The Impact of Neural Priming on Rehab and Recovery in Occupational Therapy

In Occupational Therapy and the Rehabilitation world in general, innovation is paramount. Therapists are constantly searching for novel approaches to optimize patient recovery. One promising method gaining recognition is the fusion of neural priming with robotics: two pre-existing techniques that together could promise faster and more effective outcomes.

What Works Best:

Anything from task-oriented activities to sensory integration therapy have been used to promote motor skills and cognitive response. Additionally, the Bobath concept emphasized a neurodevelopmental approach, aiming to facilitate normal movement patterns in individuals with neurological disorders. Over time, these techniques have evolved, and today's occupational therapists continue to integrate innovative methods, like neural priming and robotic assistance, to optimize rehabilitation outcomes.

Speeding Up Recovery (with Neural Priming):

Neural priming has taken center stage as a transformative rehabilitation technique, involving the priming of the central nervous system before rehab exercises. This harnesses the brain's adaptive capacity, expediting the learning of new motor skills. When done in conjunction with robotic assistance, massive gains can be made in patient improvement and cognitive function. Much research is still to be done to explore the exact application of neural priming, but here’s a few ways it's used today: 

1. Transcranial Magnetic Stimulation (TMS):

 TMS utilizes focused magnetic fields to induce electrical currents in specific brain regions. This modulates neural activity, preparing the brain for more effective rehabilitation. In one example, TMS has been employed to target motor cortex regions in individuals recovering from stroke. By precisely stimulating the affected area, therapists can reactivate and retrain Stroke-affected areas of the brain. By promoting neuroplastic changes, individuals can even regain lost motor function!

2. Transcranial Direct Current Stimulation (tDCS):

tDCS involves applying a low, direct current to the scalp, modulating the resting membrane potential of neurons. In rehabilitation scenarios where individuals are recovering from motor impairments, therapists have employed tDCS to target specific brain regions associated with motor control. By doing so, they aim to optimize the neural environment, making it more receptive to subsequent motor training sessions. In practical terms, this might involve using tDCS to enhance the responsiveness of the motor cortex, aiding patients in relearning and refining motor skills after Traumatic Brain Injuries or Spinal Cord Injury.

Making a Plan:

Incorporating Electrical Stimulation (E-Stim) is one way to enhance the effectiveness of therapeutic interventions. One strategy involves priming specific muscle groups through E-Stim for a few minutes before engaging in functional activities. To do this, therapists may prime the muscles in the legs using E-Stim to optimize the legs’ responsiveness. Then, walking exercises are initiated – a patient can be independent or supported – followed by E-Stim again. After walking, evaluate the patient’s success as compared to their normal abilities. Are they performing better movements after E-Stim?

Additionally, try to vary the form of neural priming used. Vibration, tastes, or any sensory inputs are effective ways of stimulating the Central Nervous System before an exercise. 

It's worth noting that while the integration of neural priming in rehabilitation is widely accepted, there is still a notable gap in comprehensive research regarding specific treatment dosage. How often? How much? How often? Use this as an opportunity to explore your own techniques. Find ways that work for you – match them with the devices, tools, and machines at your disposal. 

Barrett’s Burt:

With Barrett Medical’s Burt robot, neural priming is made simpler and easier than ever before. Built into the robot are haptics that help stimulate a patient before they’ve completed an activity. Cognitive stimulation is integral to patient success and Burt does this too! Each 3D movement done on the robotic arm is accompanied by movement on the screen in a game. 

Neural priming via matching movements (lifting an arm) to activities (doing laundry) are especially useful in patient rehab. Check out this link to see our Laundry Loader Activity

Hannah Cox