Highs, Lows, and Plateaus: A Path to Recovery from Stroke

By Anne Burleigh Jacobs

Stroke survivors, health care professionals working in rehabilitation, and anyone whose life has been affected by a stroke, will find critical information in Highs, Lows, and Plateaus.

Anne Burleigh Jacobs, PT, PhD, a neuroscientist and a physical therapist with a successful track record of helping patients recover from stroke, explores complex topics in an easy-to-understand and conversational tone. Using real examples and powerful analogies, she leads readers along a path of recovery.

From the initial injury, to mechanisms of recovery, to the future of rehabilitation, you will get guidance on:

recognizing the initial signs of a stroke and the importance of emergency treatment;
understanding the physical and neural processes associated with rehabilitation;
understanding the concepts of neuroplasticity that drive recovery of the brain;
providing useful resources and ideas to progress one through the stages of recovery from stroke.

Dismissing the negative connotations of plateau, this book provides hope and inspiration along the continuum of recovery. Each step along the path is supported by basic science, concepts of neuroplasticity, and the resilience of the human spirit. Filled with illustrations, this guidebook to recovery from stroke also includes information that can be helpful to those who have suffered a traumatic brain or spinal cord injury.

Dr. Jacobs is innovative and displays initiative in developing new ideas to help people with neurological disabilities. In her private practice, she was among the first in applying the concepts of neuroplasticity in therapy.
Jack and Cyndy Bradley, stroke survivors

• Language: English
• Publisher: AuthorHouse
• Release date: Mar 13, 2014
• ISBN: 9781491862292

Anne Burleigh Jacobs

AU's instructions: this will not appear on back cover of soft copy. Anne Burleigh Jacobs, PT, PhD, earned a physical therapy degree from the University of Colorado in 1985 and a doctorate in Neuroscience and Physiology from the Oregon Health Sciences University in 1995. She specializes in post-stroke recovery through her private practice, provides research consultation to technology companies, and teaches neuroscience and movement science courses. Dr. Jacobs was a contributor to the textbook, Neuroscience: Fundamentals for Rehabilitation and has lectured nationally and internationally on topics related to neuroscience, recovery of sensory and motor function, and motor learning. As a co-founder of the Peninsula Stroke Association (now Pacific Stroke Association), Dr. Jacobs remains committed to education and advocacy for stroke prevention and recovery.

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© 2014 Anne Burleigh Jacobs, PT, PhD. All rights reserved.

No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.

Published by AuthorHouse 07/22/2015

ISBN: 978-1-4918-6231-5 (sc)

ISBN: 978-1-4918-6230-8 (hc)

ISBN: 978-1-4918-6229-2 (e)

Library of Congress Control Number: 2014902856

Any people depicted in stock imagery provided by Thinkstock are models,

and such images are being used for illustrative purposes only.

Certain stock imagery © Thinkstock.

Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

CONTENTS

Acknowledgements

Introduction To The Author

Preface

Chapter 1. What Is A Stroke?

Chapter 2. Emergency Treatment Of Stroke

Chapter 3. Stroke Strikes Anywhere, Anytime

Chapter 4. The Not So Obvious Effects Of Stroke

Chapter 5. History And The Plastic Brain

Chapter 6. Restoring Electrical Pathways

Chapter 7. Plateau Is Not A 4-Lettered Word

Chapter 8. Injury To The Brain And Then What

Chapter 9. Stages In The Continuum Of Recovery

Chapter 10. Requirements For Learning And Plasticity

Chapter 11. Emerging Tools In Rehabilitation

Chapter 12. Simple Rules To Promote Improvement

Appendix. References And Recommended Reading

About The Author:

ACKNOWLEDGEMENTS

I want to thank my husband, Ron Jacobs, PhD and my daughters, Heather and Merel, for their insistence that I write this book and for their creative insights for the cover design. Also, thank you to Rosalie and Stephen at AuthorHouse for their assistance in creating the illustrations. Lastly, I want to acknowledge the many, many survivors of brain injury that I have been blessed to know over the years. They have shared with me the power behind personal resilience and taught me that to survive is not enough. One must also thrive.

INTRODUCTION TO THE AUTHOR

This book is inspired by years of research, teaching, and clinical practice developed around the concept of Neuroplasticity and the phenomenal capacity of the human brain and spirit to overcome injury.

The author, Anne Burleigh Jacobs PT, PhD, graduated with a Bachelors Degree in Physical Therapy in 1985 and a Doctorate in Neuroscience and Physiology in 1995. As a licensed Physical Therapist, she has worked in private hospitals, university hospitals, nursing homes, home-care settings and in her own private clinic. During graduate school she had many amazing opportunities. While at the R.S. Dow Neurological Sciences Institute in Portland Oregon, she was exposed to rat spinal cord preparations, single cell thalamic recordings in raccoons, spinal cat locomotor studies, and human balance studies. In addition to her own research under Fay Horak, PT, PhD at the R.S. Dow Neurological Sciences Institute, Dr. Jacobs was also able to study at multiple laboratories including the Biomechanics Laboratory in Waterloo, Canada; Queens Square Neurology Hospital in London, England; and Clinical Wintersol in Tenerife, Spain.

After earning her PhD, Dr. Jacobs taught neurology, neuroanatomy and human physiology at the Hogeschool Enschede in The Netherlands and was a visiting lecturer at multiple other Physical Therapy programs in The Netherlands. She also had the opportunity to assist in developing a public program and research line for Parkinson’s Disease studies and assisted in graduate student projects at the University of Twente. While living in the Netherlands, Dr. Jacobs edited and contributed to the 1st edition of the textbook, NeuroScience: Fundamentals for Rehabilitation.

Upon returning to the United States, Dr. Jacobs began teaching continuing education courses through The Dogwood Institute and became one of the founders of the Peninsula Stroke Association (now Pacific Stroke Association) where she served as the Executive Director during the first three years of the fledgling non-profit organization. She developed all of the programs and has spoken with hundreds of small groups to teach about the warning signs of stroke and the potential of post-stroke rehabilitation.

Pursuing her love of teaching, Dr. Jacobs sought out opportunities as an instructor at numerous universities in degree programs for physical therapy as well as at continuing education courses for health care professionals. At the same time, building her private practice – SensoMotor Neurological Rehabilitation, LLC. Recently, she has provided consultation to companies developing robotics, bionics, and orthotics for neurological rehabilitation.

It is with this diverse background and an ever-burgeoning love of neuroscience, that Dr. Jacobs writes this book. It is an attempt to bridge the gap between medicine, rehabilitation, basic science research and the stroke survivor. A friend in graduate school once dubbed her as The Librarian, because of her voracious appetite for reading research and neuroscience text books in her spare time and then knowing which reference to bring into a conversation at any give time. The goal of this book is to bridge the gap by creating a useful and easily understandable connection for the reader.

Recovery from neurological injury is a long, long road with highs, lows, and plateaus – but each day is a new day toward reaching one’s goal.

PREFACE

As a new graduate from physical therapy school, I took my first job at a small private hospital in Denver, Colorado. A new physiatrist – doctor of physical medicine and rehabilitation - had recently joined the staff and he was going to develop a comprehensive stroke rehabilitation program with PT, OT, Speech and Family services. I was so excited to be part of something that fueled my fascination with the brain and nervous system!

I still remember the day I met Steve. Well, I can’t say that we met, but at least I knew about him. He was a young man and he was in the Neuro ICU. I was working with a patient on the other side of the curtain, when I overheard the neurosurgeon tell Steve’s wife that she should accept the fact that her husband would need to go to a care facility/nursing home. With the severity of the stroke he suffered, he would never walk again or be able to live independently.

I was bold. I was brazen. I was naïve. I approached the neurosurgeon and told him about the new comprehensive stroke rehabilitation program and suggested that he refer Steve for physical therapy. He actually laughed and then said, O.K. Good luck with this one. Anyone who knows me knows that I love a challenge. But it was more than that. I truly believe in the potential of the human brain and the resilience of the human spirit. I believed that a young man with a new wife, a new career and a chance at life would make a good recovery.

There were other therapists who worked with Steve, but I remember Pam. She and I put in a lot of extra time together. Too much time has passed for me to remember