One of the most under-appreciated aspects of taking care of people is engagement. You can tell when someone is "going through the motions" versus an individual that is highly motivated to push themselves to do more. This is important because plasticity can vary depending on active engagement, salience and "buy-in" for the process.
One way to get this buy-in and engagement is through play, or in this instance gamifying the recovery" by making an activity fun, it becomes more than just some boring neck, back, or eye exercises. We can help patients play through a number of mechanisms like creating a game where you have to score the most points in 1 minute. We can make a simple hand-eye coordination exercise using the FITLIGHTS®. Timing an activity to see who can do it the quickest. Adding cognitive difficulties to physical exercise is a good idea. Simply playing a game that contains the required movements will suffice.
Play does some really unique things happen to the brain that facilitate recovery:
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Play can produce joy which amplifies the use of dopamine. Dopamine can facilitate the reward centers in the brain that can maximize learning. Joy triggers increased dopamine which activates reward cascades in the brain to facilitate improvements in: memory retention, motor learning, stress reduction, increase in plasticity, attention and focus.
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Play incorporates goal directed behaviour which strengthens important centers in the prefrontal cortex. Patients want to win, which reinforces repetition and creativity which drives the prefrontal cortex.
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The emotional benefits of play stimulate the memory centers of the hippocampus which is important for emotional, memory, and cognitive regulation.
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Play gets disparate areas of the brain to connect more strongly with each other than doing a single repetitive task and can help maximize plasticity.
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Play can conquer fear. Fear avoidance behaviour can limit recovery from functional aspects of pain & dizziness. Play can help the frontal lobe overcome fear behaviour by being engaged in the game. When patients get lost in play, they may realize they were performing a fearful movement or balance activity and it doesn’t worsen their symptoms.
We love using different games and tasks in our practice to encourage play for the recovery process. We use FITLIGHT® to get cardiovascular exercise with cognitive tasks. Patients love it and they realize they could do things that they didn't think they could do. This is a core fundamental with our team.
Here is an example of a FITLIGHT® drill we created as a progression for patients who have overcome vestibular issues, especially for our post concussion athletic patients. From a performance standpoint, It’s also useful for athletes that require the ability to turn and quickly identify a target to catch a ball or avoid an oncoming hit.
1. For this drill we are using the reaction lights at varying heights and 4 different colors of soccer cones.
2. We programmed the lights to have the same 4 colors as the cones. The goal is to match each cone to the same colored light before hitting the light. You have 20 seconds to hit all 4 lights (less time if you are a trained athlete)
3. We orient the lights to surround the patient so they have to turn their bodies and head to find correct light and cone combination. This provides a strong challenge to the vestibular and ocular system. If you have a dysfunctional vestibular system, turning quickly can be challenging because it disorients you, or it can make your eye movements less accurate. The varied heights force you to engage the vertical plane of eye and head movements as well.
If you are standing in an athletic stance and moving quickly, 10 sequences of this drill is enough to get you breathing harder on top of the brain and vestibular challenge.
We've seen the success of patients who are overcoming vestibular problems in our facilities, particularly among our post-concussion sports athletes. FITLIGHT® has proven to be an invaluable aid in their recovery and growth.
