Joey's Story

One of my sister's co-workers, Tony, has a 14-year-old son named Joey. After a terrible accident in April 2009, Joey, a surfing champion, was left in a wheelchair and told that he would never walk again. However, with very expensive treatment there is hope that he will walk again. I thought I'd share his inspiring story.

This is re-posted from Joey's mom's online journal:

Use it or lose it

There has been research done and recent books published on brain plasticity (the ability of the brain to "rewire" itself). It seems to me that they are basically saying just this: use it or lose it. The more fascinating thing that is now being looked at is how, once you lose it, you can use it again.

From my understanding, whether it's called plasticity or learned unuse, if you stop using part of your body, it will adapt by redirecting neuropathways/brain signals to somewhere else in your body that you do use. The theory holds true for those that lose an entire sense and can't hear or see; their other senses use those unused reserves in neuropathways to increase the senses that are working. There is a therapy called constraint-induced movement therapy where if one arm is paralyzed and the other is not; the working arm is constrained so that you can't rely on it to compensate for the nonworking arm - you don't allow it to take over the unused pathways that were used at one time to tell the paralyzed arm to work. If there is no attempt to use the paralyzed arm, the brain will tell the body that it is no longer needed, but if your able arm is placed in a sling, and you continually tell the brain to move the paralyzed arm, it begins to fire the pathways necessary to move it.

There have also been unbelievable things done where the brain can actually be tricked into thinking that a paralyzed arm works (using an able arm and mirror). The brain sees, in a mirror, what appears to be the paralyzed arm working, and when it registers that it can work, suddenly the paralyzed arm does work. I've heard this mirror method used when working with phantom pain as well. Dr Joe, Joey's Chiropractic Neurologist, explains some of these things by discussing the inhibitors that the brain naturally sends or does not send to the body based on the brains input from different sources (I may not have interpreted that exactly right-I've given up trying to quote dr joe as the terminology is like a foreign language to me - but I think I'm close).

The brain is pretty incredible and it's encouraging to see more and more interest and information out there on its ability to "rewire itself". It can only be expected that more research on plasticity and the spinal cord will follow.

In the past, physical therapists worked with spinal cord injury (SCI) patients on only those muscles above the level of injury, and pretty much ignored anything that was paralyzed. New therapies (Project Walk among them) concentrate on the areas that are paralyzed and work on the body below the level of injury. It is hard to imagine how you work on a an arm or leg that is paralyzed, but the first thing they do is ask you to try to move. Then they assist the movement while you visualize doing it on your own. This is about making connections, reconnecting, or maybe even redirecting, neuropathways that at one time told the body to move this way.

Another important aspect scientists have found with connecting neuropathways is the importance of reward. When studying plasticity, it was found that major changes in rewiring the brain occur when the body releases endorphines, or other pleasure chemicals in your body, at the same time it is attempting to rewire. Even if there is no result when trying, rewarding the attempt (shaping) will help to build neuropathways. This is like how the body responds to some addictive behaviors. The more the body is rewarded, the stronger the addiction becomes. I think this is also the power of positive thinking, muscle memory, and mind over body; maybe all that stuff will be scientifically supported and explained in the future as brain plasticity.

On Joey's first day at Project Walk they made a video as his starting point in recovery. He was asked to try to move his leg while the trainer moved his leg for him. Joey was encouraged at each attempt and by the end of the first hour, they had to retake the video because he was able to do more than he thought he could, and a lot more than he showed in the first filming. Seeing that he could do more than he thought was another boost of confidence/reward and those initial movements were built upon.

Having an exercise-based therapy like Project Walk also adds the reward of endorphines which are naturally released with exercise and help reward and strengthen the message to the brain that this is what we want the body to do.
While at Project Walk, the trainers use positive reinforcement for effort, and with gradual and repetitive movements, tap into those connections and eventually strengthen muscle.

A very long way to say just this: Use it or lose it.