and intervention ideas for post-stroke fatigue. Alyssa and Sarah share their experiences with post-stroke fatigue through different lenses. Alyssa explains her fieldwork from an acute care standpoint, whereas Sarah shares her experience with the population through an outpatient or chronic lens. Alyssa discovered that she witnessed post-stroke fatigue on more of a cognitive level in the early stages of stroke recovery. Post-stroke fatigue in the chronic stages after stroke (3-6 months or longer) has a different effect on the individual.
  • PSF is extremely difficult to research. The definition of post-stroke fatigue also varies through the timespan of recovery. It was found that up to 50% of stroke patients report post-stroke fatigue as their worst symptom. Alyssa reports her definition of PSF, statistics of the phenomenon, and prevalence rates of the phenomenon that were found in the literature. Debra notes how common and debilitating PSF can be. There are few evaluation methods specific to stroke, they are broad evaluation methods. PSF is dependent on a number of factors before and after the injury occurs. It affects a variety of areas in your brain and translates into how the patient acts following the incident.
  • Real experiences of patients and their concerns entering the workforce after stroke and what can be done to support fatigue in their roles. Alyssa explores the need for healthcare practitioners to be providing patients and caregivers with hard copies of resources prior to discharge from acute care to be referenced throughout their recovery journey. Tracy and Sarah support Alyssa’s point in saying maybe healthcare practitioners need to use unified language to describe post stroke fatigue to reduce the unknown factors, and related post stroke fatigue in the group of cognitive deficits.
  • Interventions including journaling were found to be effective in literature examining that caregiver and patient journaling can be brought to occupational therapists to determine patterns. Such patterns can be used to design individualized care plans and reduce fatigue based on the performance patterns present. Debra then explores educating fatigue management from sleep, exercise, and nutrition from a group process standpoint to enhance the social support of fatigue. Sarah further supports this idea and describes the central adjustment to stroke by re-establishing a self identity through confidence, occupational management, and seizing control. Energy conservation, routine planning, pacing, alternating physical and mental activities, gradual grading of exercise, meditation and more are touched on to manage fatigue.

Stroke manifests in various ways that are individualized to each patient and caregiver. It is important to note that stroke recovery is an adjustable and continually changing journey where each day will present differently. A decrease in performance does not mean patient regression, rather an occupational performance area strengthened, leaving another area open for improvement. Being aware of one’s symptoms, including fatigue, as well as understanding why fatigue manifests post-stroke is important to then advocate on behalf of yourself to health care practitioners for adequate resources and sports needed to move forward in one’s re-establishment of routine, identity and occupational performance.

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

Factors associated with post-stroke depression and fatigue: lesion location and coping styles

Managing post-stroke fatigue: A qualitative study to explore multifaceted clinical perspectives

Occupational Therapy - Energy Conservation Booklet Patient Information Leaflet

Post-stroke fatigue: a deficit in corticomotor excitability?

Post-stroke fatigue: a review on prevalence, correlates, measurement, and management

Poststroke Fatigue | Stroke

Review article Lack of content overlap and essential dimensions – A review of measures used for post-stroke fatigue

Social Support as a Predictor of Community Participation After Stroke

As always, we want to hear your top takeaways!

Questions and Comments about the podcast: NogginsAndNeurons@gmail.com

Donate to The Noggins And Neurons Podcast using your PayPal app:

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Donate to Noggins And Neurons and get an Allstar Pete Trading Card

PETE’S RESOURCES:

DEB’S OT RESOURCES:

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!

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MUSIC

Music by scottholmesmusic.com

Perspectives on Neuroplasticity: Part 2

Perspectives on Neuroplasticity: Part 2

May 4, 2022

EPISODE TITLE:  Perspectives on Neuroplasticity Part 2

INTRO: This episode is the continued conversation between two OTRs and two soon-to-be new grad OTs. During this episode we will wrap up virtual reality and move into other methods of traditional and non-traditional therapy with a focus on safety and interprofessional communication. The conversation rounds out with caretaker, friends, and family roles and the importance of support in rehabilitation and neuroplasticity. 

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified Perspectives on Neuroplasticity Part 2, with Tracy Bentley Root, Morgan Wellenzohn, and Sarah DiMayo we talked about:

  • Virtual reality and the contraindications associated
  • Mirror therapy and what are appropriate activities
  • Action observation opportunities in the hospital with caretakers
  • Weightbearing as a rehabilitation technique and safety
  • Constraint Induced Movement Therapy
  • Including caregivers/friends/colleagues in the rehabilitation process
  • Equipment used in clinic and safety

As was stated in part 1 of this podcast “practice makes progress” and practice can come in many forms of therapy. They may be traditional such as mirror therapy and constraint induced movement therapy or non-traditional such as action observations with a family member. No matter what, recovery to desired rolls is possible, with careful consideration from healthcare providers and unique ways friends and coworkers can get involved. A great student take-away is to not underestimate the amount of knowledge we bring to our level II fieldwork sites and supervisors. Therapy is a collaborative process that requires and is enhanced by contributions from various perspectives.

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

Park, J., Chang, M., Kim, K., Kim, K. (2015). The effect of mirror therapy on upper-extremity function and activities of daily living in stroke patients. Journal of Physical Therapy Science, 27(6), 1681-1683. https://doi.org/10.1589/jpts.27.1681

Related Noggins And Neurons podcast episodes:

Neuroplastic Beats Spastic

Measuring Spasticity

Subluxation and Shoulder Pain

  • Join the Noggins And Neurons Facebook group

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  • Donate to The Noggins And Neurons Podcast using your PayPal app:

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Donate to Noggins And Neurons and get an Allstar Pete Trading Card

PETE’S RESOURCES:

DEB’S OT RESOURCES:

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!

MUSIC

Music by scottholmesmusic.com

 

Perspectives on Neuroplasticity: Part 1

Perspectives on Neuroplasticity: Part 1

April 22, 2022

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EPISODE TITLE:  Perspectives on Neuroplasticity Part 1

INTRO: This episode is a conversation between two OTRs and two soon-to-be new grad OTs. The topic of conversation is neuroplasticity, but this discussion dives deep into more specific topics on stroke rehabilitation.

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified,  Perspectives on Neuroplasticity Part 1 with Tracy Bentley Root, Morgan Wellenzohn, and Sarah DiMayo, we talked about:

  • What is neuroplasticity?
  • What does the phrase “practice makes progress” mean to each of us?
  • What happens in the brain when changes occur? Building bridges!!
  • Visual feedback and imagery

Neuroplasticity is a never ending phenomenon that has many avenues to explore. In a therapeutic mindset, one of the most important lessons to learn when recovering from a stroke is that practice makes progress! There are so many different ways to treat an injury resulting from a stroke including different therapeutic techniques and evidence-based practice. Tune into the second part of this podcast with Tracy, Sarah, and Morgan to learn about more evidence-based practice and techniques that have been experienced and researched.

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION WE TALKED ABOUT:

Khan, F., Amatya, B., Galea, M.P., Gonzenbach, R., Kesselring, J. (2016). Neurorehabilitation: Applied neuroplasticity. Journal of Neurology. 1-13. Doi: 10.1007/s00415-016-8307-9.

Mobile Arm Supports: Evidence-based benefits and criteria for use

Reference to previous Noggins And Neurons episodes:

Neuroplastic beats spastic

Measuring Spasticity

Subluxation and Shoulder Pain

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Donate to Noggins And Neurons and get an Allstar Pete Trading Card

LINKS TO:

MUSIC

 Music by scottholmesmusic.com

Remembering Pete Part 2: Practice Gems with Doro & Lynette

Remembering Pete Part 2: Practice Gems with Doro & Lynette

April 1, 2022

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In this episode, I chat with Doro & Lynette from the Neuro Hub. Before he left, Pete told me he wanted them to step in where he left off…for sure those are some pretty big shoes to fill. Our conversation is all over the place, like old friends sitting around the table reminiscing about a loved friend and colleague. We discussed neuro gems we learned from Pete and implications for practice, carrying on his legacy and some of our fears. We had moments of laughter and somber pauses as well. We wound the conversation down with wisdom, trial and error and thinking outside the box…all within clinical reasoning, of course. Topics that came up:

  • Lynette as a fan girl & why Pete was such a great teacher
  • How Neuro Hub puts learning into practice
  • Noggins And Neurons, kindred spirits and instant connections
  • Brainstorming around honoring Pete’s legacy and bringing all the cool people together
  • Don’t make the perfect the enemy of the good
  • Pete as the silent observer who listened…he got it! Learning to listen with intent
  • What would Pete say about trying new things…
  • Use it and loose it to reduce spasticity

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

MUSIC “Soft Inspiration“ by Scott Holmes/ Scott Holmes Music

Remembering Pete: PART 1

Remembering Pete: PART 1

March 24, 2022

In this episode of Noggins And Neurons, we remember Pete. Here’s what you’ll hear. It’s a long one…

LINKS TO CHECK OUT

Pete Levine Allstar Trading Card

Intro Episode: Stroke and TBI Recovery Simplified

Trio Rehab & Wellness Solutions

The Healing Power of Telling Your Story by Lissa Rankin, MD

Jennica & Suzanne from Trio Rehab: PART 1

Stronger After Stroke book

Stronger After Stroke blog:

Neuroplastic Beats Spastic

Measuring Spasticity

Learned Non-Use

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

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

Pete’s interview with Bill on Strokecast

Bill from Strokecast remembers Pete

Join the Noggins And Neurons Facebook group

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Healthcare Through a Legal Lens

Healthcare Through a Legal Lens

March 7, 2022

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EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Deb talks with attorneys Kelly Barret Sarama and Rachel Baldassaro from the Center for Elder Law and Justice. This rich conversation covers:

  • Medical legal partnerships and the benefits of having lawyers on healthcare teams
  • Getting help while in the hospital or other care facilities through patient advocate and ombudsman services
  • How the legal system can help in the areas of quantity and quality of care, getting providers paid and more.
  • Navigating Medicare coverage and getting ambulance bills paid.
  • Plateaus and baselines as they relate to person-centered care and service provision
  • The importance of self-advocacy and the role of healthcare providers in this process, including good, solid documentation as part of advocacy
  • Patient bill of rights and what to do if a person thinks their rights are violated while in a healthcare facility.
  • Planning for the future: Unpacking advanced directives, health care proxy and other relevant legal terms and directives.

We hope you find this episode helpful!

LINKS TO OTHER IMPORTANT INFORMATION:

Support Noggins And Neurons with Pete’s Allstar Trading Card

 

National Institute of Health (NIH) Patient Bill of Rights

 

Center for Elder Law and Justice Website

 

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

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with PayPal:

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  • Add the note NEURONS under donation amount)

Pete’s blog and book Stronger After Stroke

Debra's Website:

Music by scottholmesmusic.com

 

Clinical Confidence Through Clinical Competence Part 2

Clinical Confidence Through Clinical Competence Part 2

February 12, 2022

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Deb talks with occupational therapist, Andrea Reed about gaining clinical confidence through clinical competence. We discuss:

  • Mentorship, learning environments and trying new things
  • Overcoming negative cultures, self-confidence, doing your best and resiliency
  • Reflective practice and the importance of inquisitiveness for optimal learning
  • The pause…Andrea’s strategy for coping when receiving mixed signals, self-regulating and showing up with confidence
  • Accountability, self-compassion and grace throughout the learning curve
  • Taking our practice to the next level: using small groups for study, learning, and mastery (simple, accountability through own note taking)
  • How small groups can be helpful when starting new practice ideas…To decrease feelings of fear and intimidation, getting encouragement while seeking feedback and moving forward
  • Andrea’s adaptive equipment prototype – rehab, compensation and feeding independence for quality of life
  • Andrea’s commitment to learning this year

LINKS TO OTHER IMPORTANT INFORMATION:

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

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with PayPal:

 

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Pete’s blog and book “Stronger After Stroke”

Debra's Website:

Music by scottholmesmusic.com

Clinical Confidence Through Clinical Competence Part 1

Clinical Confidence Through Clinical Competence Part 1

February 6, 2022

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Deb talks with occupational therapist, Andrea Reed about gaining clinical confidence through clinical competence. We discuss:

  • Learning by hosting a clinical student – what the experience is like from a clinician’s and FW Coordinator’s viewpoint - finding a good fit for site and student
  • Role of the environment and workplace culture in facilitating or hindering growth
  • How the Covid -19 pandemic changed clinical learning opportunities and experiences
  • Selecting appropriate interventions with confidence
  • The effects of time “management” on recovery, clinical performance, and outcomes
  • Moving away from “shiny object syndrome” to focus on one thing and learning it well for clinical competence and client carryover
  • Plateau thinking, breaking out of a rigid mindset, and bringing “home programs” to rehab for wise use of the other hours in rehab to set clients up for success.
  • The service gap that occurs when people leave rehab
  • Healing is a journey and recovery time varies for each person
  • Moving towards a collaborative practice model and benefits of simplicity in practice
  • Clinician inspiration, learning curves and bringing meaning into our practices

LINKS TO OTHER IMPORTANT INFORMATION:

Pre-Print All Star “Pete” Trading Card

New York State Continuing Education Presentation

JOURNAL ARTICLES:

Evidence-Based Practice Profiles of Physiotherapists Transitioning into the Workforce: A study of two cohorts

Transitioning From Occupational Therapy Student To Practicing Occupational Therapist: First Year of Employment (Abstract only)

Enhancing Occupational Therapists’ Confidence and Professional Development Through a Community of Practice Scholars (Abstract only)

APPLY TO BE A PODCAST GUEST

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

Questions and Comments about the podcast?

Donate to The Noggins And Neurons Podcast with PayPal:

  • Use the PayPal app (add the note NEURONS under donation amount)

Pete’s blog and book Stronger After Stroke

Debra's Website:

Music by scottholmesmusic.com

 

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:

  • Use your PayPal app - add the note NEURONS under donation amount

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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

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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 your PayPal app 

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RESOURCES:

Deb's OT Resources:

REQUEST TO BE A GUEST ON NOGGINS & NEURONS. If you’re passionate about stroke recovery and have information or a story you believe will help others, we’d love help you share it on the show. Complete the guest request form below and let’s see if we’re a good fit!   Guest Request Form

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MUSIC:

“Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

 

Update: Noggins & Neurons Happenings

Update: Noggins & Neurons Happenings

December 11, 2021

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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)  

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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

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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 PayPal:

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

  • 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

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

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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 your PayPal app

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

 

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MUSIC:

“Soft Inspiration” by Scott Holmes/Scott Holmes Music/scottholmesmusic.com

 

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