Subluxation and Shoulder Pain

“And my problem with taping generally is, it’s kind of band-aidy because as soon as you take it off the arm could fall right back out. However, if you could get that to reduce pain and then have them do stuff, which then activates the SITS muscles and the deltoid and it brings that humerus back into where it needs to go, in the meantime because they are doing stuff...they’re driving cortical change, which reduces spasticity, which may indicate more movement and now we get this upward spiral of recovery that could be quite helpful. So taping may be a temporary thing but it might be a good temporary thing.”

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified covers subluxation and pain. In this episode we learn:

• That moving the hand engages the shoulder and the muscles that reduce subluxation

Join Pete and Deb as we talk about subluxation statistics, how to prevent shoulder subluxation and/or soft tissue damage and the importance of safely moving a hemi-paretic shoulder. We discuss several braces that are commonly used to support the shoulder as well as common challenges experienced when donning and doffing them.  We also cover e-stim, NMES, functional e-stim, TENS, stretching, and taping as effective methods for addressing subluxation. We learned that brain controlled interfacing (BCI) with e-stim (which incorporates action observation and motor imagery) results in greater improvements in reducing subluxation and pain, than when functional e-stim is used alone.

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

Comley-White, N., Mudzi, W., & Musenge, E. (2018). Effects of shoulder strapping in patients with stroke: A randomized control trial. South African Journal of Physiotherapy, 1-11. ISSN. (Online) 2410-8219, (Print) 0379-6175.

Hartwig, M., Gelbrich, G., & Griewing, B. (2012). Functional orthosis in shoulder joint subluxation after ischaemic brain stroke to avoid post hemiplegic shoulder-hand syndrome: a randomized clinical trial. Clinical Rehabilitation 26 (9) 807-816. DOI: 10.1177/0269215511432355 cre.sagepub.com

Jang, Y., Kim, T., Lee, B. (2016). Effects of brain–computer interface-controlled functional electrical stimulation training on shoulder subluxation for patients with stroke: A randomized controlled trial. Occupational Therapy International, 23(2), 175–185. https://doi.org/10.1002/oti.1422

Chatterjee, S., Hayner, K., Arumugam, N., Goyal, M., Midha, D., Arora, A. (2016). The California tri-pull taping method in the treatment of shoulder subluxation after stroke: A randomized clinical trial. North American Journal of Medical Sciences (8)4

Kate Hayner's Calif Tri Pull Taping Method video

Where electrodes should be placed for NMES and subluxation

Products to help subluxation and shoulder pain:

OmoTrain

GivMohr Sling 

StimRouter

Research:

A randomized controlled trial on the immediate and long-term effects of arm slings on shoulder subluxation in stroke patients

Effect of arm sling application on gait and balance in patients with post-stroke hemiplegia: a systematic review and meta-analysis

Questions and Comments about the podcast: [email protected]

DONATE TO NOGGINS & NEURONS:

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

Using your PayPal app:

RESOURCES:

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

• Blog

Deb's OT 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

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“I have to say, out of all the therapies that rehab can do, mirror therapy seems like it’s the most robust. The EBRSR and other meta-analyses get behind mirror therapy so much I’m amazed. And this is just because I’ve known you and we started doing this podcast, I’ve been keeping an eye on mirror therapy, thinking ok it’s a good thing...apparently it’s not a good thing, it’s a great thing...Unlike a meta-analysis that is done where you might look at a meta-analysis from 2016...well, it’s been a while since 2016. The EBRSR is updated every year so you’re always getting the latest and greatest in meta-analysis form and here’s some of the stuff they say...’mirror therapy on its own or in combination with other interventions can improve many aspects of upper limb function following stroke.’  Now you might think that that’s a pretty mild statement, but it says can improve and the word can there is bizarre for the EBRSR cuz they never say can. They say, ‘it may, it may not, it doesn’t seem to, it may, maybe, kinda, sort of’ but this is the one they say ‘it can.’ And that stuck out because there’s only like that and nothing else where they are willing to go out on a limb and say ‘it can.’ And it showed strong evidence, Level 1A, the best, the highest evidence to support the use of mirror therapy to improve unilateral spatial neglect in the subacute phase of stroke recovery and improve upper extremity kinematics and motor function...

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified is all about mirror therapy. We talked about:

• The history of mirror therapy and V. S. Ramachandran

• 20% of the monthly investment for “THE OT’S GUIDE TO MIRROR THERAPY” use coupon code: NOGGINS

Join Pete and Deb as we discuss the ways that mirror therapy can be used to help many of the problems faced by stroke and brain injury survivors.

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

• S. Ramachandran TED Talk “3 Clues To Understanding Your Brain”

Questions and Comments about the podcast: [email protected]

DONATE TO NOGGINS & NEURONS:

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

Using your PayPal app:

RESOURCES:

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

• Blog

Deb's OT 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

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CONSTRAINT INDUCED THERAPY II

OVERVIEW: Pete: Yeah, although be forewarned that if you have questions, we may read it on the air and, uh...on the air! Are we on the air? I don’t even know...

Deb: Like WKRP In Cincinnati.

Pete: Hey ‘now for the big sounds of the big town where the daddy-o of the radio in a city so nice they named it twice. New York, New York.’ I was communications....

Deb: You’ve been waiting your whole life for this opportunity!

Pete: I used to practice that...  

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified is part 2 of Constraint Induced Therapy (CIT). Part 2 begins with Pete reiterating important points covered in Episode 1, including:

• Commitment is required for participation in a CIT program

The conversation further evolved into:

• Research on the use of CIT at the acute stage and the VECTORS trial

This engaging conversation goes deeper into Constraint Induced Therapy. Survivors, caregivers and clinicians alike will benefit...

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

• The Brain Science Podcast with Ginger Campbell, MD.

• Episode 119 with Dr. Edward Taub

• Wolf SL, Winstein CJ, Miller JP, Taub E, Uswatte G, Morris D, Giuliani C, Light KE, Nichols-Larsen D; EXCITE Investigators. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. JAMA. 2006 Nov 1;296(17):2095-104. PubMed PMID: 17077374.

• Ince J. Escape and avoidance conditioning of response in the plegic arm of stroke patients; a preliminary study. Psychonom Sci 1969; 16: 49-50.

Questions and Comments about the podcast: [email protected]

DONATE TO NOGGINS & NEURONS:

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

Using your PayPal app:

RESOURCES:

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

• Blog

Deb's OT 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

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Constraint Induced Therapy: Part I

OVERVIEW: Pete: And I asked whoever answered the phone, may I please speak to Dr. Ince. And he goes ‘hello’ and I’m in a panic because I’m like this is the guy! It took me three days to find him! And I’m like, ahh, Dr. Ince my name is Pete Levine and I’m doing a book on ah Constraint Induced Therapy and um Dr. Taub said that you were the first human to ever do it on humans and I’m really excited to talk to you... and he goes ‘I can’t hear you. There doin’ construction outside. Wait, let me close the door.’ Boom! Door slams and he comes back and he tells me this fantastic story. 

Pete quoting Dr. Ince: In 1967, I’m in a Macy’s and I’m standing there next to this guy. I don’t know who he is, and ah, we’re at a table with toys and our wives are gone doing something, I don’t what they were doing. And he was fooling with this toy...’

Pete: I always imagine this toy was the monkey with the two cymbals going like shika tik tik.

Pete quoting Dr. Ince: ‘And he was foolin’ with this toy and we got to talking and I’m a physiatrist and he was doing this stuff and he invited me to his lab in Brooklyn...’

Pete: And this is my best NY accent...I’m so sorry...you know I was born in Manhattan, so I have a little bit of right to do this.

Pete quoting Dr. Ince: ‘And um, and I asked him: What you're doing with these monkeys... Can I do it with humans? And what I found was that it could be done with people. We did the experiment. We were the first to publish about it and with some people it was successful, with some people not so successful, and some people it was a total failure.’

Pete: And that’s still where we are today. Constraint Induced Therapy is not for everyone. I think you would agree.

Deb: Yes. That’s fascinating! What a cool life you have!

Pete: I know! Lawrence Ince... he was so cool with me. Once he saw that I wasn’t calling him to sell him life insurance or something...you know he was willing to talk. So, he was great. It was just great. It sends shivers up my spine still...

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified is all about Constraint Induced Therapy (CIT). CIT is a big topic and we talked for a long time – enough for two full episodes. In this part 1 section we:

• Heard about the history of CIT - that it began with Nobel Prize winner, Sir Charles Sherrington 

This episode begins with a bit of fascinating neuroscience history to include Nobel Prize winner Sir Charles Sherrington. There’s no rabbit hole involved as it ties right into the topic of Constraint-Induced Therapy! Pete takes us along a journey into the research using his artful way of telling a story that keeps everyone captivated.  We transition smoothly from the early days of CIT into Dr. Edward Taub’s work, and then onto detailed information around the modified version of CIT with our very own Peter G. Levine’s work.

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

• The Brain Science Podcast with Ginger Campbell, MD.

• Episode 119 with Dr. Edward Taub

• The EXCITE trial: Large multi-site constraint induced therapy trial

• Wolf SL, Winstein CJ, Miller JP, Taub E, Uswatte G, Morris D, Giuliani C, Light KE, Nichols-Larsen D; EXCITE Investigators. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. JAMA. 2006 Nov 1;296(17):2095-104. PubMed PMID: 17077374.

• Page SJ, Boe S, Levine P. What are the "ingredients" of modified constraint-induced therapy? An evidence-based review, recipe, and recommendations. Restor Neurol Neurosci. 2013 Feb 8.

• A journal article about the first time constraint induced therapy was tried in humans, by Lawrence Ince, MD.

• Ince J. Escape and avoidance conditioning of response in the plegic arm of stroke patients; a preliminary study. Psychonom Sci 1969; 16: 49-50.

Questions and Comments about the podcast: [email protected]

DONATE TO NOGGINS & NEURONS:

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

Using your PayPal app:

RESOURCES:

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

• Blog

• 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

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OVERVIEW: Now the one thing that they do have is finger flexion. And often therapists think you cannot let them flex their fingers because if you do you will strengthen the overwhelmingly strong flexors; and if you do that you will make the spasticity worse – which is NOT true. Spastic muscles are weak so even if you strengthen them it wouldn’t be the end of the world. But you’re not trying to strengthen them; you’re just trying to activate them. How are you gonna re-establish brain control over the finger flexors if you don’t allow them to flex the fingers? But what about a ball – a squishy ball? Who doesn’t like a squishy ball? You squish into the ball, it re-establishes brain control over the flexors thereby reducing spasticity. That’s the whole thing.

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified is all about spasticity. In this deep dive we learn:

• What spasticity is and is not

Pete shares his in-depth knowledge about spasticity in this informative episode of Noggins And Neurons. Deb’s brain kicks into OT gear and attempts to process information Pete shares – some of it as she hears it for the first time. This must listen episode will change the way some of us think about spasticity while also giving everyone ways to think about it that will ultimately benefit the survivor.

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

• Li, S. (2017). Spasticity, motor recovery, and neural plasticity after stroke. Frontiers in Neurology, 3, April 2017. doi: 10.3389/fneur.2017.00120

Evidence for the "neuroplastic model of spasticity reduction"

• "The Neuroplastic Model of Spasticity Reduction" in a nutshell

 CIT decreases spasticity and “pathological” synergies

• CIT reduces spasticity 2017

Questions and Comments about the podcast: [email protected]

DONATE TO NOGGINS & NEURONS:

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

Using your PayPal app:

RESOURCES:

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

• Blog

Deb's OT 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

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Research for Recovery

OVERVIEW: “So here's a little fun fact: In a lot of these articles the contact information for the researchers is made available. And I have been known to reach out to researchers over the course of my career and they do respond to me and oftentimes they're very happy—very happy—to share their information and some of their PowerPoint slides and stuff that will help you in your practice. It goes back to what you were saying in the beginning. Researchers want us using their information.” 

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified gets into research for recovery. We talk about research in terms that everybody can understand. In this episode we talk about:

• What to look for when starting off on a research path

To help offset fears and symptoms of research, Pete and Deb discuss their personal investigative styles that make research fun for them! Neither one experiences migraines or nausea whenever engaging in this exciting aspect of their work and don’t think you should either...Pete goes into history around evidence-based medicine and speaks from his research background while Deb talks from her clinical and teaching experiences. We hope you find great value in both the conversation and the show notes. HINT: There’s more in the notes than we talked about during our time together.

Pete and Deb agree that applying evidence to practice is essential for optimal recovery outcomes following stroke and TBI. We understand that knowing where, how and why can be challenging and cause procrastination, which is the reason for covering this much needed topic. We hope this RESEARCH FOR RECOVERY episode helps steer you in a right direction as you take the next step, whatever the reason for investigating stroke and TBI recovery.

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

• Evidence Pyramid: There are many available online. This link highlights the EBM Pyramid used by University of California Irvine. It includes information about the TRIP database that I learned about through net, a good resource.

• KTDRR Library Descriptor Scales – page with charts referred to in the podcast:

• Strength of Evidence

• ProQuest – Links to citations, full text articles and more

ResearchMatch helps match volunteers researchers and their studies at institutions across the country.

NIH-sponsored clinical trials that are currently accepting participants.

The National Institutes of Health (NIH) Clinical Center Search the Studies site 

Find clinical trials from around the world.

The number of medical articles published  per year 

Find all of the following under "RESEARCHING" in the middle of the web page:

Evidence-based review of stroke rehabilitation

StrokEngine: Tons of info for therapists and survivors

PubMed Central: Free Journal Articles (NIH)

MedlinePlus Simple and Free bottom line reviews

Bookshelf: free online books and docs (NIH)

Cochrane Database of Systematic Reviews

Bio med central free open-access articles

TRIP Database: a smart, fast tool to find high quality clinical research evidence

Hindawi Free Access to Journals

Directory of Open Access Journals (DOAJ)

CONNECT WITH US:

Questions and Comments about the podcast: [email protected]

DONATE TO NOGGINS & NEURONS:

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

Using your PayPal app:

RESOURCES:

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

• Blog

Deb's OT 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

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How Repetition Rules Recovery

OVERVIEW: "What we all want at the end of the day is better quality, fluid, coordinated movement. But sometimes we don't get there. I would suggest to therapists: Don't make the perfect the enemy of the good. We're not trying to make them perfect, we're just trying to get them better. And better is good.

So sometimes the beauty is not in the beauty but in the ugliness of the movement. Let it be ugly. Let it be sweaty. Look— if you don't think that this has value, here's what you need to do: Go to a music store and get yourself a viola, and let me know how that doesn't sound like a dozen doing cats for the next six months. ‘Cause it’s gonna! Take up golf! It's gonna be— it's not supposed to be beautiful. It's supposed to be ugly. You got to enjoy the stuff."

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified explains the importance of repetition for regaining movement. We talk about:

• Repetition and where it fits in the trifecta of brain rules

Pete and Deb discuss the real-world motor and physiological effects of stroke and how thoughts impact behaviors. Pete explains research that details the challenges around determining a specific number of repetitions survivors need to perform to get better. He stresses the importance of incorporating meaning into interventions.

We found great research that looks at survivor and therapist perceptions around intensity that should help everyone feel more comfortable and confident in developing rehab programs with appropriate intensity levels that facilitate functional 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?

• Carey et al., subjects with impaired grasp-and-release 1,200 total reps of a finger-tracking exercise and demonstrated significant cortical reorganization and functional improvement compared with control subjects.

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.

• The number of repetitions typically done in a rehab session I

1. Janssen, J., Klassen, T., Connell, L., & Eng., J. (2020). Factors influencing the delivery of intensive rehabilitation in stroke: Patient perceptions versus rehabilitation therapists perceptions. Physical Therapy 100:307-316.

CONNECT WITH US:

Questions and Comments about the podcast: [email protected]

DONATE TO NOGGINS & NEURONS:

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

Using your PayPal app:

RESOURCES:

Information about Pete’s blog, book, “Stronger After Stroke: Your Roadmap to Recovery” 3rd edition,  and  talk.

• Blog

Deb's OT 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

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OVERVIEW: "Something I try to tell therapists all the time.... when you take all the neuroscience and you look at it all I swear neuroscientists say "Wow we think repetitive practice works—who does a lot of that?" And they look down that long hallway and they see therapists already doing it and having done it since the early 1900s.  And they go "Well it should be challenging. Who vectors in challenge?" And they see a therapist down there and they've been doing it since the early 1900s. And then they go, "It should be repetitive, and challenging... and it should be meaningful. Who does that? OTs do that!" So you guys are in the perfect position to leverage the great neuroscience that we have and... I swear I think neuroscientists are like jealous or maybe they're angry or—I don't know. But every time they turn around they see a therapist having done it for decades and decades and decades.  Here's what I would say... if you want to know in a neuroscience would say about rehab they'd say "We agree with everything you're doing just put it on steroids."  That's it. Don't overthink it."

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified brings the concepts of motor learning to light in ways everyone can understand. Pete and Deb talk about:

• Principles of Motor Learning

We dove pretty deep into the principles of motor learning. Pete and Deb highlighted research around difficulties with implementing these concepts and also how clinicians are already using aspects of this theory.  We discussed the roles of cognition, emotional health, and socialization related to motor learning. There are a lot of components involved and we’re sure everyone already knows this at some level. This podcast episode brings to light the fact that people can’t be reduced to component parts; rather we must incorporate all aspects of a person for optimal motor recovery.

We hope our conversation makes this important topic digestible and more understandable in ways that help you add to your practice, support or recovery.

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

1. The guy (George Bush, PhD.) who discovered where emotions are processed in the brain. 

CONNECT WITH US:

Questions and Comments about the podcast: [email protected]

DONATE TO NOGGINS & NEURONS:

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

Using your PayPal app:

✨iTunes    

• How the brain changes by imagining a movement, or just observing someone else move! 

• Information about Pete’s blog, book Stronger After Stroke,  and  talk.
  

• Blog

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

OVERVIEW: "Carr and Shephard are two Aussie physical therapists. They were the first to dovetail modern motor learning with rehab which was a sea change from the neurofacilitation crowd. Janet Carr, one of them, passed away in 2014. But they wrote this great book, I think it’s called, “Stroke Rehabilitation.” I think that’s what it’s called. I wrote a review on Amazon, you can read it, it’s just glowing because I just, I adore this book...But they make it very, very clear...There’s four situations in which you’re most likely to fall. And this is especially for people with brain injury, but also for anybody. Starting to walk, so right when you start the acceleration of walking; when you stop walking...you know...can you come to a full stop and not lose your balance? Turning – a whole bunch of problems with turning because you know, you have to shift your gaze constantly, you have to shift your feet constantly...and then uneven surfaces. So when you’re out walking and you’re thinking “Wow, I don’t want to be afraid of walking, I want to get out and I want to see things and I want to see people and I want to do my life, think about those four situations - When you start walking, when you stop walking, when you’re turning and then any sort of uneven surfaces – be really hyper-focused on those four situations."

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified is all about not falling...Pete and Deb talk about helping people not to fall. We started and ended with the rabbit hole topic of Deb’s anthropology degree and bipedalism – super fun part of the conversation! Climbing out of the hole, Pete and Deb then talked about:

• The relationship of medications to fall and the Paper Bag Test

This meaningful conversation gets into the literature, preventing falls, the negative impact of fear of falling, assessments and home safety. We share tips and tricks from the PT and OT perspectives. We hope survivors, caregivers and clinicians all find value in this conversation.

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

1. Fall Risk Assessment Tool - Johns Hopkins Medicine  

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CONNECT WITH US:

Questions and Comments about the podcast: [email protected]

DONATE TO NOGGINS & NEURONS:

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

Using your PayPal app:

RESOURCES:

• Information about Pete’s blog, book, “Stronger After Stroke: Your Roadmap to Recovery” 3rd edition,  and  talk.

• Blog

• 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

Super Survivor Kathy Spencer On Successful Recovery

OVERVIEW: Kathy - Well, when I got in the arm study, I was like ten or eleven months out and my I could barely— I couldn't move my wrist, my hand, or my fingers. All I could do is clench but that was it. And I thought, if I just believe that I would have given up and I wouldn't be recovered today. So, I always tell people— and Pete's book is outstanding on the plasticity of the brain— but doctors don't tend to tell us that. I went around talking to certain groups around here a while back and people were crying, they said, "You know I believed the doctor" and they gave up on their therapy.

I said: You are never done unless you quit.

Deb - Something that you said caught my attention...what your OT said to you when you were being discharged. Remind me what she said and I want to know how that made you feel because a lot of what we do in occupational therapy has to do with that rapport that we build with people and I’m just curious to know how that made you feel. It sounds like you knew more about yourself than the therapy team.

Kathy:  I loved, loved, loved my OT. We laughed every day...because I would laugh at myself.

EPISODE SUMMARY: This episode of NOGGINS & NEURONS: Stroke and TBI Recovery Simplified is an ear-gripping conversation with Super Survivor Kathy Spencer. She graciously shares her story of having and recovering from an ischemic stroke. We hope you enjoy listening as much we loved being a part of this time with her. Join in the learning as Kathy:

• Reminds us that recovery never ends

Kathy shares her lived experience from when the stroke occurred, her rehab journey and beyond. Strategies that worked for her include evidence-based interventions such as repetitive practice, mental imagery/visualization and journaling for self motivation. Kathy learned how perseverance plus patience equals peace, and tells inside details about this puzzling equation. Lastly, she reminds us that while repetition might be boring, recovery is not! This is a must listen for anyone who works with stroke survivors, knows a survivor or is a survivor.

As always, we want to hear your top takeaways!

LINKS TO ARTICLES, BOOKS AND OTHER IMPORTANT INFORMATION:

1. Kathy’s blog article: Bouncing Back From Stroke by Katie D. Neal on February 24, 2011

CONNECT WITH US:

Questions and Comments about the podcast: [email protected]

DONATE TO NOGGINS & NEURONS:

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RESOURCES:

• Information about Pete’s blog, book, “Stronger After Stroke: Your Roadmap to Recovery” 3rd edition,  and  talk.

• Blog

• 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

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