Do you feel like you have plateaued? What I mean is, has your arm and leg movement recovery slowed to a crawl? Or maybe progress has stopped altogether? The common belief is that someone loses the ability to move because that part of the brain has been damaged. But there is another phenomenon at work that might be the “missing link” in your rehab. This phenomenon is call learned non-use.
What Is Learned Non-Use?
In the context of neurologic injury, learned non-use is the suppression of particular movements, irrespective of the damage to the actual “movement part of the brain”. It is losing particular movement in the arm or the leg due to a learned behavior that gets hardwired into your brain in the weeks and months after the neurological injury.
Why Does Learn Non-Use Happen?
In the days and weeks following the injury, the attempt to move that arm or leg is unsuccessful due to weakness. As the neurologic system recovers, you may not even attempt to use the arm or the leg because of those failed attempts.
So, eventually, as you don’t use it, you lose it.
As the cycle keeps repeating itself, you attempt, you fail, you further suppress that movement. This behavior then becomes hardwired into your brain.
Why do you lose movement in the first place after injury to your brain?
The common misconception is that the area that controls the arm and the leg movement gets damaged; hence you cannot move them. It is a bit more complex than that. A few areas of the brain could be damaged that cause an impact on the arm or leg movement.
One is the motor cortex that controls the arm and leg movements, which is also known as the motor cortex. Damage of the motor cortex can impede the arm and the leg movement, which could look like weakness of the arm or the leg.
The damage to the sematosensory cortex can also restrict your movement. This section is responsible for receiving information from the body. There could also be damage to the Thalamus. For example, if you experienced a thalamic stroke, then you can have damage to the Thalamus.
The thalamus works as the processing center for the brain. It does a range of work, like receiving information from the body and processing it. The region also receives information from motor cortex and cerebellum. The latter is the one responsible for movement control and coordinated movement. The thalamus also receives information from the brain stem and the basal ganglia. Hence, the thalamus is the main hub. Damaging that region can also impact the voluntary movement of the arm and the leg.
But what happens on that first day of the injury is not the full picture, whether it is a stroke or injury. Even for ischemic stroke, it is the cause of lack of blood flow to the arteries and damage of the arteries and the nerve. However, there is a region outside the damaged or dead nerves due to the still alive injury. They are kind of asleep, so while the dead nerves cannot regain function, the ones outside the damaged ones do not receive adequate blood flow due to the injured nerves.
As time progresses, there is a spontaneous recovery process within a few months, which is during the first few months. Spontaneous recovery actually sees the functioning of these sleeping nerves. Hence the progress seems to be quite significant. Physical therapy is critical during this time as they help the dormant nerves to get active and function. It facilitates movement.
It is also during this time the brain is ready to reorient and reprogram about the learned non-use. The failure results in non-using and eventually your new normal, where you don’t use or move that muscle or part anymore.
Is It Possible To Reverse Learn Non-Use?
The answer to this question is a bit complicated. At times you can relearn to use it, and at times there is a failure. Various factors will impact your ability to move your leg or arm after a stroke. However, there is a scope to learn the new habit. Hence there is the potential for reversing learn non-use.
The next question that is likely to be in your mind is how to do that? Well, there are certain strategies you can follow, but before we delve into that, here are two points that you should remember.
The feature helps in brain reorganization, which facilitates motor movement.
Learning To Get Signal:
At times, due to the injury, the brain fails to identify a body part, but it is your duty to develop the sensory part of the component along with the motor component.
These two factors are important because intrinsic motivation is essential in relearning motor skills and mainly reversing the non-use.
It is also essential that you stop thinking your brain has been damaged so you cannot have leg or hand movement due to it. This detrimental thought process will only impact your relearning of the movements.
Now let’s get into the strategies into reverse learn non-use.
Strategies For Reversing Learn Non-Use
The core of reversing learn non-use is having the intrinsic motivation, also known as self-efficacy, which is the key factor in learning anything new. It requires you to believe that you will be at least one per cent better than yesterday when you try.
That should be the bulk, almost 90 per cent of every therapy program when it comes to reversing the learned non-use. Part of it includes setting up goals that you can achieve rather than higher goals that you will fail at and eventually move you towards not using the muscle due to the failure and facilitating the new normal of non-use. Once you succeed in your goal, the brain will stop suppressing the muscle, and you can start developing it for the better.
You can use gravity-eliminating exercises, which are super valuable in movement retraining. Also, anything that allows you to remove friction is good, like sliding the arm on a table, suspending the arm, to name a few. You can use an air sling to do such a movement.
It’s vital to go in with a positive attitude, with achievable goals and a few movement exercises instead of a plethora of them. Repeating a few movements until you succeed in them is crucial in reversing learn non-use.
Choose Activities Important To You
One of the best strategies to integrate with reversing learn non-use is selecting important activities and your lifestyle. Once you can achieve even a little in those, it works as a reward and boosts the intrinsic motivation to do better, which eventually helps unlearn the new normal of not using your muscle.
Using Adaptive Equipment
When you are trying to relearn the new, it can be helpful to use some adaptive equipment in developing those movements—equipment like arm support.
It is also beneficial to imagine those movements or others; seeing them can help you reverse the learn non-use.
Using the good arm to be reflected in the mirror while trying to mimic that same with the one that is not in use can be helpful. But you have to be very mindful and concentrate on your good hand or arm’s movements.
Constraint Use Movement
This involves restricting the good arm while forcing the involved arm. It can be challenging when there are zero movements in that arm, so it is not recommended. But it can be used when you can do little activities with them, and the strategy can help improve the movement.
While these strategies are in place, you must believe that you can have the movement. It is up to you to decide and develop your movements again with intrinsic motivation and self-efficacy.
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