SAC Profile: Cameron Mang & Brain Power Hour

We are incredibly grateful to the members of our Scientific Advisory Committee for their support in developing evidence-based information for the brain injury community. They are doing great things in their respective fields – like Cameron Mang. As a practicing Kinesiologist and Certified Exercise Physiologist in the field of Neurorehabilitation, Cameron conducts research with real-world implications for people with neurological conditions. He is an assistant professor at the University of Regina, and has developed crucial links between research and community programming, fostering knowledge mobilization. Recently, he shared details of a community program Brain Power Hour.

There is a need for safe community programming for people with brain injury to address secondary impacts of the pandemic. The “Brain Power Hour” program manual will support expansion of low-cost exercise and recreation programs in Saskatchewan

After a brain injury, people experience many life changes, including losses in physical function and decreases in socialization and mental health. Rehabilitation after brain injury often ends within about three years  from the injury, and people are not always able to maintain or build on the gains made in rehabilitation, sometimes regressing. The purpose of this study was to develop an outdoor exercise and recreational walking program and study its impact on the lives of people in late stages of recovery from acquired brain injury.

The “Brain Power Hour” exercise and walking program was developed and implemented with members of the Saskatchewan Brain Injury Association (SBIA) in Regina, Saskatoon and Moosejaw in the spring and summer of 2021. Across Saskatchewan, 22 program participants consented to be involved in the study. Participants attended up to two, one-hour weekly group exercise and/or walking sessions. A researcher and program facilitator conducted interviews with participants in Regina during program delivery. Program facilitators recorded field notes describing notable experiences with the program.

Interview findings suggested that many people with acquired brain injury are not able to exercise or participate in recreation independently due to functional challenges and safety concerns. Individuals commented on the COVID-19–related disruption of therapy and community programming, which contributed to functional challenges, loneliness, and decreases in well-being. Interview responses suggested that the “Brain Power Hour” program provided a means to mitigate these negative impacts by providing physical and social benefits.

This project was made possible by the Saskatchewan Brain Injury Association (SBIA) and was funded by the University of Regina Community Engagement and Research Centre – ‘Community Research and Action Fund”. Student funding for Ms. Jeannie Postnikoff was provided by the Saskatchewan Centre for Patient-Oriented Research.

Motivate yourself to complete physical activity

For many people, a barrier to physical activity is that they don’t want to do it. This could be because they view it as challenging or unenjoyable. You may feel the same way, even though you know physical activity of any kind is good for you.

If you struggle with motivation when it comes to physical activity, here are some tips to help get you excited about moving.

1. Set goals

Many people work better when they have something to move towards. The same is true of physical activity. By setting goals, you will be more motivated to complete activities.

Example: Sarah wants to be able to walk a 5 kilometre race route. Every time she goes on a walk, she goes a little further each time.

Example: Bill wants to be able to touch his toes. He does simple yoga stretches each week to help improve his flexibility.

Your personal goals can be set around time, distance, an action – whatever you want. And when you reach those goals, don’t forget to celebrate them!

2. Create a reward system

Rewards are a great way to motivate yourself, particularly if you find that other motivation tips haven’t worked for you. By incorporating rewards into your physical activity plan, you associate the activity with something you want.

Example: If Ian goes on a walk 5 days a week for a month, he’ll get himself a present he’s wanted for a long time.

Example: If Eleanor completes all her at-home exercises for 6 months, she’ll reward herself with a trip to see the Atlantic Ocean.

Rewards can be short-term or long-term, and they can be anything. This could include a take-out dinner, a new outfit, or an hour of television. The choice is up to you!

3. Pick activities you enjoy

You won’t like every activity, and that’s totally normal. Many people engage in activities they don’t love because they think they have to do it to be healthy. But that’s not true!

For example, if you don’t like running, you don’t have to run. There are plenty of ways to move. By picking the activities you enjoy, you’ll be more likely to exercise – and like it.

Example: Jamie feels good when they stretch, so they do yoga 3 times a week.

Example: Cynthia tried doing pushups, but they weren’t the right fit for her. She now uses small wrist weights.

4. Ask friends or family to do it with you

When you have someone completing activities with you, it’s another external motivator that can make physical activity enjoyable. You can set goals or set up a friendly competition, and spend some quality time with them.

Example: Joanna and her sister use Zoom to perform a series of exercises together.

Example: Glen and his son go on walks together.

5. Track your progress

It can be kind of discouraging not to see any progress when you exercise. Progress with exercise isn’t something you can see quickly or easily. It’ll take time.

One way to see your progress and keep yourself motivated is to track your exercise. You can use this downloadable physical activity tracker, or use your own system (like an app on your phone) to record your exercise. Over time you will see your progress: you may lift more weight, walk farther, or do something faster.

Example: Marcus started being able to walk 1 kilometre in 20 minutes. 6 months later he can walk 1 kilometre in 15 minutes.

Example: Sandra started lifting 3 lbs. weight, and 3 months later was up to 5 lbs. weights.

6. Use music to motivate you

Many people enjoy music. It can be incredibly uplifting and influence mood and attitude. By incorporating music into your physical activity, you can increase your enjoyment.

It also doesn’t have to be music. Some people like to watch television or movies or listen to podcasts while they exercise.

7. Adjust how you define successful physical activity

Physical activity can quickly become a chore or feel like an obligation. While it is an important part of healthy living and rehabilitation, you should not punish yourself if you miss a session or don’t reach a goal.

Instead, change how you view successful physical activity. It doesn’t have to be all or nothing. Any exercise is better than none. And if you miss a day? That’s okay!

8. Schedule your exercise, and pick a time when you have the most energy

Many people have full days with lots going on, and try to cram physical activity into an already packed schedule. This can lead to some stress and often a lack of motivation.

Scheduling your physical activity can help ensure you have the time for it. You should also pick the times you have the most energy: for example, in the morning after you have breakfast.

Ideas for physical activity

Physical activity has a broad definition, and there are plenty of ways you can move. And remember – any sort of movement is better than nothing. If you are concerned about what forms of activity you can engage in, speak with your medical/rehabilitation team. They will have recommendations for you.

Some examples of physical activity include:

  • Walking
  • Dancing
  • Running
  • Swimming
  • Bicycling
  • Online fitness classes
  • Yoga
  • Stretching
  • Lifting weights
  • Outdoor games like catch
  • Jump rope
  • Community sports clubs for soccer, basketball, baseball, etc.
  • Skating
  • Tennis
  • Cleaning/yard work

This is just a small selection of possible physical activities. And remember, exercise is not just for your physical health – it helps with your mental and emotional health as well. That’s why it’s important to find activities you enjoy and make sure you include them in your daily living.

Exercise after brain injury

Many people may be nervous to try exercising after brain injury in case they make their symptoms worse. But when you start slowly, complete your exercises safely and listen to your body, it can have a lot of benefits for your brain health. This is the reason many health professionals make recommendations for physical activity as part of a brain injury recovery plan.

Please note: You should always consult with your doctor or primary care physician about what exercises are appropriate for you. Not all exercises or exercise programs will be safe or effective for you.

The benefits of exercise after brain injury

Improved mood

Regular exercise that increases the heart rate can cause the release of serotonin and dopamine, which help alleviate feelings of depression [1]. Endorphins from exercises are also associated with improved mood [2].This means that exercise can actually help make you feel happier.

Support for brain healing & function

Studies into the effects of exercise on brain injury survivors have shown that individuals with traumatic brain injury (TBI) who exercised, had fewer cognitive, physical, and emotional symptoms [3]. Additional reviews of existing studies demonstrated that physical exercise also has a positive effect on cognitive functioning [4,5]. This includes thought processing and memory. According to research [6], the physiological factors of exercise that contribute to improvements in cognition include:

  • Increased blood flow to the brain
  • Changes in the brain involved in cognitive behaviour

Support for bodily health & well-being

The main purpose of exercise for the majority of people is to improve their physical health. Different types of exercises can strengthen the heart, lungs, and muscles. It’s an essential building block for a healthy lifestyle.

Exercise comes in many forms – you don’t have to be at the gym to be healthy, and you don’t have to exercise for hours at a time. The health benefits come from being consistently active in your day to day life to the best of your ability. Walking or stretching can be as beneficial as strenuous activities: it’s all dependent on what your body is able to do and what it needs.

The challenges of exercising after a brain injury

After a brain injury, you may face some challenges when it comes to exercise:

  • Changes in physical capacity and mobility
  • A lack of motivation, interest or energy
  • Symptoms such as fatigue and headaches that may impact your abilities
  • A lack of access to appropriate physical rehabilitation, exercise space or appropriate equipment
  • Not enough support

While these definitely are challenges, that does not mean it’s impossible for you to exercise and receive the benefits. It just means that you may have to get creative.

Physical rehabilitation

Physical rehabilitation (physiotherapy) is one of the most common therapies for people of all abilities. It can be helpful for people with brain injury who are experiencing challenges with mobility, strength, balance, and cardiovascular fitness. A physiotherapist will perform an assessment and work directly with you to develop a treatment plan based on your challenges and your goals. The treatment plan will largely consist of exercises or physical motions that will be modified to your needs so that you can replicate them at home. It may be recommended that you continue the exercises at home to the best of your ability either on your own or under someone else’s guidance.

There are both private and public physiotherapy practices, and you may be covered for some of the costs through your provincial/territorial insurance plan, a private insurance plan, or an auto insurance plan (depending on the cause of your injury and type of coverage).

Types of exercises

Aerobic exercise

Aerobic exercise can also be known as cardio: in other words, any type of exercise that strengthens the cardiovascular system (your heart and lungs) [7]. Types of aerobic exercises include walking, running, cycling, or swimming. Aerobic exercises are meant to increase your heart rate, and are done for longer periods of time on a consistent basis.

A 12-week study on the effects of aerobic exercise on depression symptoms in those with traumatic brain injury (TBI) found that participants had higher self-esteem, improved cardiovascular function, and fewer symptoms of depression [8].

Aerobic exercise is often connected to a healthier heart, but it has tremendous effects on body and brain health as well. Check with your doctor to make sure you understand what you are able to do safely for exercise. You may not be able to go for a run, but you could go for a walk.

If you need some extra support for your aerobic exercise, there are assistive mobility devices that may be helpful for you.

Strength & conditioning exercise

For individuals with muscle weakness, strength and conditioning exercises after brain injury can be incredibly beneficial. Types of exercises that can help with strength and conditioning include resistance training, which can include using body weight or using free weights.

The key to strength and endurance training is patience. You don’t want to push yourself too hard or too quickly. Working with a physiotherapist or occupational therapist on a recovery program can be beneficial and help you progress safely.

Range of motion exercise

Range of motion (ROM) exercises can also be called flexibility and mobility exercises. Depending on the physical effects of your injury, you may be experiencing problems with your muscles or joint tightness. The purpose of ROM exercises is to help increase muscle flexibility and joint mobility. With time and patience, these types of exercises can help you move more easily (such as lifting your arms or bending your legs).

Balance exercise

Many individuals struggle with balance after brain injury. Balance is the ability to keep yourself centered.  Specific exercises can help you work on your balance and make you feel steadier as you move through your day.

Remember – any exercise is a gradual process. You may be feeling good one day, and not as great the next. And that is totally normal – the important thing is to take it slow and not get discouraged.

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