Stroke and Brain Injury
Episodes
Friday Oct 29, 2021
Friday Oct 29, 2021
Jennica & Suzanne from Trio Rehab: PART II
Noggins & Neurons Facebook Group: CLICK HERE or scan below!
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)
Pete’s blog, book, Stronger After Stroke, and talks.
- Music by scottholmesmusic.com
Monday Oct 25, 2021
Monday Oct 25, 2021
Jennica & Suzanne from Trio Rehab: PART I
Noggins And Neurons Facebook Group: CLICK HERE or scan below!
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 your PayPal app:
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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 by scottholmesmusic.com
Friday Oct 22, 2021
Friday Oct 22, 2021
Jus' a lil' bit o' Everything
Noggins And Neurons Facebook Group: CLICK HERE or scan below!
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
- Noggins And Neurons Facebook Group :)
- Nurses Raw And Uncensored
- Traumatic or acquired brain injury support group
- Traumatic brain injury healthy alternatives
- Trauma informed occupational therapist
- Young stroke survivors global network
- Young Stroke Survivors
- NeuroOT
- NeuroCollaborative Professionals
- Neuro-Specialized Physical Therapy
- Geriatric OT, PT, and SLP
- Physical Therapist Assistant Professionals
- The Stroke Channel TV
Questions and Comments about the podcast?
Donate to The Noggins And Neurons Podcast with your PayPal app:
Pete’s blog, book, Stronger After Stroke, and talks.
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Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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 by scottholmesmusic.com
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Wednesday Oct 20, 2021
Wednesday Oct 20, 2021
Emotions After Brain Injury: The Recap
Noggins And Neurons Facebook Group: CLICK HERE or scan below!
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 your PayPal app
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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
- Music by scottholmesmusic.com
Tuesday Oct 12, 2021
Tuesday Oct 12, 2021
Emotion Perception After TBI/Stroke w/ Drs. Zupan & Neumann PART 2
Noggins And Neurons Facebook Group: CLICK HERE or scan below!
OVERVIEW
- 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 your PayPal app
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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
Sunday Oct 10, 2021
Sunday Oct 10, 2021
Emotion Perception After TBI/Stroke w/ Drs. Zupan & Neumann
Noggins And Neurons Facebook Group: CLICK HERE or scan below!
- 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.
- 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 your PayPal app
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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
Monday Oct 04, 2021
Monday Oct 04, 2021
Brain Injury Vision Recovery Recap
Noggins And Neurons Facebook Group: CLICK HERE or scan below!
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
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 your PayPal app
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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
Monday Sep 27, 2021
Monday Sep 27, 2021
Mary Warren: Vision and Brain Injury. Part II
Noggins And Neurons Facebook Group: CLICK HERE or scan below!
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.
- 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
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 your PayPal app
- Eye-Search Therapy Online vision correction game
- Durham Reading & Exploration Training (DREX) Durham Reading & Exploration Training (DREX)
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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
Sunday Sep 26, 2021
Sunday Sep 26, 2021
Mary Warren: Vision and Brain Injury. Part I
Noggins And Neurons Facebook Group: CLICK HERE or scan below!
- 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
Questions and Comments about the podcast?
Donate to The Noggins And Neurons Podcast with your PayPal app
- Eye-Search Therapy Online vision correction game
- Josephine Moore, PhD, OTR, FAOTA, a mentor of Mary Warren’s, a pioneer in OT’s involvement in low vision rehabilitation.
- Durham Reading & Exploration Training (DREX) Durham Reading & Exploration Training (DREX)
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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
Wednesday Sep 22, 2021
Wednesday Sep 22, 2021
Listener Q's & Decoding Teasell
Noggins And Neurons Facebook Group: CLICK HERE or scan below!
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!
- Surface EMG
- Nine-Hole Peg Test
- Brunnström Fugl-Meyer Assessment of Motor Recovery after Stroke
- Action research ArmTest
- Minnesota Rate of Manipulation Test / Manual Dexterity Test
- Minnesota Rate of Manipulation Test YouTube video
- Jebsen Hand Function Test
- Box and Blocks Test
- Wolf Motor Function Test (WMFT)
- Arm Motor Ability Test
- Mental practice recordings at Saebomind
Questions and Comments about the podcast?
Donate to The Noggins And Neurons Podcast with your PayPal app:
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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
Sunday Sep 19, 2021
Sunday Sep 19, 2021
Pete & Deb Review Teasell's Insights
Noggins And Neurons Facebook Group: CLICK HERE or scan below!
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 your PayPal app:
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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
Saturday Sep 18, 2021
Saturday Sep 18, 2021
Stroke and TBI Recovery with Dr. Robert Teasell MD: Part II
Noggins And Neurons Facebook Group: CLICK HERE or scan below!
- 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
- 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:
- 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
- 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:
- direct evidence and can
- 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....
- Modified Constraint Induced Movement Therapy. Developed by yours truly, Pete Levine, and his colleague Dr. Steven Page
- Functional e-stim
- Theta burst stimulation
- Motor imagery
- 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 your PayPal app:
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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
Tuesday Sep 14, 2021
Tuesday Sep 14, 2021
Stroke and TBI Recovery with Dr. Robert Teasell MD: Part I
Noggins And Neurons Facebook Group: CLICK HERE or scan below!
PETE: When I first got involved in clinical research, I remember there was this statistic that the lag time between bench and bedside and rehabilitation was 15-20 years and the idea was you know that in oncology you couldn’t have that much lag time because people die of cancer whereas typically nobody dies of bad therapy. Do you think that the translation is still that long? What would you estimate is the, or is it impossible to estimate, it depends on the therapist kind of deal?
TEASELL: It depends on the treatment and it depends on the kind of support that the treatments got. A lot of it’s cultural as well but I would say that 15-20 years...you know from moving into the research into regular clinical practice would be considered to be a very early adoption. That would be considered to be rapid. It’s more than 15-20 years. In some cases, I think it’s a couple generations. You know, when we sit down with our therapists and ask them, you know, ‘do you use the adjunct therapies?’ the answer is usually not a lot and why? Well there’s a number of reasons-timing, but it’s just like it’s not part of the culture. Like it’s just not part of the culture. You know...And you ask them, ‘would you like to do it?’ ‘Of course, we would, I mean, why wouldn’t we? Right. I wouldn’t mind trying something new or trying this new technology or this new treatment but I don’t know where to start; it’s not what we’ve traditionally done; it’s not what we tend to do; I’m busy enough as it is’ and so these treatments don’t get incorporated or added. So, you know, the reasons are legit, they’re fine, but I mean, if we’re looking at ways that we might be able to further improve recovery and the next big step...cuz you know, one of the things that you get a feeling in stroke rehab is people just not sure where we’re gonna go next. It strikes me that this is a lost opportunity that we could take advantage of.
EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified is Part 1 of a captivating interview with Dr. Robert Teasell and Marcus Saikaley of the Evidence-Based Review of Stroke Rehabilitation (EBRSR). Join us as we learn about:
- The history of EBRSR, including Teasell’s original work:
- To demonstrate that chronic pain can be debilitating, the evidence supporting facts around chronic pain, patient advocacy and policy change.
- With the Ontario government to create and implement best practice guidelines for stroke recovery, therapists inability to agree on recommendations and Dr. Teasell’s idea to duplicate his work in chronic pain research.
- With the Ontario government funded project of stroke evidence as the birth of the EBRSR.
- The growth of research and importance of using the research in practice.
- Evolution of additional research reviews for Traumatic Brain Injury and Spinal Cord Injury.
- Stroke rehab has more evidence than any other area of neuro rehabilitation.
- Behind the scenes look at how systematic reviews are completed, including PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines.
- Knowledge Translation and clinical practice change.
- Reasons why research tends to focus on the Upper Extremity
- Changes in stroke rehab over the years, Canadian and American processes and standardization of care and outcomes. Best practice includes:
- The right amount of intensity
- Task-Specific interventions
- Early intervention
- Adjunct therapies, brain primers and missed opportunities. Examples include mirror therapy, Repetitive Transcranial Magnetic Stimulation (rTMS), Robotics, Action Observation and Functional Electrical Stimulation (e-stim). NOTE: Despite the fact that adjunct therapies account for 85% of the research they are rarely used.
- Home programs, early supported discharge and best “patient handoff” to promote continued recovery and optimal results.
We hope you find value in part 1 of our conversation to the extent you feel empowered to look at your current practice and discover possibilities to improve client and clinic outcomes.
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 your PayPal app
Pete’s blog, book, Stronger After Stroke, and talks.
-
-
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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 by scottholmesmusic.com
Friday Sep 10, 2021
Friday Sep 10, 2021
More Listener Q's & More StrokEngine
Noggins And Neurons Facebook Group:
PETE: And having other kinds of problems like diabetes flares up or whatever it is...and so they cycle back through to the therapist and what the therapist sees is not the people getting better because they’re gone. They’re Kathy Spencer...they’re people that are living their life and going to work and doing stuff that’s important to them. The therapists keep seeing the sick people, who are often sick because they don’t exercise, and the therapists don’t interface with the successful survivors. And that’s the other thing, like, some of the people that I’ve met through some of the survivor Facebook groups, they’ve come to my talks. And you know, I’ve got to meet them, and they’re still working and they’re pressing and they’re exercising and those people I think it would be good if you knew who those people were. And that you kept in touch with them. We trashed Facebook in the last episode so now let’s say something nice. There’s some groups on Facebook that you can get engaged in that are really good to help you know the full rainbow of the kinds of survivors that exist.
DEB: Yeah...
EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb got into more N & N FB group member questions and another Stroke Engine intervention. We discussed:
- Goal setting strategies to instill motivation for recovery:
- Benefits of involving athletic trainers for stroke recovery success
- Hard (honest) conversations about interventions that work and what’s required
- Habits, routines and home programs during inpatient rehab
- Thinking about the dreaded plateau before it happens
- Patient and practitioner viewpoints about pushing harder on the recovery journey
- Improving service delivery with tele rehab, consultations, part B and the “low-level athlete” mindset
- Survivor Facebook groups are opportunities to interact with successful survivors
- Moving away from practice are territorialism and into professional collaboration to optimize survivor recovery
- Using therapy opportunities wisely to educate and empower clients to be involved in their recovery journey
- Tiny changes lead to big improvements
- The dance of cognitive rehab: no pencil & paper tasks! Only the “doing” works
- Understanding the fatigue factor and the just right challenge
- Stroke Engine A-Z:
- Aerobic exercise following stroke to improve cardiovascular health, quality of life, leg and body function, spasticity, cognition, dexterity and more!
- Task specificity, brain re-wiring, task focus (bring in meaning), repetition and follow through
- Mental imagery, wandering thoughts and guided mental practice to reduce boredom
- Use brain primers first: mental imagery & mirror therapy prepare for task specific training
- High and low intensity related to task specific training and efficacy for the upper and lower extremities
As always, we want to hear your top takeaways!
LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:
- The Power of Habit by Charles Duhigg
- Atomic Habits by James Clear
- Stroke Engine Executive Function
- AOTA 2021 CPT CODES
- AOTA 2020 COGNITION CPT CODES
Questions and Comments about the podcast?
Donate to The Noggins And Neurons Podcast with your PayPal app:
Pete’s blog, book, Stronger After Stroke, and talks.
-
- Blog
- Book: Stronger After Stroke, 3rd edition
- Talks:
- Sept. 28, 11:10 AM. Recovery from Brain Injury: The Nexus of Neuroscience and Neurorehab. American College of Rehabilitation Medicine. *Virtual
- October 28, 8:00 PM (ET) The Neuroplastic Model of Spasticity Reduction *Virtual.
- April 24 – Recovery from Brain Injury: The Nexus of Neuroscience and Neurorehab, Ohio Physical Therapy Assn. *Virtual
- Sept. 28, 11:10 AM. Recovery from Brain Injury: The Nexus of Neuroscience and Neurorehab. American College of Rehabilitation Medicine. *Virtual
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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 by scottholmesmusic.com
Monday Sep 06, 2021
Monday Sep 06, 2021
EPISODE TITLE: Deb's Trip & Listener Questions
Noggins And Neurons Facebook Group:
DEB: I think too, that if we do a case study and we talk about it and we kinda say what our process is and the way that we think about things and link it to the research, maybe it will help clinicians to know that they’re probably thinking about things the right way. I think sometimes there’s just insecurities around trying something new. Or, even doing what you think you should do. Especially if you don’t have a mentor available to you...which I always recommend anybody have a mentor of some type or even work in a clinic where there are seasoned therapists there or at least people who have some more experience than you do because it’s hard. Especially when you’re a new grad. It’s hard to put all those pieces together in a meaningful way. And then...yeah!
EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb talked about Florida travels and listener questions. We talked about:
- Deb’s Florida travels-rural towns and ALF visiting leniency, catching up with cousins, dolphins and beauty.
- Florida driving challenges were worth it to see Doro, Lynette and the Neuro Hub in person.
- While at the Neuro Hub, Deb got to see the RecoveriX in action and experience the Neofect Smart Glove.
- Upcoming podcast guests, including Dr. Teasell and Marcus Saikaly from the EBRSR, Mary Warren, PhD, OTR/L, vision, tennis and learned non-use; Jennica Colvin and Suzanne McCrum from Trio Rehab in Texas, and Drs. Dawn Neumann and Barbra Zupan who will talk about their work in recovery of emotional behavior in folks with brain injury.
- Diaschisis, neural pruning, what happens in the brain when a person no longer does an activity and brain area interdependence.
- Pete’s next book and publishing decisions, his mom and New Jersey weather
- The Noggins And Neurons Facebook group is growing
- A listener question about the difference between ischemic and hemorrhagic strokes, survivor stories and recovery stats.
We hope you enjoy this fun conversation as much as we did!
LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:
Improvement of functional was greater in hemorrhagic than ischemic stroke
Cognitive Rehabilitation Training Course (ACRM)
Questions and Comments about the podcast?
Donate to The Noggins And Neurons Podcast with your PayPal app
Pete’s blog, book, Stronger After Stroke, and talks.
-
- Blog
- Book: Stronger After Stroke, 3rd edition
- Talks:
- Sept. 28, 11:10 AM. Recovery from Brain Injury: The Nexus of Neuroscience and Neurorehab. American College of Rehabilitation Medicine. *Virtual
- October 28, 8:00 PM (ET) The Neuroplastic Model of Spasticity Reduction *Virtual.
- April 24 – Recovery from Brain Injury: The Nexus of Neuroscience and Neurorehab, Ohio Physical Therapy Assn. *Virtual
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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 by scottholmesmusic.com
Wednesday Aug 25, 2021
Wednesday Aug 25, 2021
Brain 'Splain Pete Style
Noggins And Neurons Facebook Group
EPISODE TITLE: Brain ‘Splain Pete Style
DEB: What?
PETE: So, I’ve got a funny story for you...So, my college had a career development day. And they wanted people to do an hour, hour and a half on whatever they wanted to do and people were doing it on how to run a good zoom meeting and how to grab a great power point and a lot of other interesting things and of course I pitched my crazy, ‘how does the brain really learn? and ‘how can we engage students if we look at it from a neuroscience perspective?’ And they said ok, we’ll give you an hour and a half to do that, so I show up at the college today and I go to the room that I’m supposed....it’s in this big convention center....and I go to the room I supposed to be in and, ah, the door’s locked. So I called the lady that runs the whole thing and she says, “well, um” I said ‘when will the door be unlocked?’ And she said, “well, um, at 9:00 they’ll be coming in,” this is by the way at 1:00 in the afternoon or 12:00 in the afternoon. “At 9:00 they’ll be coming in and they’ll set up everything so you have it ready” And I’m getting this weird vibe from her and I realize I’m there a day early.
DEB: Awesome!
PETE: And then I said to her, ‘I got a funny story, I’m out in front of the door waiting for somebody to unlock it like an idiot. So, ah, that was fun. But here’s the favor I have to ask you...So what I would like to do is, I know we had an agenda tonight but I would like to do my entire talk for tomorrow for an audience of one and that way I get to practice it.
DEB: That’s a great idea!
PETE: You like that idea?
DEB: I do...
EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete presents valuable information on “The Brain and How it Learns Simplified: Driving Cortical Plasticity.” We talked about:
- Deb’s upcoming road trip and her fast car.
- The number of CEU talks Pete has done from 2010 to 2020 (700 of them) and this teacher presentation being the first live presentation since March of 2020.
- Review of Pete’s work in research-do you love hearing this stuff as much as I do?
- Learning defined, the circulatory system defined, the difference between the two and
- Motor learning, college and motor cognition. It’s the original template for all learning.
- Brain Derived Neurotrophic Factor, exercise, sleep and protein synthesis are essential for learning.
- The homunculus man, the motor cortex and why hands-on learning is key for learning.
- Using eating, mating and patterns to keep an audience engaged.
- The Davinci man, arm span and murmurations of starlings to understand how the brain works
- Repetition, challenge and meaning are necessary for learning. Celebrate small wins to stay motivated and feel life satisfaction.
- Hemispherectomy and the ability to be independent-no excuses, action observation, tossing balls in class, repetitive practice and measuring change.
Pete practices his presentation and Deb enjoyed being the audience. We hope you find the information valuable too.
As always, we want to hear your top takeaways!
LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:
Spark: The Revolutionary New Science of Exercise and the Brain by John Ratey, MD with Eric Hagerman
Questions and Comments about the podcast?
Donate to The Noggins And Neurons Podcast with your PayPal app
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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 by scottholmesmusic.com
Thursday Aug 19, 2021
Thursday Aug 19, 2021
StrokEngine: A-Z Treatment Options
Noggins And Neurons Facebook Group
DEB: Acupuncture has to do with stimulating certain trigger points along the body’s meridian lines to help regulate the flow of energy or chi. They looked at this in the different phases of stroke and they found that it’s not more helpful in general. So they looked at in terms of balance, cognitive function, depression, dexterity, independence a lot of other things, that it’s not really effective for. But you know what it’s effective for? Swallowing problems. It’s effective for dysphagia.
PETE: What? Get out!
DEB: I’m not kidding you....
EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb talk start a conversation on stroke treatments listed on the Stroke Engine website. We started the episode with a listener question about the number of repetitions needed for the brain to change and motor recovery to occur. Pete shared more research and we talked about what it means for real life recovery. We also discussed:
- Growth mindset, learning and recovery
- Hints about our upcoming conversation with Robert Teasell and Marcus Saikaley of the Evidence Based Review of Stroke Rehabilitation (EBRSR)
- Virtual Reality for the upper extremity, the View Master and the Ramachandran Rule
- Acupuncture and dysphagia, cognitive function and insomnia
- Virtual Reality for the lower extremity, measuring real-time data, gait rhythmicity, the Nu Step and the Kinetron
Pete and Deb took a deep dive into these topics, looking at pros and cons of each along with next steps for clients and clinicians, including measuring change.
As always, we want to hear your top takeaways!
LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:
How many repetitions does it take to drive brain changes and movement changes in folks with brain injury/ stroke?
This study showed that there were similar outcomes under three dosages of repetitive practice...
There were four groups:
- Group A (the control) received 3 hours of traditional therapy consisting of passive movement, therapeutic positioning, and weight bearing on the affected limb. Throughout study the score increased ~3 points for the Fugl-Meyer.
- Group B: Modified constraint induced therapy consisting of 3 hours of shaping practice per day, and a constraint on 90% of all waking hours. Throughout study the score increased ~17 points for the Fugl-Meyer.
- Group C: 300: repetitions per day, 5 days per week, increases across all outcomes (FM, MAL, WMFT, etc.) started at 2 weeks and the trajectory continued throughout the study. Throughout study the score increased ~17 points for the Fugl-Meyer.
- Group D: Same as Group C, but double the number of repetitions. Throughout study the score increased ~19 points for the Fugl-Meyer.
The Brain Boosting Power of the Mighty N -Back
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How the N-Back Game improves fluid intelligence with training on working memory
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Video: Virtual Reality Gait Training | Brooks Rehabilitation
Questions and Comments about the podcast?
Donate to The Noggins And Neurons Podcast with your PayPal App
Pete’s blog, book, Stronger After Stroke, and talks.
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Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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 by scottholmesmusic.com
Friday Aug 13, 2021
Friday Aug 13, 2021
What Makes a Great Therapist?
Noggins And Neurons Facebook Group
“I want to do what I did with the smaller group earlier this week and read you my favorite letter. Because, I think the thing that pushes me and everything...My why...My purpose...are embedded in the idea of service in care to others. Meaning all of those to self, to family, to community, the society. And, if you’re not clearly in touch with just how unbelievable it feels to care for others, my favorite letter of several hundred thousand will hint.”
EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb talk about qualities that make someone a good clinician. Here’s what we came up with:
- Understanding qualities of excellence can aid in selecting the right therapist
- Striving for excellence is a lifelong quest
- Proper training may lay a foundation for clinicians developing necessary skills for clinical success
- Asking significant questions is as important as knowing what to do with the answers
- Be a good listener to provide excellent patient care
- Advocacy and listening often go hand in hand
- Lifelong learning includes topics beyond diagnoses and deficits
- “The Diving Bell and the Butterfly” book or movie can help with understanding brain injury
- Develop observational skills and don’t be afraid to speak up about what you learn so you can help your patients
- Traumatic brain injury survivors can re-learn empathy
Pete and Deb talk about these topics and more. We share stories and thoughts from personal experiences and hope this helps you in your clinical practice or recovery.
- Empathic Responses to Affective Film Clips Following Brain Injury and the Association with Emotion Recognition Accuracy
- Test Your Emotional Intelligence: How well do you read other people?
- People with traumatic brain injury, who often lose empathy, can regain it with treatment
- The 7 basic emotions - Do you recognize all facial expressions?
Questions and Comments about the podcast?
Donate to The Noggins And Neurons Podcast with your PayPal app
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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 by scottholmesmusic.com
Sunday Aug 08, 2021
Sunday Aug 08, 2021
Sleep: Vital for Everyone, Essential for Survivors
Noggins And Neurons Facebook Group
DEB: Did you know that rest and sleep are considered occupations? The Occupational Therapy Practice Framework is a document that we use in occupational therapy to guide the process of what we do in OT and it also explains what occupations are and what they mean. And sleep preparation is a thing in the OTPF and it talks about routines. Bedtime routines to prepare yourself, to prepare the body, to prepare the mind that it’s time to wind it down and get ready to fall asleep. They talk about how routines that prepare the self for comfortable rest are important and then they have some examples; grooming, get your clothes out for the next day, reading and listening to music, saying goodnight to others and engaging in meditation or prayers before bed, determining the time of day and length of time that somebody desires to sleep. And then how much time somebody needs to be awake...so being mindful of that and planning for that. And establishing healthy sleep patterns. When you start with these habits you can build them into a routine and then your body just kind of gets used to looking for that.
EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb talk about all things sleep. In this conversation we cover:
- Sleep disorder statistics in stroke survivors
- The effects of insomnia on behavior and emotions
- How lack of sleep can lead to Alzheimer’s Disease
- Sleep stages and what occurs in the body, including dendrite formation and learning consolidation
- The effects of sedatives and prescription medications on sleep
- Sleep hygiene strategies for people who have difficulty sleeping
Pete and Deb also talk about avoiding caffeine and sugar before bed time to improve sleep quality; the value of routine for sleep preparation and establishing healthy sleep patterns and natural ways to set the internal clock for improved sleep quality.
We hope you enjoy our thoughts and find them mentally stimulating and thought provoking!
As always, we want to hear your top takeaways!
LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:
Neurobiology of Sleep and Circadian Rhythms
Male seahorse "birthing" baby seahorses!
Questions and Comments about the podcast?
Donate to The Noggins And Neurons Podcast with your PayPal app
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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 by scottholmesmusic.com
Thursday Aug 05, 2021
Thursday Aug 05, 2021
Dr. Jones, TexMex, and Synaptic Connections
Noggins And Neurons Facebook Group
PETE: Hey everybody, this is Pete. I just wanted to jump in real quick and tell you about a mistake I made. I forgot to put the bio for our interview with Dr. Theresa Jones ahead of the actual interview. So, I’m gonna put the bio at the beginning of this episode, which kinda works because it is a review of the episode and what we learned, when we did interview Dr. Jones. Thanks!
DEB: New clinicians working in the world of stroke recovery need to understand what is too much too soon. And I think she made some good points about it. That early mobility doesn’t mean early intensity. So, you know, early mobility really is to get the person up so that other systems in the body don’t start to fail them. And...which would impact negatively, negatively impact their recovery. So we keep them healthy while they’re still in that acute stage so that when they enter that more subacute phase they can participate.
EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Pete and Deb have a stimulating conversation about our interview with the Great, Dr. Theresa A. Jones, a behavioral neuroscientist from University of Texas at Austin. Some things we reflect on include:
- How repetition rules in learning. In fact, intensity and learned non-use came up again. It’s nice to hear Dr. Jones’ perspective and how to think and talk about these topics in practice and recovery.
- Getting beyond feelings of intimidation and putting people on different levels based on education and ego for improved communication and care.
- Real time look into the brain through windows in rat skulls.
- Being a woman in a male dominated field, making it work and resilience.
- Humility, communication and translating animal research to humans.
- Sorting through compensation and recovery and Dr. Jones’ research perspectives
- Moving into gray areas, thinking and clinical reasoning. Ask questions from the understanding that even science doesn’t have all the answers. Don’t be afraid to hear that you’re thinking is off track and be open to where it will take you in future thinking.
- Neuroplasticity in action and what it looks like in real time.
- Monkeys in research, COVID, travel and more questions to ask Dr. Jones.
We hope you enjoy our thoughts and find them mentally stimulating and thought provoking!
As always, we want to hear your top takeaways!
LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:1
Repost of articles posted on the Dr. Jones interview:
Theresa A. Jones, PhD Articles:
Dorothy A. Kozlowski, PhD and Theresa A. Jones, PhD Articles:
Use-Dependent Structural Events in Recovery of Function
Use Dependent Exaggeration of Neuronal Injury After Unilateral Sensorimotor Cortex Lesions
Use Dependent Exacerbation of Brain Damage Occurs During an Early Post-Lesion Vulnerable Period
Neural Plasticity and Neural Rehabilitation Following Traumatic Brain Injury
Learned Non-Use Article:
Questions and Comments about the podcast?
Donate to The Noggins And Neurons Podcast with your PayPal app
Pete’s blog, book, Stronger After Stroke, and talks.
Deb's OT Resources:
- Deb's OT resources
- The OT’s Guide to Mirror Therapy
- Tri-Fold Mirror (US address only)
- Occupational Therapy Intervention: Scavenger Hunt Visual Scanning for Adults
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 by scottholmesmusic.com