Regular exercise can help people who have sustained a traumatic brain injury in many important ways. Studies have shown that regular physical activity — planned or unplanned — can help with improving emotional regulation, decreasing stress and anxiety, improving our relaxation response, decreasing perception of pain, improving symptoms of fatigue, and neurogenesis: the creation of new connections in the brain.

Understanding what type of exercises to do and how to do it properly can sometimes be a challenge. However, the benefits of regular exercise far outweigh the costs and obstacles associated with it. In this blog, I outline the essential components of an exercise program, in addition to offering four complete exercise programs with modifications to movements and techniques one can engage in having sustained a brain injury.

Essential Components of an Exercise Program

A complete exercise program should incorporate four essential components: warm-up, exercises or circuits, core exercises, and a cool-down with or without deep breathing exercises. Each has a specific purpose and importance to a workout. Below is a brief explanation of each with some general guidelines.

Warm-up: A good warm-up is about 5-10 minutes long and done before the start of a workout, at a lower intensity. Warm-ups help prepare your muscles for activity by dilating blood vessels to deliver oxygen to the working muscles. It also helps increase your heart rate and breathing rate from the resting rates, which minimizes the stress on your heart.[1]

An appropriate warm-up can decrease the likelihood of injury and provides you with feedback on what to expect during the actual exercise session.

Exercise Circuit: the exercise circuit is the heart of the workout and should include a variety of activities that improve strength and endurance. We aim to exercise at a moderate intensity (RPE of 5-6, see below for an explanation and visual of RPE scale). There are small rests between each exercise (as we transition from one exercise to the other) and longer rests between circuits. However, make sure you take a break whenever you need to.

Core Exercises: Core exercises are important for improving balance and stability. Almost all of our daily activities (cleaning, lifting, walking) use our core muscles! When we learn how to use our core and strengthen it, it helps spare our spine from excessive loads that may be placed on it.

Cool-down: After a workout, your heart is still beating faster than at rest, your blood vessels are still dilated and your body temperature is higher. The cool-down allows your body to slowly return to its resting state. Cool-downs often include stretching and breathing exercises (see below for more on breathing exercises).

Four Exercise Programs to Connect Mind and Muscle

As a certified exercise physiologist, I challenge clients with brain injuries to connect their minds with their muscles through a sequence of intentional exercises and movements. Throughout the month of June, I will be hosting a series of four workshops through the Brain Injury Association of York Region to highlight brain injury awareness month.

In this series, participants will improve their intention to movement, challenge their strength and conditioning, and be in touch with moving mindfully. Each program has a unique focus and an easy-to-follow structure.

If you are interested in participating in one of these exercise programs for survivors of brain injuries and their caregivers, register for the online workshops for free or email me to receive a private link to the recorded workshop series.

1. Laying the Foundation – Exercise Program

Focus: “Big 5” exercises + variations

Date: Friday, June 4, 2021 from 1:00PM – 2:15PM

If you want to progress strength, mobility, and endurance, it’s important to have a strong foundation before progressing to the next movement. There are 5 key exercises (with variations) that you should be comfortable performing before progressing to the next stage: Squat, Deadlift, Bent Over Rows, Shoulder Press, and Floor push up. We will also add in Bicep curl.

This exercise program includes:

  • Warm-up
  • Posture and core setting
  • Practice and going over cues to connect mind to body awareness
  • Circuit of 2-3 rounds of 5-8 exercises, 30-45 seconds.
  • Finish with core strengthening
  • Stretching cool down

Equipment options include:

  • Yoga mat
  • Open and safe space to move around (approximately two of your own snow angels)
  • Light resistance bands
  • Weights or household objects
  • Sturdy chair or bolster for sitting
  • Nearby wall or counter top for support (if necessary).

You can learn more about this exercise program for brain injury recovery and watch me or join me as I perform the complete workout in the video above.

2. Mind Muscle Connection – Exercise Program

Focus: Deadlift, direct attention to specific body parts, push-up + pause, squat +pause, isometrics

Date: Friday, June 11, 2021 from 1:00PM – 2:15PM

Exercise is as much a physical workout as it is a mental one, if you’re being engaged correctly! Being mindful, aware, and bringing thought to each movement can make your exercise sessions even more valuable. Having an appropriate mind-muscle connection will enable you to isolate muscle groups appropriately and ensure your form is on point.

This exercise program includes:

  • Warm-up
  • Posture and core setting
  • Practice and going over cues
  • Circuit of 2-3 rounds of 5-8 exercises, 30-45 seconds rounds
  • Intentional stretching cool down

Equipment options include:

  • Yoga mat
  • Open and safe space to move around (approximately two of your own snow angels)
  • Light resistance bands
  • Weights or household objects
  • Sturdy chair or bolster for sitting
  • Nearby wall or counter top for support (if necessary).

You can learn more about this mind-muscle exercise program and watch or join me as I perform the complete workout in the video above.

3. Low Impact and Modified HIIT – Exercise Program

Focus: Intensity, low impact, level changes, and directional changes, modified or mini jumps, get HR up as appropriate, mindful of intensity and education on Borg RPE.

Date: Friday, June 18, 2021 from 1:00PM – 2:15PM

Being able to exercise at an appropriate intensity is always a moving target, especially if you’ve sustained a brain injury. Persistent symptoms, underlying orthopaedic conditions, pain, and dizziness may contribute to not knowing how intense you’re able to bring your exercises.

With low impact, modified High Intensity Interval Training, you’re able to push yourself to an appropriate level, while still respecting some physical and neurological limitations. Using a tool like the BORG Rating of Perceived Exertion Scale (Borg RPE) as a means of gauging intensity, can help you pace yourself and be more in control of your exercise session.

  • Warm-up
  • Practice and going over exercises
  • Circuit of 3-4 different exercises, multiple circuits; 20-30 secs + timed break
  • Intentional stretching cool down

Equipment options include:

  • Yoga mat
  • Open and safe space to move around (approximately two of your own snow angels)
  • Light resistance bands
  • Weights or household objects
  • Sturdy chair or bolster for sitting
  • Nearby wall or counter top for support (if necessary).

4. Strength + Conditioning+ Balance – Exercise Program

Focus: Resistance bands or weights, Resistance focus, isolating muscles, compound movements, dynamic balance with strength and conditioning, feeling smaller intrinsic muscles work to keep balance in check.

Date: Friday, June 25, 2021 from 1:00PM – 2:15PM

In this class, we use the classic principles of strength and conditioning to improve muscular endurance for people who have difficulty with daily tasks and their dynamic balance. Improving one’s strength and conditioning can carry over to better performance of instrumental activities of daily living, while challenging one’s dynamic balance can play a part in falls prevention and gait quality.

This exercise program includes:

  • Warm-up
  • Practice and going over exercises.
  • Circuit of 3-4 different exercises, multiple circuits; 20-30 secs + timed break.
  • Finish with core strengthening.
  • Intentional Stretching cool down.

Equipment options include:

  • Yoga mat
  • Open and safe space to move around (approximately two of your own snow angels)
  • Light resistance bands
  • Weights or household objects
  • Sturdy chair or bolster for sitting
  • Nearby wall or counter top for support (if necessary).

As exercise professionals, we know that everyone can benefit from regular exercise or physical activities when these movements are performed efficaciously. This is even true for people who have sustained a traumatic brain injury.

Although carving out time to be physically active is often challenging, we cannot deny the relationship between the body and brain. Professional guidance from a certified exercise physiologist, who understands the barriers to movement and exercise, can help you achieve your physical activity goals.

Written by

Shriya Maharaj
Shriya MaharajCertified Exercise Physiologist
Shriya believes in finding ways for clients to be active no matter their mobility or fitness level. She uses a combination of education and exercises principles to help clients, including the elderly and those with musculoskeletal, neurological, metabolic and cardiovascular conditions, complete daily activities and manage pain.

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