Effectiveness of Brain Gymnasium for Motor and Cognitive Impairments through the Unaffected Hemisphere in Post-Stroke Individuals

Abstract

Background: Stroke, a leading cause of death and disability in India, often results in cognitive and motor impairments due to disrupted blood flow to the brain. The most common type, ischemic stroke, deprives the brain of oxygen and nutrients, leading to various neurological deficits. Recovery heavily depends on neuroplasticity, where the brain reorganizes itself to compensate for damaged areas, with both the affected and unaffected hemispheres playing a role in motor and cognitive recovery. The unaffected hemisphere plays a crucial role in compensating for lost functions, aiding in the re-establishment of motor control and coordination during stroke recovery. Brain Gym, an intervention based on kinesiology, uses targeted exercises to stimulate cognitive and motor functions, including activities like puzzle solving and sensory stimulation, to support rehabilitation in stroke survivors.

Method: An interventional study was conducted at Krishna Vishwavidyapeeth, following institutional review board and ethics committee approval, to assess the effectiveness of brain gymnasium techniques in improving motor and cognitive impairments in post-stroke individuals through the unaffected hemisphere. The study involved 30 participants selected based on inclusion and exclusion criteria, with a 3-week program conducted six times a week. The primary goal was to evaluate the efficacy of this intervention in enhancing motor and cognitive skills, contributing to evidence-based practices in neurological rehabilitation.

Result: The brain gymnasium intervention significantly improved both cognitive and physical functions in post-stroke individuals. MoCA scores increased from 13.1 (SD = 2.280) to 21.9 (SD = 2.076) with a P-value < 0.0001. Motor function (Fugl Meyer) improved from 34.7 (SD = 3.261) to 58.6 (SD = 4.054), joint ROM increased from 13.2 (SD = 2.524) to 19.6 (SD = 1.905), sensation improved from 5.4 (SD = 1.102) to 10.0 (SD = 1.438), and joint pain reduced from 11.8 (SD = 2.069) to 19.2 (SD = 2.212), all with P-values < 0.0001, highlighting the intervention's effectiveness in enhancing cognitive and physical recovery.

Conclusion: In conclusion, the brain gym program targeting the unaffected hemisphere significantly improved cognitive and motor functions in stroke patients. Using sensory stimulation, bilateral exercises, and therapies like mirror box therapy and PNF, participants showed notable gains in motor skills, joint ROM, sensation, and cognition, highlighting its effectiveness in enhancing neuroplasticity and recovery.