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Fatigue and the Role of Stress in the Stroke Survivor A/Prof Michelle Byrnes

Fatigue and the Role of Stress in the Stroke Survivor A/Prof Michelle Byrnes. FATIGUE / STRESS ?. National Stroke Foundation (September 2013) : “The Needs of Stroke Survivors in Australia” 765 Stroke Survivors Across Australia (Regional & Rural)

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Fatigue and the Role of Stress in the Stroke Survivor A/Prof Michelle Byrnes

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  1. Fatigue and the Role of Stress in the Stroke Survivor A/Prof Michelle Byrnes

  2. FATIGUE / STRESS ? National Stroke Foundation (September 2013) : • “The Needs of Stroke Survivors in Australia” • 765 Stroke Survivors Across Australia (Regional & Rural) • Included questions regarding Health, Everyday Living, Work and Leisure, Family Friends and Support, and Financial Needs

  3. HEALTH NEEDS National Stroke Foundation: “The Needs of Stroke Survivors in Australia”

  4. CONCLUSIONS National Stroke Foundation: The Needs of Stroke Survivors in Australia • 765 Stroke Survivors Across Australia (Regional & Rural) • Survey reinforced the clear message from Stroke Survivors and Carers in their “Call to Action: Fight Stroke” document released in 2012. • Stroke Survivors are telling US LOUDLY that there must be changes to the way they are supported and receive therapy after Stroke. • There must be changes to ensure that Stroke Survivors and their Carers can access the care they need. • There must be changes so that Stroke Survivors no longer fall through the cracks of a health and welfare system that is not geared to meet the specific needs of Stroke.

  5. Neuroplasticity and the Art of Using the Brain Wisely to Enhance Psychological, Cognitive and Physical Functioning A/Prof Michelle Byrnes

  6. Measuring Neuroplasticity and Its Relevance CEREBRAL PALSY- reorganisation of motor representation disassociated from sensory WRITER’S CRAMP - correlates with BoTox TORTICOLLIS – hand maps – reverse with BoTox MULTIPLE SCLEROSIS- correlates with EDSS STROKE - correlates with strength PARKINSON’S DISEASE- correlates with UPDRS

  7. MRI vs. FMRI MRI studies brain anatomy. FunctionalMRI (fMRI) studies brain function.

  8. Measuring Neuroplasticity and Its Relevance

  9. NEUROPLASTICITY

  10. CLIENT SELF - EFFICACY

  11. ACCEPTANCE AND COMMITMENT THERAPY (ACT) • Most models of therapy are focused on symptom reduction • Assumption is that clients need to reduce their symptoms before they can lead a better life. • Whereas ACT assumes that quality of life is primarily dependent on mindful, values-guided direction. • Behavioural therapy with emphasis on values-guided direction. • “What do you want to stand for in life?” • Core values are used to guide, motivate, and inspire behavioural change that enriches your life. “Be yourself: everyone else is taken.”

  12. ACCEPTANCE AND COMMITMENT THERAPY (ACT) Six Core Therapeutic Processes: • Self-conceptdevelops flexibility in how the person views and defines themselves. • Defusion involves “stepping back” and detaching from thoughts, images and memories and promotes behavioural flexibility. • Acceptance teaches the individual to embrace emotional and cognitive events/experiences without attempts to change. • Mindfulness teaches perspective on the present rather than dwelling on thoughts and experiences in the past or projected future. • Values clarifies for the individual the domains of life most meaningful for them. • Committed actionfollows through in the direction of goals and future quality of life priorities.

  13. FATIGUE AND STRESS • Fatigue is “extreme tiredness resulting from mental or physical exertion or illness”. • Stress is “a state of mental or emotional strain or tension resulting from adverse or demanding circumstances”. Reconnect Brain, Mind, Body and Spirit • Physical Exercise / Practice • Mental / Cognitive Exercise / Practice • Emotional Exercise / Practice • Living a Meaningful and Valued Life

  14. EXERCISE / PRACTICE / THERAPY • Exercise is derived from the Latin root meaning “to maintain, to keep, to ward off”. • Exercise is to practice, put into action, train, perform, use, improve. • “Mindful Movements” • Adaptive & “Progressive Overload” & Training Reconnect Brain, Mind, Body and Spirit • Physical Exercise / Practice • Mental / Cognitive Exercise / Practice • Emotional Exercise / Practice • Living a Meaningful and Valued Life

  15. HEALTH NEEDS National Stroke Foundation: “The Needs of Stroke Survivors in Australia”

  16. ICE BERG ANALOGY Stroke Survivor Medication Depression Insomnia Anxiety / Panic Attacks Relationship Issues / Intimacy Adjustment Difficulties Stress Pain Self Concept Fatigue / Burn Out Lifestyle Changes Anger

  17. RETRAINING PROGRAMS Post Stroke Retraining Packages: • Since 2010, my team and I have designed and utilize various Integrated Holistic Retraining Programs with individuals with Neurotrauma (Stroke, Traumatic Brain Injury, Brain Tumors) and Neurological Disorders (Multiple Sclerosis, Parkinson’s Disease) based on NEUROPLASTICITY. • Each program is specifically designed to target the Emotional, Cognitive and Physical Domains in which the Stroke Survivor is experiencing difficulties. • Programs incorporate Individual Therapy and/or Computer Based Programs carried out with our Multidisciplinary Teamsof Clinicians / Researchers. • ADAPTIVE: Adjusts the complexity level for each meaningful exercise, in real time, for maximum training effect. • Neuroplasticity Retraining Therapy Programs > 1 year and beyond. • Targeted to “Living a Life of Meaning and Value”

  18. EMOTIONAL / COGNITIVE / PHYSICAL THERAPY • Individual and Group Therapy (Clinical & Research Settings) • Pacing / Practice / Perseverance / Precision Testing • Repetitive, Adaptive, Creative & Experiential Acceptance and Commitment Therapy (ACT) PLUS … • Fatigue & Fitness: Psychology, Exercise Physiology, Eng & IT • Cognitive Retraining: Psychology, Exercise Physiology, Eng, IT • Virtual Reality: Psychology, Exercise Physiology, Eng & IT • Return to Driving: Psychology, Exercise Physiology, Eng & IT • Pain & Pacing: Psychology & Exercise Physiology, Eng & IT • Art / Singing / Dance: Psychology & Art / Physical Therapist • Fluency & Confidence: Psychology & Speech Pathology

  19. NEUROPLASTICITY EXTRAORDINAIRE

  20. NEUROPLASTICITY EXTRAORDINAIRE

  21. NEUROPLASTICITY EXTRAORDINAIRE

  22. NEUROPLASTICITY EXTRAORDINAIRE

  23. NEUROPLASTICITY EXTRAORDINAIRE

  24. NEUROPLASTICITY EXTRAORDINAIRE

  25. Dr Michelle Byrnes michelle.byrnes@wanri.uwa.edu.au info@growyourlife.com.au

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