Gym for the brain – how do you do it? Life with MS

Feeling less sharp than before? Is it harder for you to concentrate? Are you afraid of forgetting details if you don’t write them down? A brain gym is a form of practicing the functions of thinking that can preserve and even improve thinking abilities over time. So how do you do it in practice?

People with multiple sclerosis often face cognitive changes. These changes often appear gradually, and not always as part of an attack, so they can develop slowly over time. ¹

What can be done with cognitive changes?

First, it is important to emphasize that with the help of correct practice it is possible to change the cognitive state. Just as we can change our physical condition by training that includes strengthening muscles and increasing the flexibility of the joints, so it is also possible to train the thinking functions, prevent or slow down future deterioration, and even improve the existing condition. The human brain is flexible, and the nervous system has the ability to change and shape itself. This ability is called “brain plasticity”. At any age there is the possibility of creating new connections between the different parts of the brain. These connections are called synapses, and the more their number increases, the more efficient the thinking functions. ²

New synapses are built when performing actions that challenge the different parts of the brain.

Our daily activities can be divided into two: ³

Productive activities

Productive activities – these are challenging cognitive activities that activate active learning processes. In these activities cognitive abilities such as working memory, the ability to solve problems, the ability to draw conclusions and more are used.

Productive activities

Automatic activities – these are activities that are carried out throughout the day, without activating new learning processes. The automatic activities do not require the use of much brain energy, which is an energy conservation mechanism of the brain. For example, performing automatic actions such as brushing teeth or even crossing a road, do not require an investment of cognitive energy from a mature person. Automatic activities do not help produce new brain synapses.

What are productive actions that could contribute to brain changes?

In order to create effective training for the brain, it is necessary to practice new activities that challenge the various thinking abilities, and especially those that require the use of several cognitive abilities at the same time . For example, practicing an activity that requires the use of memory abilities, information processing, problem solving and drawing conclusions together. An excellent way to practice cognitive abilities is by participating in recreational activities that are cognitive in nature. Among them are thinking games and computer programs designed for cognitive practice. For example, practicing Sudoku requires the use of attention, memory, drawing conclusions, problem solving, and more. The practice should be incorporated into your daily life on a regular basis, as will be explained later ³ .

Software and apps for cognitive practice

In recent years, the field of computer software for cognitive practice has been developing. At the same time, the field of thinking game applications on the smartphone or tablet is also developing – which, although not specifically developed for cognitive training, are very suitable for this type of practice. The advantages of cognitive training through computer programming and game applications are the high accessibility, the ease of operation, the ability to train and continue playing in a variety of different environments (when using a smart phone or tablet), as well as the dynamism when using games – something that increases the desire to perform more practice.

Some of the software and computer mind games can be downloaded and used for free, which makes them even more accessible. The digital thinking games allow a lot of practice, over time, which increases in difficulty and cognitive requirements. The games are interactive, attractive, and cause enjoyment alongside active practice of thinking abilities.

Principles for performing a brain gym

First, it is important to choose interesting activities that are close to personal interests in order to increase motivation. After that, it is necessary to integrate the practice into everyday life, throughout the week. As with physical training in the gym, you should build a weekly training program in which specific times are dedicated to performing the exercise. The frequency of training can gradually increase starting from training twice a week, up to a recommended dosage of three to five times a week. The recommended length of training is half an hour to an hour. Studies show that after about half an hour of cognitive training, new brain synapses begin to form, so half an hour is the minimum recommended period of time for such practice. ⁴

Computer software for cognitive practice

There are many cognitive practice software on the market that were developed specifically for this purpose. These programs adjust the level of difficulty automatically, according to the abilities and personal needs of each user. Depending on the progress in the practice, the training changes and increases in difficulty. For the most part, in these programs you can receive feedback after each practice about the progress in the practice program. Most of the software is connected to a support center for answering questions and learning how to use the software. Some of the companies even have physical branches where you can go to practice – accompanied by a professional. You can find programs for cognitive practice developed abroad, so the practice will be in the English language, or programs that offer practice in the Hebrew language. The computer programs for brain training are commercial and the practice is possible after registration and making a monthly payment. To find this type of software, you can type in Google search terms such as: brain training, cognitive training or cognitive training.

Thinking games (apps) on smart phone and tablet

Mind games that can be effective for cognitive practice are evolving all the time.

Practice in these games has several characteristics:

• Most of the games are free, but include advertisements that appear during use.

• The games can be downloaded from the app store installed on the device, where you can also search for suitable games.

• Using the games is very enjoyable. You should choose games that, in parallel with brain training, also provide a sense of pleasure and satisfaction, as well as a desire to continue playing them next time as well.

• You should choose games that challenge your thinking abilities, but not games that are too difficult, which will reduce the motivation to continue practicing.

• It is recommended to choose games with many stages, which will allow continued practice over time.

• During practice, you can combine the use of several applications in one training session, to avoid quickly exhausting each game.

• Most of the thinking game apps are suitable for use on a smart phone, which definitely increases the accessibility of the game. However, using these games on a tablet device is more convenient. The screen is bigger and allows you to see the different objects easily, and the hand gestures are simpler, so the operation of the game may be easier.

In order to find thinking game apps, you can write search terms in the app store such as: thinking games, logic games, puzzle games, logic games. In the list that appears you can read a description of each game and download it. After finding a suitable and interesting game, you can enter the app store again and look for the “similar games” tab on the game page. In this tab it will be possible to find additional games that could also be relevant for practice. In this way, you can switch from game to game and find several relevant applications.

What to do after downloading appropriate apps?

• For starters, it is recommended to download 3-4 game apps and try using them. Sometimes the apps will be suitable and the practice in them will be useful and fun, but sometimes the app will turn out to be inappropriate or far from the personal interests. In this case, you can delete the application that is not suitable and continue searching for other applications.

• When learning a new game, it is recommended to be attentive to the instructions of the game and not to skip the first steps, even if they are easy, since in these steps a learning process of the game is created. Sometimes it will be convenient to cancel the music that is activated when using the application, in the game’s settings menu, and this is because the music can be a distraction and damage the learning process of the game itself.

• The advertisements that usually appear when using game applications can also be a distracting factor, and to avoid them you can play the application when the Internet is not connected. If the internet is connected, and advertisements appear, close them and continue playing normally.

• As the practice progresses, you should download more difficult and challenging apps, which can help in further cognitive training. It is possible that at this stage it will be possible to return to applications that were downloaded earlier, but were too difficult, and therefore not used.

In conclusion, people with multiple sclerosis often face cognitive changes that appear gradually. Cognitive abilities can be preserved, and sometimes even improved, by brain training known as “brain gym”. Brain training can be done in a fun way during your free time. The training should be done at regular times by using digital thinking games, which challenge the various thinking abilities, and increase the motivation to continue practicing.

The author: Dr. Noa Givon Shaham, PhD, an occupational therapist specializing in geriatrics

Sources:

1. Rocca et al. Lancet Neurol, 2015; 14:302-17.
2. Sasmita et al. Int J Neurosci, 2018; 128:1061-77.
3. Park et al. Psychol Sci, 2014; 25:103-12.
4. Owen et al. Nature, 2010; 465:775-8.

Video: “Rehabilitation of the patients with Multiple Sclerosis”

MULTIPLE SCLEROSIS. EXERCISES FOR STRETCHING AND IMPROVING BODY FLEXIBILITY AND JOINT MOBILITY, REDUCING TONE

For additional information about Rehabilitation of the patients with Multiple Sclerosis you can watch a video demonstrating exercises and rehabilitation recommendations.

Check out the demo version of our sets of exercises for Multiple Sclerosis on YouTube

You can find more information about  Multiple Sclerosis in our Library of Articles.

Our website presents the following sets of exercises for the rehabilitation of the patients with Multiple Sclerosis:

1. MULTIPLE SCLEROSIS. EXERCISES FOR STRETCHING AND IMPROVING BODY FLEXIBILITY AND JOINT MOBILITY, REDUCING TONE

2. MULTIPLE SCLEROSIS. EXERCISES TO STRENGTHEN THE MUSCULOSKELETAL AND MUSCULAR SYSTEM, ENDURANCE

3. MULTIPLE SCLEROSIS. EXERCISES TO IMPROVE COORDINATION, BALANCE AND GAIT

4. MULTIPLE SCLEROSIS. STRETCHING AND WORKING WITH A MASSAGE ROLLER. ADVANCED STAGE OF REHABILITATION