Tuesday, February 16, 2016

Movement and cognition

"Your activity not only affects brain functionings; it can also provide a window into how your mind is operating. Take walking. Doctors used to think that signs of Slow walking were just a normal part of the aging process. They were wrong. It turns out that slow or unstable walking is often an indicator of subtle cognitive impairments. Many of the same brain circuits that control complex cognitive activities also help us coordinate the complex movements needed to walk down the hall. Using walking to assess cognition represents a real departure from how mental fitness is normally assessed in older adults: while they are sitting down. Many neuroscientists studying the aging mind firmly believe that, when older go to the doctor and get their eyes and their blood pressure checked, they should get their walking checked too. Even subtle signs that walking is slowed or impaired may tell doctors that something important is going on in the brain." (p. 186, How the Body Knows its Mind by Sian Beilock)

I wasn't going to post anything more from this book until I finished reading it, but this passage caught my eye and I have been thinking about it ever since. It isn't the gerontological aspect of the study that interests me, but the interaction between cognitive functioning and physical functioning, mainly in terms of what I see in H. and R.

When H. first joined our family, she moved like an infirmed 90 year old woman. She shuffled, she would feel for each step, she was slow and unsteady, she held her arms out. I know some of that was her eyesight, but it couldn't have been all of it. It took us over three years to get to an eyeglass prescription where she was really seeing well, with a couple of years of patching thrown in there as well. While seeing well can't help but enable a person to move easier, this explanation couldn't have been the whole story, as she started to move quicker and more easily long before sorting out her eye issues. It was also something that we specifically worked on. We practiced stairs, we hiked, we jumped, we stretched, we climbed, we lifted weights, we did sit-ups, we did push-ups. A lot. Eventually about a year and half home, A. comes running into the house to announce that H. ran. Really ran down the block. A. had been coaching her and she was finally able to put the pieces all together. (And can I just put in a plug for the role a large family plays in doing this? There are a lot of people who are always moving and doing things. One of the therapists who worked with K. early on would often comment that just trying to keep up with everyone was the best therapy he could receive.)

After about a year of doing this, we noticed H. moving significantly better in her world. We also started to see gains in her cognitive abilities. We were seeing more complex sentence structure, and increasing awareness of the world around her, an awareness of her own emotions, likes and dislikes, etc. It has very much been a two-part dance of physical ability and cognitive ability. I had never quite put the pieces together until I read the above paragraph.

What if it is more of a chicken-and-egg question than the above paragraph implies? What if there is a correlation between physical adeptness and cognitive function that is more of a two-way street? This is certainly what we have seen in H. It is also what we are currently seeing in R., our new resident 90 year old woman-type mover. Once again we have a daughter who is very unsure of her own movements. She walks slowly and deliberately, there is a stiffness in how she holds and uses her body (not in the actual musculature, she bends and moves her limbs and body just fine), and her coordination is poor. (I am working on teaching her to crawl.) Currently, she absolutely refuses to even try to stand on the trampoline, whereas Y., the child who has a physical reason for being unsteady on her feet loves it. I know we need to have R.'s eyes tested, but her hesitancy to move in her environment seems more than eyesight related. It feels just like H.'s movement issues did.

My gut told me we had to work on the physical stuff before we even tried to do anything more remotely academic. I love finding actual studies which confirm my own little pet theories. The brain is just so gosh darn interesting, isn't it?


c smith said...

Studying Early Childhood Development and Education as well as studying my own young children has given me strong belief in the value of large motor development. As a preschool teacher I saw many children who were "delayed" improve cognitively when we focused on including running, jumping, throwing balls and so on in their daily activity. I believe it is a fact that such physical activity stimulates the brain's ability to think logically. That's one of the reasons I have such an issue with very small children being required to sit still for large chunks of the day in public school. Inactivity just stagnates the brain.

Shecki Grtlyblesd said...

Wow, thanks for sharing that! I've been feeling like, "why bother?" with making Luke stand or "walk" with hands held, since even should he miraculously gain the skill of walking (most kids with his condition don't) he will eventually lose that skill as he deteriorates.

Your post made me rethink that. Maybe if we help him work on the physical stuff, we'll see glimmers of something going on in his head.

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