Saturday, 14 June 2008

The Plateau and 'Bedding Down' Gains

I introduced the idea of a plateau in a previous post, Beware the Plateau! I have two reasons for not liking the concept of a plateau: the first I discuss in the post, The Plateau and Switching Activities, and the second here.

The discussion of the Concept of a Plateau under Myth 3 of Debunking Ten Myths of Brain Injury Recovery makes a further point. It's that TBI recovery can be made up of "fits, starts, and bursts, often interspersed with periods of apparently little change, or even falling back."

My sister has spoken to me before about a 'bedding down' period that happens as the brain properly absorbs new information and starts changing behaviour. Obviously, when the brain gets injured, bedding down can take longer. Accordingly, the times of "little change" can just be times of bedding down. Further gains will happen after the ones already made are bedded down.

In my balance example, the bedding down of gains came as I slowly realised that a lack of core strength in my trunk was contributing to my poor balance. What was required to help that was sticking with exercises that improved that strength. The 'bedding down' happened as I realised one cause of my problems and then set about working on specifically on that.

The bedding down of gains makes it dangerous to write off the possibility of more changes just because changes slow down. There is nearly always more scope to recovery, there is always reason to think about how to recover!

Cheers,
Mike

1 comment:

Kate said...

Hi Mike, I found your recent posts about plateauing so timely. To quote you "A "plateau" can be used as an excuse by TBI recoverees, by families, even by therapists and specialists to stop making an effort; to slacken off; to "take it easy", when doing so can lead to the recoveree missing out on valuable care". I am challenging just that phenomenon at the moment, which I find somewhat surprising at a rehab facility. Thanks for reconfirming my beliefs and recharging my batteries!! Kate