Aquatherapy for Gait Training

I have waxed poetic in previous blog posts about my love of the water, so when I began my PT today at the Kennedy Krieger Institute, I was super excited that it was pool day!

The Center has two different pools – one slightly larger than the other (but definitely not large enough for swimming). The second pool has a built in treadmill (!!). Both pools have several video cameras so you can see what your body is doing underwater.

In the first pool, we strapped on a resistance tool on my ankles so they would have more “drag” (i.e. weight) through the water. In the first exercises, I kicked my left (affected, weak, MS-y) ankle back and forth through the water. Bonus here is that my hip flexor is also weak, and the same motion works both hip and dorsiflexion at the same time. Here’s the view of it that I could see on the TV.

Next up, I stood on a step to try to stretch out my ankle some (it stretches very little, but the water was heated so that helped a bit).

Then I worked on hopping (fun!) and bounding (fun, but I felt like an idiot), which is just a long hop. I do not bound or hop well as my ankle has prevented me from doing these things for years. My left calf  muscles are both tight and weak, so they don’t generate the force needed for power moves well, but it was a little easier with the bouyancy of the water (also more fun). That said, part of the plan that we’ve been working on all week at Kennedy Krieger are things to help reduce the tone in my calf so that jumping can be something I add to my training on land (but I digress.)

After the resistance work in the first pool, we transferred to the other pool with the treadmill. These pools are used by people of a lot of varying functional levels, including people in wheelchairs, so they have an ingenious way for you to get into and out of them. They have a floor that raises and lowers you in and out of the water. Check it out in photos below to see how the floor (filled with holes) lowers, and the water comes through the holes in the floor.

Once I was lowered down into the pool, I started walking (Kim walked with me). We went at both fast and slow paces, and you could see how hard my left leg was working to lift against the weight of the water as time progressed in the video link below. At the end of the video, you see the view that I saw on the TV.

I also walked forward, backward, and sideways in each direction.

Since I don’t have access to a pool treadmill, Kim said if I wanted to practice walking in a regular pool, I should go to the kids pool and weave in and out of children. “It’s great ankle and hip stability training!,” she said.

In health,

Mariska

Is an MS Cure Already Here?

Ever since I was diagnosed with multiple sclerosis in 2002, I’ve been hoping for a cure. Since that time, doctors and scientists have given us more than a dozen new medications, you can get a stem cell transplant if you meet some criteria (I don’t) and want it (plus have amazing insurance or enough money to do it), and researchers have been making progress on finding even more options to treat symptoms. I’m personally hoping to be involved in a clinical trial that is testing a novel (and super cool) electronic stimulation unit that uses the tongue’s sensory nerves to deliver signals to the brain to help improve balance. 

Just last week, I saw a story that really stood out about a Cambridge University doctor trying to cure MS. Probably a dozen colleagues, friends, and associates also sent it to me. Because if the doctor’s right, she figured out a cure.. that isn’t even actually a medicine… that will be available… soon(ish). (Where can I sign up for a trial??? Seriously – if you’re in the know, hook this girl up!)

Here’s a Cliff Notes version: There is a type of stem cell particle called a LIF. Apparently, this wonder particle can turn off the autoimmune response that results in the damage seen in MS. Mix it with a nano-particle that can make LIF survive in your body longer, send it where it needs to go, and boom – MS cure AND (!!!!) a way to fix the damage MS has done. They even think it could be a cure for other things, like dementia.

Many people think that I have made peace with having MS. But that’s not true at all. I fight against what it’s doing to my body every single day. I do not accept its potential damage as my fate, and I encourage others with chronic neurological diseases to do the same. There are a lot of things you can do to help prevent or mitigate disease progression. But if someone could just give me a cure? I’d sign up for that in a second. I’m really over of having MS every damn day.

In health,
Mariska

Can Mirror Neurons Help Us Become Better Athletes?

Just over a couple of years ago, we talked about the sports spectating phenomenon known as mirror neuron, here on our blog.  In a nutshell it’s about the idea that we’re not just watching other people’s action (in this case, a soccer match), we can actually feel ourselves in it. To a certain extent, our minds seemingly go through the ordeal these athletes experience, as if we’re part of the action.

The article pointed out, as a simple example, how we see someone stub his or her little toe really hard on the edge of a piece of furniture, and we feel that particular pain. It’s our brain’s way of reminding us of that exact feeling – going through flashbacks of past scenarios. This is also what happens if we watch sports. Some of us have played soccer growing up, so watching say a World Cup, Major League Soccer, or even a UEFA Champions League match gets us excited. However, aside from enjoying every bit of action on the pitch and understanding what the players are feeling, is it possible we learn soccer skills just by watching?

Here, again, is where these so-called mirror neurons come into play.

One of the things that set us apart from other species is our aptitude to learn from other people. Subconsciously, we adapt their movements, the basic ideas of them; we just can’t perform them as well as how professionals do them. Also by watching live inside a venue or in front of a television, we’ll know if a shot goes in. In hindsight, soccer players – specifically those who play on the grandest stage like the UEFA Champions League – are some of the most finely tuned athletes in the world. Stephen Tudor, a soccer journalist who regularly contributes pieces to the Champions League section on claims these soccer players are very similar to that of Formula One engines. For this reason alone, professional soccer players are activating our mirror neurons, instinctively teaching us how to execute actions and acquire skills in the process.

Back in 2010, researchers at UCLA conducted a study about the deeper intricacies of mirror neurons. They found a subset of brain cells that show it actually inhibits activity, probably telling the observers to escape reality and adapt what the mirror neurons were imitating. These same specials cells might also be the reason why we love sports so much, according to Axon Potential. 

So ultimately, this answers the question of whether or not we get better at sports just by watching them. If we’re a soccer player whose talents are nowhere near the standard of the likes of Cristiano Ronaldo and Lionel Messi, then watching won’t help us skill-wise. Part of this is because soccer – or any other sport for that matter – has techniques that are different and have more to them than just what we see on the surface. Mirror neurons, for its part, give us the feeling of “what ifs,” and at the end of the day, gives us a glorious glimpse of what it’s like to score a goal. So it’s up to us to be inspired to practice our chosen sport seriously or watch it passionately. Either way, it’s a win-win situation for us all.

Understanding Stroke – 4 Minutes/4 Hours

There are several types of strokes, but for this article – let’s look at the most common – an ischemic stroke (85% of strokes). In this type, a blockage (like a blood clot) occurs and prevents oxygen and nutrients from reaching parts of the brain. Any point downstream of the blocked blood vessel can be affected. Where the blockage occurs determines what side effects a person will experience.

In the first 3-4 minutes, a lack of oxygen causes irreversible cell death. Billions of neurons can die.

Over the next several hours, something called the ischemic cascade can make the problem worse. Without blood and oxygen, there is less ability for the neurons to carry out energy production. Lactic acid can be produced, causing additional cell damage. There is also less energy production because the sodium potassium pump in the cell can’t work properly. When this happens, water rushes into the cells to try to dilute the over-abundance of sodium, causing the cells to swell.

Swelling can cause additional damage and cell death. 

Also, within the first 4-6 hours of a stroke, parts of blood vessels can also break down, affecting the blood brain barrier. This barrier is designed to protect the brain from infections, proteins, etc. traveling in the blood stream. Without this barrier completely intact, proteins and water that would usually be blocked from the brain start to leak in, worsening the swelling even more. 

What does this mean? If you suspect you or someone you know is having a stroke, you need to get them to a hospital ASAP. There probably is very little you can do in the first 4 minutes. But in the first 4 hours, there are medications that can keep a stroke’s damage from getting much, much worse.

Also know that as the swelling decreases over days, many stroke symptoms will improve. And, with some of the amazing therapies out there today, the brain can learn to work around quite a bit of damage. 

To learn more about how to exercise to help improve stroke recovery, check out one of our workshops.

In health, 
Mariska

Fixing Neuropathy Through Desensitization

Damage to the sensory nerves or sensory nerve pathways can cause an extremely painful condition called neuropathy. It’s common in neurological conditions, as well as conditions such as diabetes and even damage from chemotherapy. What does it feel like? Depending on the person – it can present as burning pain, numbness, tingling, hypersensitivity, buzzing, and other weird sensations.

Neuropathic pain is unique in that it doesn’t typically respond to pain medication like aspirin or even opioids. In fact, the medications most commonly used for it include drugs that are also used for epilepsy since the signal disruption caused by neuropathy is closer to a mini-seizure than a normal “pain.”

The problem with any type of pain is that it can become hardwired in the brain. Feel pain long enough and it actually changes how your brain works. So, to “cure” the pain requires your brain unlearning it. And that’s where desensitization comes into play.

Let’s say your feet hurt. You probably limit walking and wear thick soled shoes so you avoid feeling the pressure of the ground as much as possible. But to turn down the hyperactive pain signals, you need to touch your feet. Massage can be helpful. So can introducing different textures.

One of my favorite techniques is to use a sandbox. Go to the Container Store and get a box big enough to insert your painful foot. Fill it with sand (or alternately, rice), and press your foot into it, moving it around softly and more firmly. Curl your toes, and spread your toes. Importantly – focus on the pleasantness of the sensations. Better yet – take a vacation to the beach where you can introduce sand and water! Here’s a great blog post on just that!

Your brain can adapt to the problem, rewire, and voila – neuropathic pain lessens or disappears completely. Bonus – you strengthen the intrinsic foot muscles. 

(Note that you have to do desensitization exercises daily – the brain is slow to make these changes).

Want to learn more about the brain-body connection? Check out our workshops in person or on-line.

In health,
Mariska

Are Cures on the Horizon?

I have a fairly hefty number of Google alerts set up, and because of that, I read a lot about potential cures and treatments for neurological diseases. In the past month, some potentially exciting news has hit the Internet.

Since many neurological diseases have complicated or unknown causes, scientists may have struck gold when they find the cause for one of them. That seems to be the case for Amyotrophic Lateral Sclerosis (ALS), quite possibly the worst neurological condition you can develop (although arguments can be made that Huntington’s is just as bad or worse).

For ALS, researchers recently were able to locate the protein responsible for motor neuron death. Being able to find it could be the first step in finding treatments or medications to cure it.

In equally interesting news, Australian researchers have been able to use ultrasound technology (a non-invasive, non-pharmaceutical treatment) to clear out the plaques that have been shown to cause the memory loss in Alzheimer’s disease. Check out the story here. 

There are also regular reports on advancements in understanding multiple sclerosis, stroke, and other common neurological diseases. Here’s hoping a lot of the scientists working on these treatments have “find a cure” on their New Year’s Resolutions list. “Get a cure” is always on mine.

In health,
Mariska