I need to make my body and mind work again
The brain controls movement and sensation in our body, our thinking and feeling/emotions. When neurological conditions disrupt normal brain functioning, it is common for survivors to experience multiple problems in their body and mind, all at the same time.
Body:
In acquired conditions like stroke, physiotherapy via public healthcare services may be available in the short-term to address physical difficulties such as hemiplegia, gait disturbances, loss of balance, vestibular problems, dyspraxia, and wider sensory or mobility restrictions. However it is a common scenario that many survivors want to receive more and/or ongoing physiotherapy after the public healthcare provision of such has come to an end. While the goal of improved physical functioning is motivating, it can be hard to maintain the regular completion of exercises suggested by therapists. Most physiotherapists will emphasise the ongoing maintenance of functional movement as part of everyday life once formal physiotherapy provision has ended. However it can be hard to remember/cue oneself to utilise a diverse range of movements during everyday tasks.
For these and other reasons, there end goal of improved functional movement of the body and limbs is not sufficient to influence the regular practice of movement exercises over months and years. Other factors are important. The popularity of recent developments within the community sector such as ARNI groups highlights the appeal of a long-term group-based activity where survivors can come together, both working on improving functional movement but also experienced increased social motivation and social cueing to perform the movements by training with others.
A Tai Chi class offers the practice of whole body movements that have been shown to confer physical benefits to people with a range of neurological conditions (see here for more info), and the social motivation/cueing previously described (read more on flowing together in Tai Chi). Furthermore, once the movements are performed safely, the main goal is the state of mind created by the movements (flow), not the perfection of the movements at a physical level. So there is less disconnect between the movements and the goal – you will want to perform the movements not just to achieve something in the future (the physical benefits from ongoing practice), but more importantly to feel good now, in the present.
The movements that generate this state of mind should be ones that are at your own personal level of ability, which seem like a moderate challenge initially but not too daunting. The movements used in Neuro-Flow Groups © and individual sessions have been selected from a range of Tai Chi styles and Qi Gong practices, to allow you to attain a flow state during practice and maintain this over time. As you become familiar with certain movements, new routines can be introduced that increase the physical and cognitive challenge, if desired.
Mind
You may feel that your emotions and thinking has been equally or more disrupted than your bodily abilities following the onset of your condition. Or it may be that your focus is on physical rehabilitation. While you request more physio that is harder to come by, others in your life may be suggesting that you need instead to talk to a psychologist, counsellor or psychotherapist to work on your adjustment to and acceptance of the condition. Or perhaps to manage an immediate form of psychological distress such as anxiety, depression, anger or traumatic-stress. As a clinical neuropsychologist, I can vouch for the value and role of talking therapies within neuro-rehabilitation. However sitting down and talking to a stranger like me for an hour may not always be the best way to receive psychological support for everyone, particularly if you have difficulties with attention or comprehension. In addition, Eastern meditative practices such as mindfulness have been shown to offer benefits for people with a range of neurological conditions, but the similar requirements of these practices on attention can be obstacles for some.
You may personally feel that you would not benefit from a talking therapy or sitting meditative practice, or would like to compliment psychotherapy sessions with an approach that focuses more on your body. In both cases Tai Chi may be a useful way of stilling your mind while performing functional movements. As discussed here in more detail, Tai Chi has been shown to improve mental health and wellbeing for people with different neurological conditions, even when the psychological aspect of practice has not been prioritised by researchers. Neuro-Flow Groups © and individual sessions are uniquely offered with a central focus on psychological wellbeing. These are delivered by a qualified clinical neuropsychologist and incorporates techniques from differing psychotherapies (e.g., cognitive-behavioural, experiential) but adapted responsively for the particular cognitive and physical needs of each survivor.
At the end of the day, someone can perform Tai Chi movements apparently perfectly from an outsider’s perspective, but internally they are giving themselves a hard time and are frustrated at not being good enough. This is not Tai Chi! Performing soft, relaxed flowing movements that you have practiced many times should make you feel better, not worse.
While many people with neurological conditions look for ways to retrain aspects of cognition, such as memory or attention, the majority of the clinical evidence favours a systematic use of external strategies to manage the functional consequences of cognitive difficulties. Currently, there is no strong evidence that Tai Chi confers particular cognitive benefits for practitioners with neurological conditions, as this outcome has not been studied in existing research. However tentative results highlighting an association between Tai Chi practice and greater higher attentional control for practitioners in the general population (see here for more info) support the inclusion of Tai Chi in any person’s lifestyle to support cognitive health.
The teaching of Tai Chi by someone who is both a clinical neuropsychologist and Tai Chi instructor will ensure the optimal adaptation of the learning and practice of the movements if you have cognitive difficulties as part of your condition.
Fatigue
Fatigue is one of the most common consequences of all neurological conditions. The experience of shutdown when depleted energy has been used up during both mental stimulation and physical activity is profound (influencing mood, cognition, physical functioning), yet poorly understood by people who do not have a neurological condition. Often there are unhelpful comparisons to other people’s experience of tiredness, minimising what is unique about neurological fatigue. Rehabilitation approaches to managing fatigue emphasise activity pacing to conserve the energy that is available to you. Eastern approaches such as mindfulness meditation have also been explored as a therapeutic option.
Within ancient Daoist practices, Qi Gong exercises are designed to actually increase the flow of intrinsic energy in the body through regulated breathing and relaxed bodily postures and/or movements, and are worthy of future scientific study. Some existing investigations of Tai Chi and Qi Gong practices have found reductions in measures of sleep dysfunction, including fatigue, and related practices such as yoga has been demonstrated to reduce fatigue in certain neurological conditions.
Body:
In acquired conditions like stroke, physiotherapy via public healthcare services may be available in the short-term to address physical difficulties such as hemiplegia, gait disturbances, loss of balance, vestibular problems, dyspraxia, and wider sensory or mobility restrictions. However it is a common scenario that many survivors want to receive more and/or ongoing physiotherapy after the public healthcare provision of such has come to an end. While the goal of improved physical functioning is motivating, it can be hard to maintain the regular completion of exercises suggested by therapists. Most physiotherapists will emphasise the ongoing maintenance of functional movement as part of everyday life once formal physiotherapy provision has ended. However it can be hard to remember/cue oneself to utilise a diverse range of movements during everyday tasks.
For these and other reasons, there end goal of improved functional movement of the body and limbs is not sufficient to influence the regular practice of movement exercises over months and years. Other factors are important. The popularity of recent developments within the community sector such as ARNI groups highlights the appeal of a long-term group-based activity where survivors can come together, both working on improving functional movement but also experienced increased social motivation and social cueing to perform the movements by training with others.
A Tai Chi class offers the practice of whole body movements that have been shown to confer physical benefits to people with a range of neurological conditions (see here for more info), and the social motivation/cueing previously described (read more on flowing together in Tai Chi). Furthermore, once the movements are performed safely, the main goal is the state of mind created by the movements (flow), not the perfection of the movements at a physical level. So there is less disconnect between the movements and the goal – you will want to perform the movements not just to achieve something in the future (the physical benefits from ongoing practice), but more importantly to feel good now, in the present.
The movements that generate this state of mind should be ones that are at your own personal level of ability, which seem like a moderate challenge initially but not too daunting. The movements used in Neuro-Flow Groups © and individual sessions have been selected from a range of Tai Chi styles and Qi Gong practices, to allow you to attain a flow state during practice and maintain this over time. As you become familiar with certain movements, new routines can be introduced that increase the physical and cognitive challenge, if desired.
Mind
You may feel that your emotions and thinking has been equally or more disrupted than your bodily abilities following the onset of your condition. Or it may be that your focus is on physical rehabilitation. While you request more physio that is harder to come by, others in your life may be suggesting that you need instead to talk to a psychologist, counsellor or psychotherapist to work on your adjustment to and acceptance of the condition. Or perhaps to manage an immediate form of psychological distress such as anxiety, depression, anger or traumatic-stress. As a clinical neuropsychologist, I can vouch for the value and role of talking therapies within neuro-rehabilitation. However sitting down and talking to a stranger like me for an hour may not always be the best way to receive psychological support for everyone, particularly if you have difficulties with attention or comprehension. In addition, Eastern meditative practices such as mindfulness have been shown to offer benefits for people with a range of neurological conditions, but the similar requirements of these practices on attention can be obstacles for some.
You may personally feel that you would not benefit from a talking therapy or sitting meditative practice, or would like to compliment psychotherapy sessions with an approach that focuses more on your body. In both cases Tai Chi may be a useful way of stilling your mind while performing functional movements. As discussed here in more detail, Tai Chi has been shown to improve mental health and wellbeing for people with different neurological conditions, even when the psychological aspect of practice has not been prioritised by researchers. Neuro-Flow Groups © and individual sessions are uniquely offered with a central focus on psychological wellbeing. These are delivered by a qualified clinical neuropsychologist and incorporates techniques from differing psychotherapies (e.g., cognitive-behavioural, experiential) but adapted responsively for the particular cognitive and physical needs of each survivor.
At the end of the day, someone can perform Tai Chi movements apparently perfectly from an outsider’s perspective, but internally they are giving themselves a hard time and are frustrated at not being good enough. This is not Tai Chi! Performing soft, relaxed flowing movements that you have practiced many times should make you feel better, not worse.
While many people with neurological conditions look for ways to retrain aspects of cognition, such as memory or attention, the majority of the clinical evidence favours a systematic use of external strategies to manage the functional consequences of cognitive difficulties. Currently, there is no strong evidence that Tai Chi confers particular cognitive benefits for practitioners with neurological conditions, as this outcome has not been studied in existing research. However tentative results highlighting an association between Tai Chi practice and greater higher attentional control for practitioners in the general population (see here for more info) support the inclusion of Tai Chi in any person’s lifestyle to support cognitive health.
The teaching of Tai Chi by someone who is both a clinical neuropsychologist and Tai Chi instructor will ensure the optimal adaptation of the learning and practice of the movements if you have cognitive difficulties as part of your condition.
Fatigue
Fatigue is one of the most common consequences of all neurological conditions. The experience of shutdown when depleted energy has been used up during both mental stimulation and physical activity is profound (influencing mood, cognition, physical functioning), yet poorly understood by people who do not have a neurological condition. Often there are unhelpful comparisons to other people’s experience of tiredness, minimising what is unique about neurological fatigue. Rehabilitation approaches to managing fatigue emphasise activity pacing to conserve the energy that is available to you. Eastern approaches such as mindfulness meditation have also been explored as a therapeutic option.
Within ancient Daoist practices, Qi Gong exercises are designed to actually increase the flow of intrinsic energy in the body through regulated breathing and relaxed bodily postures and/or movements, and are worthy of future scientific study. Some existing investigations of Tai Chi and Qi Gong practices have found reductions in measures of sleep dysfunction, including fatigue, and related practices such as yoga has been demonstrated to reduce fatigue in certain neurological conditions.
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