Massed Practice: Why High Repetition Is Excellent for Recovery

Massed practice is one of the most important concept for recovering from a neurological injury. Almost all rehabilitation methods revolve around it, because it’s the key to recovery.

Massed practice, at its most basic definition, involves continuous practice of a task without rest. However, there’s much more that goes into it, especially during neurological recovery after a stroke, spinal cord injury, or brain injury.

You’re about to learn the nuances of massed practice and how you can apply it to your recovery. When used correctly, it can help accelerate improvements during rehabilitation.

Why Massed Practice Is the Best Remedy during Rehabilitation

After neurological injury, a portion of the nervous system becomes damaged. When the brain or spinal cord is affected by stroke or injury, the affected cells are unable to communicate with the rest of the body.

This disconnect between the nervous system and body is what causes most side effects after neurological injury, such as hemiplegia and hemiparesis (weakness or paralysis on one side of the body).

To recover from these injuries, the surrounding areas of the brain and/or spinal cord must pick up the slack. This is possible through the phenomenon of neuroplasticity.

Neuroplasticity is the mechanism that the nervous system uses to rewire itself and form new neural connections. Each time a meaningful task is practiced, those neural pathways are reinforced and become stronger.

As neural pathways begin to reform and strengthen, it improves the communication between the brain and body. Gradually, motor impairments on the affected side begin to improve because the nervous system is able to send signals again.

The more you practice, the stronger those skills become. This is how massed practice helps recover the functions lost after neurological injury. Donald Hebb, a neuropsychologist, phrased it best:

“Neurons that fire together, wire together.”

How Repetitive Action Helps Rewire and Heal the Brain

Looking at habits can help illustrate the importance of massed practice during rehabilitation.

A habit is something that you do with little effort because you’ve done it hundreds of times before. Repetitive action creates strong pathways in the brain for that specific habit, which is why habits eventually become “mindless.”

In contrast to this, a neurological injury can cause a patient to exert more effort to perform the basic activities of daily living, like getting dressed. That’s because the injury damaged the strong neural pathways that once controlled those skills.

Luckily, the brain can rewire itself to rebuild those neural pathways again. After an incomplete spinal cord injury, the spinal cord is also able to rewire itself. However, consistency is key. As with all habits, you won’t see results without consistent effort repeated on a regular basis.

One study connected a lack of consistent therapy with the reason why patients remained at the same level of disability 5 years after stroke as they were just 2 months after the initial injury. Without consistent therapy, most patients do not get the exercise and repetitions they need to keep improving.

This is why a motivating at-home therapy regimen is critical for regaining function. Results are made when you put in the reps day after day. When you put in the work, the brain will respond.

Which Secondary Effects Can Be Healed Through Massed Practice?

Most secondary effects of a neurological injury can be affected by massed practice. By practicing the skills that you need to rebuild, it is possible to regain lost functions.

Here are some examples of secondary effects that you can treat through repetition:

• Impaired movement can be treated through massed practice of rehab exercises. The more repetitions you perform during physical therapy, the more your nervous system rewires itself. As a result, mobility improves.
• Impaired speech can be treated through massed practice of speech therapy exercises. By repetitively practicing different skills related to language, like tongue movement and reading comprehension, the skill of language improves.
• Impaired senses, like difficulty feeling hot/cold, can be treated through massed practice of sensory reeducation exercises. Exposing your skin to different textures and temperatures on a consistent basis helps your brain get better at processing sensory information (i.e. your brain gets better at “feeling”).

This is how massed practice can help you recover from almost every secondary effect after a neurological injury. When the brain struggles with a skill, it can improve through massed practice.

How Much Repetition Do You Need to Recover?

Massed practice helps with recovery from the effects of a neurological injury, but how much repetition is enough? Let’s look at the studies.

In animal studies on neuroplasticity after stroke, it was shown that 400-600 repetitions per day of challenging functional tasks can lead to changes in the brain.

However, the average therapy session for upper limb rehabilitation only requires about 32 repetitions. That’s far below what the brain needs, which can explain why many survivors hit a plateau after about 3-6 months. Dozens of repetitions are good, but hundreds of repetitions is preferred.

That’s the beauty of high-tech rehab devices, like Flint Rehab’s FitMi home therapy. It helps patients accomplish an average of 400 or more repetitions per session, depending on the patient’s level of impairment. Fortunately, even patients with severe impairments can still accomplish high numbers of repetitions that are needed to rewire the brain.

This massed practice helps you rewire the brain faster and reverse the effects of a neurological injury.

Recover from Neurological Injury with Massed Practice

As you can see, massed practice is about more than continuous practice of a task. If the task is practice sporadically, it won’t make much of a difference. The key is consistency over time.

When patients pursue rehabilitation on a regular basis at home, they see the best improvements. Habits and skills are not built overnight. Putting in the work on a regular basis is how skills are regained after a stroke, brain injury, or spinal cord injury.

Fortunately, when massed practice is applied on a regular basis, patients can make enormous achievements after a stroke. In fact, massed practice is the key to maximizing your chances of a full recovery.

You’ll never know how much recovery is possible unless you put in the work and never give up. We wish you the best of luck on the road to recovery.