A traumatic brain injury causes mild to severe loss in brain function affecting an individual’s physical and occupational function along with emotional and psychosocial behavior. This can lead to restrictions in performing day to day activities, ability to work or participate in education. Individuals with traumatic brain injury receive therapy in acute and sub-acute stages after which they are discharged and return to their homes. They continue to have mild to severe limitation in function to live an independent life. Continued therapy is crucial for functional improvement.
The human brain has an inherent capacity of re-learning skills after damage from an injury or other neurological disorders. The damaged areas of the brain can relearn function from practicing the skill or movement repeatedly. Along with this; the surrounding undamaged areas of the brain also assist in taking over some of the lost function and help in the process of re-learning. This ability of the brain is called neural plasticity. Neural plasticity has been studied extensively and it is now established to be activity dependent i.e. if an individual with deficits in walking or moving his affected arm or any other movement practices these movements that he or she will be able to regain the ability to perform them again. Vice Versa, it is also true that if the individual with a brain injury doesn’t perform tasks of the affected side then the brain will undergo atrophy. It was thought that neural plasticity can take place only in the acute to subacute stages of brain injury. However this has been challenged and now proven that neural plasticity is possible also in the chronic stages.
This ‘Activity Dependent Re-Learning’ is the basis of our program at Walk The Line and is specifically designed for individuals with Traumatic Brain Injuries. Every individual with a brain injury or other neurological disorder, presents with different and specific signs depending on the area of the brain involved. We follow the basic principles of ‘task specific training’ to customize each client’s program to meet their individual needs. As the word suggests; task specific training is allowing the individual to practice a deficient skill. Re-learning of the functional skill requires repeated practice and verbal, visual and tactile cueing to guide movement. With enough practice of the corrected movements they are able to re-learn and transfer their abilities to other environments like their homes, work and daily lives.
EMG Biofeedback is a valuable part of our therapy sessions. It allows the individual to get auditory or visual feedback when performing an activity specific to their functional deficits. EMG electrodes are placed over the target muscles and auditory or visual feedback is chosen. The individual then performs the movement which is guided by the biofeedback. This can be challenging initially as their movements are predominated by increased tone, atypical movement patterns and even sensory deficits. As an example; for an individual who has difficulty in reaching for an object with his affected arm, the EMG can be first applied to his unaffected side so they are able to understand the movement. It is then applied to the affected side while they are performing the same movement. They are now able to use the feedback from the EMG to correct their movement and use an efficient pattern.
Using Biofeedback with Traumatic Brain Injury
Biofeedback is a method of providing an externally augmented auditory, visual feedback method to an individual. We use the Surface EMG Biofeedback as a part of our therapy sessions. It allows our clients to get real time sensitive feedback to guide their movement. This external feedback gives the individual an opportunity to reconnect to the movement and tap into their lost functional abilities.