Being able to stand on your own two feet following a brain injury is often at the top of most people’s list of physical rehabilitation. The ability to walk is one aspect many who have fought a traumatic brain injury want to improve. This enhancement brings a new level of independence and confidence when performing basic activities.
This post will help you overcome some of the complications you might go through when learning to walk after a traumatic brain injury. It will also guide you on steps to boost your walking manner.
Brain Injury and Your Ability to Walk
Difficulty with balance affects as high as 30% to 65% of those recovering from traumatic brain injury, probably due to several factors such as weakened muscles, damage to the inner ear, or even to the cerebellum, which is the part of the brain responsible for keeping us upright.
The damaged primary motor cortex is the part of the brain that acts as the conductor in orchestrating muscle activity. When the brain is injured, this process is disrupted, and activities that require different muscle groups to work together start to falter.
A brain injury might cause an interruption along the line of communication between the brain and muscles. The brain just won’t be able to communicate with the muscles when it tightens up. Thus, spasticity may set in to make the muscles rigid. This definitely makes post-brain injury walks quite a struggle.
With the many possible causes of difficulty walking after brain injury, survivors must work closely with their therapists to appropriately diagnose and rehabilitate their walking abilities. So, never lose hope, but instead, walk towards your recovery!
How to Regain Your Gait Post-Brain Trauma
Well, this is actually about teaching the brain to instruct the muscles involved with walking. And that’s possible- as changeable as it gets- thanks to this one cool thing called neuroplasticity.
Neuroplasticity is your brain’s so-called ‘superman’ power to reshape itself. The best part is that even in the occurrence of a brain injury, neuroplasticity can help your brain offset any loss. While injured cells in one’s brain cannot heal themselves, neuroplasticity makes it possible for the remaining part of your brain to fill in for whatever was damaged.
For example, if a cerebellar stroke hits the part of your brain controlling your balance, it will falter. However, thanks to neuroplasticity, other healthier parts of your brain can take over such a function. Neuroplasticity works through repetition and regularity. Your brain loves efficiency. Therefore, it will build and strengthen neuronal pathways for actions you repeatedly do.
During gait rehabilitation following a Traumatic Brain Injury, individuals are continuing with repetitive therapeutic walking motions. Based on the area of lesion-onset, the individual may use or practice balancing exercises with leg movements. High repetition of these movements suppresses neuroplasticity, and your brain is automatically upgrading the efficiency of those movements.
Rehab Exercises for Gait Following a Brain Injury
Customized rehabilitation exercises are the first real steps toward walking again following a brain injury. It is at this point important that an individual teams up with their therapists to develop a personalized rehabilitation plan for one’s situation. Below are some of the common therapies your therapist may recommend.
Passive Rehab Exercises
At worst, severe brain injuries could render your legs completely useless, relegating you to wheelchairs. On the bright side, however, even with such highly limited leg use, there’s still hope to get your legs mobile and walk again. You can do so via passive exercises, which are methods of guiding your legs through specific motions without the full use of muscles.
Passive exercises effectively stimulate brain activity and neuroplasticity, particularly when focusing on the movement. Brain activation can be extended by imagining one’s body, making the movement in the mind and thereby increasing neuroplasticity.
These exercises may be assisted by a therapist, an educated caregiver, or yourself using your upper body. Passive techniques form a very good basis for relearning to walk following brain injury. With time and practice, you may often achieve some return of use in your legs and move on to active exercises.
Leg Exercises
It shouldn’t be surprising that exercises centered around moving your legs and leg strength are crucial in learning to walk again after a brain injury. The legs are a priority when walking, a full-body activity.
These regular exercises focused on the rehabilitation of the legs will re-educate your brain for better coordination of your legs. While the movements get increasingly synchronized, one can attend to strengthening the legs.
Following are some of the leg exercises that are of help during gait rehabilitation:
Seated Marching
- Sit comfortably.
- Lift your affected leg toward your chest, hold gently, then lower gently.
- Do the same with the other leg.
Knee Extension
- Sit on a stool or chair.
- Straighten your knee completely and lower your foot to the ground.
- Repeat the procedure with the other leg.
Remember, with repetitive and consistent practice, rewiring of the brain and improvement in movements will occur following a brain injury.
Foot Drop Exercises
Foot drop is a common affliction following a brain injury in which it becomes difficult to lift the front part of the foot toward the shin. This could make walking or climbing stairs very frustrating; thus, improving your dorsoflexion is a critical step in learning to walk again. This can be accomplished through foot drop exercises.
Following are some of the effective foot drop exercises:
Passive Ankle Dorsiflexion can be done by sitting comfortably, crossing one leg over the other, using your hand, moving your foot toward your knee, and then back down. Do ten repetitions and then do the same to the other foot.
Assisted toe raises will help strengthen the other ankle in case you can only move one foot.
Once you have adequately built up the strength and coordination in both your legs and feet, you are ready to move on to the next significant phase of relearning to walk after a brain injury.
Practicing Weight Bearing Exercises
Weight-bearing exercises are excellent; these make your legs and core muscles strong enough to support your body weight comfortably. Other effective weight-bearing exercises include “sit to stands,” shifting between sitting and standing. Weight shifting from one leg to the other is also effective.
Also, weight-bearing exercises do not have to bear full body weight on the legs. Some techniques can provide partial weight-bearing options whereby gentle strengthening of the legs can occur along with weight-bearing without a high risk of falls. Examples include the following :
- Using parallel bars allows your arms to bear some of your body weight.
- Aquatic therapy in practice is less burdensome to exercise in water than on land.
- Using a body weight support system-a special harness attached to an overhead track.
- Remember to check with your therapist before you attempt any exercises without using your prescribed assistive equipment, such as abdominal walkers or a cane.
- Then, once you get into comfort with weight-bearing exercises, it would be the proper time to focus on balance improvement.
Exercises for Improvement of Gait and Balance
Balance is important in walking and standing; thus, rehabilitation exercises are important to help one improve balance. Most leg and core exercises improve balance by enhancing the necessary coordination. Sometimes, this is with the inner ear or even sight. These may involve vestibular and/or vision therapy to help you get through those challenges and recover your balance.
Task-Oriented Gait Training
In cases where one can walk with assistive devices such as walkers or canes, task-specific training could be the right lane for them. Walking is a great stimulus within the brain for continence.
It lets you practice the activity in which you intend to improve. However, be very careful when making such a step. You may progress to more challenging activities with improved walking skills, such as walking on uneven surfaces or stair climbing.
Never stop using your assistive devices without discussing it first with your therapist. It may be unsafe to try and walk without a walker or four-point cane if you have been relying on one for support when walking.
Remember that individuals with gait problems are likely to fall, which could be a setback for recovery. Be very careful, and always use devices recommended by your therapist.
Intensive Mobility Gait Training
In learning to walk again, the last walk is acute mobility gait training, combined cardio, and ongoing moderate-level movement. Training could be done by bike riding, repetitive rising and sitting, or other activities that raise the heart rate. The most important goal of high-level mobility training is to increase your endurance and walking without getting tired.
Conclusion
In your journey to get your stride back, you’ll make your way progressively as you fire up your brain and get it ready to adapt. The road to walking after a brain injury may be long and arduous, but this is something you can get past with persistence and grit. Above all, stay close to your therapist, who can recommend exercises you can do comfortably at home.