A new buzzword, still NOTHING SPECIFIC that will get you 100% recovered!
Neuroathletic training is a cutting-edge approach to improving athletic performance that focuses on the interplay between the brain and body. By engaging in specific exercises and activities, athletes can improve their cognitive, physical, and emotional abilities, leading to better performance on the field.
Neuroathletic training in stroke rehabilitation? A single-blind randomized controlled pilot study on the potential of neuroathletic training for balance ability in stroke outpatient rehabilitation
BMC Research Notes volume 17, Article number: 358 (2024)
Abstract
Recently, neuroathletic training has been increasingly applied in competitive sports, in therapy, and in prevention. Scientific evidence on the effectiveness of this approach, however, has been poorly developed. Potentials of neuropathologic perceptual exercises to potentially improve balance control in the context of movement therapy in stroke rehabilitation appear promising. To investigate the possible effects of neuroathletic exercises on the balance ability of poststroke patients with ischemic infarcts and intracerebral hemorrhages, a controlled trial of a standardized protocol of daily neuroathletic exercises compared to traditional movement therapy during a four-week period of medical rehabilitation was conducted (n = 19). Patients were assessed with the Berg-Balance Scale (BBS), which represents the Gold standard for clinical measurement of balance.(I thought the Berg Balance Scale testing that was common, was totally worthless since there never was any specific therapy given to address the failure points I had in that test. There is really no point in measuring something if you have nothing that will improve your ability for the next test.) The results of the prepost BBS measurement showed significant balance improvements in the intervention and control groups, whereas the intervention group reached a higher total score by half the size of the standard deviation. A comparison of the results of both groups supported the general effectiveness of movement therapy for improving balance in stroke rehabilitation. However, neuroathletic training exercises did not lead to a stronger effect. Moreover, the intervention group did not score significantly lower than the control group. A negative influence can therefore not be assumed. For further investigations of neuroathletic training compared to treatment-as-usual training to improve balance in stroke rehabilitation, additional studies with larger sample sizes and longer treatment periods should be conducted.
Trial registration United States National Library of Medicine, NCT06391801, date: 04.29.2024.
Introduction
Based on anecdotal evidence, neuroathletic training is described as effective for target groups in performance sports, leisure sports and movement therapy. Neuroathletic training is being increasingly integrated into practical fields of training, coaching education and therapy [1,2,3]. In addition to athletic objectives, central nervous system movement control and specific perception exercises, which are included in specific training sessions, are addressed [4]. Although this topic is receiving increased amounts of attention in the literature and from an increasing number of workshops for practitioners, scientific evidence supporting the effectiveness of therapeutic approaches is lacking. Only a few research findings show positive effects in the context of specific neuroathletic exercises [2, 5]. With respect to patients in stroke rehabilitation, exercises to stimulate the visual and vestibular systems were found to be effective for movement rehabilitation [6]. It could thereby be useful to consider the potentials of the approach for the target group post stroke patients and further clinical populations.
The clinical condition stroke itself does not represent a homogeneous, defined clinical picture. Rather, it describes a variety of different circulatory disorders of the brain [7]. Main forms are ischemic infarcts and intracerebral hemorrhages, which can result in years of functional impairments with very different symptoms occurring depending on the localization, affected area and severity [7, 8]. These can manifest themselves in sensorimotor, emotional, cognitive or social deficits [8]. Among other things, hemiparesis, which in around 50% of cases is accompanied by sensory disturbances, cognitive-mnestic symptoms, orientation disorders, apraxia, coordination disorders, vertigo, dysarthrophonia or dysphagia. Rehabilitation measures consist of a variety of different applications, such as speech therapy, psychological counseling, occupational therapy and physiotherapeutic treatments, which are mainly aimed at restoring the patient's motor functions [9, 10]. In this regard, classic concepts such as Bobath, Vojta, proprioceptive neuromuscular fascillation (PNF) and physiotherapy have existed for several decades. Van Cranenburgh [11] notes that some of these concepts are aimed exclusively at improving Activities of Daily Living (ADL) and are therefore less helpful for occupational purposes and leisure activities [11]. According to Lamprecht and Lamprecht [12], traditional concepts are increasingly being replaced “by new evidence-based therapy concepts” such as constraint-induced movement therapy (CIMT) and robot-assisted training including growing approaches of strength training [12].
In neurological rehabilitation in general and stroke therapy in particular, the ability to maintain balance is a mayor rehabilitation goal, since its essential for everyday activities. It represents the basis for sitting, standing and walking and all resulting everyday life activities. Stroke patients experience deficits in balance and losses in motor function during activities of daily living; therefore, temporal precision activity-related stimuli could complement movement therapy to provide targeted support for neuronal plasticity to restore functions over time [13]. Outpatient rehabilitation movement therapy aims to promote physical functions that are important in everyday life, including coordination and balance tasks, to enable independent and safe movement [14, 15].
Exploring neuroathletic perceptual exercises to improve balance seems to be promising for the target groups since a main focus are exercises to work on information processing of the brain and sensorics system [16]. It is essentially based on findings from neuroscientific research and was developed in America including a comprehensive course and training system with various key topics [17]. Neuroathletic training focuses on the quality and processing of the incoming information in the brain and aims to improve the quality of the training through more precise personal risk assessment to improve the quality of movement [16]. The approach involves improving performance in (sporting) movements through improved information intake and processing without having directly influenced classic parameters, such as muscle strength, through traditional training [17]. According to this principle, neuroathletic exercises (so-called drills) for the three systems (visual, vestibular, proprioceptive) are selected and practiced in short training units of 15 to 40 min, based on practical experience [17]. It is also recommended to monitor the effects of the drills at regular intervals [17]. Scientific evidence about effectiveness of the approach exists only to a limited extent.
Two scientific studies can be mentioned, that examined the effects in the context of sport. Di Vico et al. [5] investigated differences due to a change in tongue position during isokinetic knee flexions and extensions and showed significant differences in force development of up to 30% [5]. They attributed this to a connection between the tongue position and the central nervous system, but emphasize that further studies are required to verify this hypothesis [5]. In contexts of college football, Clark et al. [18] investigated the influence of different visual training methods on the frequency of concussions suffered by players compared to previous years without intervention. During the intervention period, the values per season were significantly lower than in the four previous years, but neuroathletic training was applied among other approaches [18]. In the scientific discourse, the approach is viewed critically, as it appears unclear whether the structures targeted by the training structures targeted by the training are actually relevant in terms of performance physiology and whether effects occur where neuroathletes postulate this [19]. The complex processes of neurophysiological information processing may be simplified in the approach, which may not do justice to the complex nature of the processes. Based on studies by Beedie and Foad [20] and Bérdi, Köteles, Szabó and Bárdos [21], potential effects could also occur due to placebo responses [20, 21]. To explore the potential of neuroathletic training for stroke rehabilitation, a single-blinded controlled pilot study was conducted in a stroke outpatient rehabilitation program in this study.
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