Brain Exercise Isn't Just for Seniors

By Claudia Anrig, DC

We all tell our patients that exercise is good for their bodies; but do we tell them the same is true for their brain? Just like any other muscle, the brain can get in shape, be strengthened and developed with use – exercise.

The human brain is made up of nerve cells called neurons; they are connected by synapses, which transport information from one neuron to the other. Just like other muscles and organs, the brain changes with age; synapses fire more slowly, some cells die off and the overall mass of the organ shrinks. However, advances in brain imaging and neuroscience, coupled with studies of twins, have shown that not all change is genetically predetermined or inevitable.

This new understanding of the brain and its response to exercise has created an entire new industry based on a word coined by Drs. Katz and Rubin in 1999 called neurobics. This is a term for mental exercises which are used to increase the range of mental motion by activating different parts of the brain. But while neurobics involves a specific set of exercises, studies have shown that any exercising of the brain may not only stave off brain degeneration, but in many cases also reverse memory loss and improve mental agility.

Infants to Toddlers

Many parents express delight in what they consider an early or advanced milestone when a child goes straight from rolling over to walking. However, the act of learning to crawl develops synapses that cross the hemispheres in the brain. Crawling requires the movement of the right arm with the left leg and vice versa. This motion or "cross-crawling" is a physical exercise that activates the nerve cells in the brain and stimulates them to create synapses or neurological pathways between the left and right side of the brain. Crawling is as vital in stimulating brain growth as it is in helping a child be mobile; in fact, it's more important.

Studies have found that not only can avoiding crawling cause learning difficulties in reading, writing and comprehension, but even speech can be affected if the crawling stage of development is skipped. Thus, if an infant has gone from rolling over to using objects to creep along in a standing position, it's important to take the child down from the furniture and encourage them to crawl.

Children and Pre-Adolescents

Obviously, children and pre-adolescents are going to benefit from brain games that encourage them to actually use their brains; for instance, memory games in which the children try to turn over one card at a time and match the cards. These games have been around for years but are still beneficial. Puzzles, card games and even riddles can be equally valuable.

This age group will also benefit in the same way from physical games. Research has shown that children in this age group can best exercise their brain by playing physical games that force them to "cross the midline" and engage both sides of their bodies simultaneously. Crossing the midline is the act of taking your right arm and crossing it over to the left-hand side of the body and vice versa; in many ways this is beneficial in the same way that learning to crawl is beneficial to an infant.

Recent studies have found that today's youth are struggling with cognitive thinking due to a lack of physical activities and games. I'm not referring to dominant-sided organized sports such as baseball or football, but instead to games like dodgeball and tag. These games require the child to involve three-dimensional space and demand the use of binocular vision beyond arm's length.

Enjoyable Games and Their Benefits

As children move into their teens, the higher demand of their studies may be beneficial brain exercise. However, since teens tend to do what they want, they will be more likely to engage in something they enjoy. Even adults will generally find themselves more willing to participate in something fun, rather than something that is just beneficial.

Sudoku, the popular puzzle game, is a perfect brain game in this regard, as it requires discerning, deciphering and decoding while still being challenging and compelling. Equally beneficial while still entertaining are crossword and jigsaw puzzles, although these may not be as amusing to today's youth.

Going to the gym is another activity you can challenge the teen with. If your parent patients have a gym membership, get their teens to join in on classes that focus on circuit training, yoga, rock climbing or dance.

Video Games

Recognizing that teens and adults are fascinated and challenged by IQ tests and trivia questions, Nintendo DS and Wii have released several video games in this genre. Brain games that will require testing knowledge and memory, and are also fun, include (for DS): Big Brain Academy, Brain Age, Brain Age 2, Ultimate Brain Age and Master Jin Jin's IQ Challenge. For the Wii, Nintendo has created Big Brain Academy, Margot's Word Brain and Brain Challenge.

Exercise With Strategy

Some of the best brain games continue to be those that have been around for years, the most obvious being chess. Requiring players to strategize, consider their moves two or three in advance, and trying to speculate what moves their opponent will make makes chess perhaps the most beneficial of all brain exercises. However, this doesn't mean that it should rule out checkers or card games. Any game that requires strategizing and decision-making regarding the potential results of a certain move will give the brain an excellent workout.

Senior Brain Health

It's not unusual for patients to share that it's easier for them to remember something from 50 years ago than from yesterday. Growing awareness about brain degenerative diseases has people in their early 50s starting to become more proactive. This may be why companies like AARP and MetLife are beginning to focus on the importance of brain health.

Research published in the Journal of Neuroscience in 2008 revealed that if a neuron doesn't receive sufficient stimulation through active synapses, it will eventually die. On the other hand, if it receives stimulation from other neurons developing along the same neural pathway, it lives and grows. It's this simple.

Crossword and jigsaw puzzles, Sudoku and reading the newspaper are just the beginning of ways to exercise neurons and synapses. Fun challenges or neurobics can be equally, if not more beneficial. For instance, wearing a wrist watch on the other arm, brushing your teeth with the opposite hand or wearing a blindfold at home for an hour; these games or mental exercises stimulate the brain by causing it to do mundane activities differently.

Remember, the brain is just like every other muscle or organ in your body: if you don't use it, then it won't perform at its peak. At any age, our brains can benefit from mental exercise. That's why it's important to share with our patients various ways they can maintain their healthy brain throughout their lifetime.

Resources

• Brain Awareness – The Baby Brain. Oregon Health & Science University.
• Sotthibundhu A, et al. ß-amyloid1–42 induces neuronal death through the p75 neurotrophin receptor. Journal of Neuroscience, April 9, 2008;28(15):3941-3946.
• Tobias L. "Exercising the Brain Helps Keep It Fit." Chicago Sun-Times, July 4, 1999.
• Santich K. "Buffing Up Your Brain: Researchers Advocate Mental Exercise." The Orlando Sentinel, June 9, 2006.
• Wood E. "Tips to Grow Younger: New Crossword Puzzle to Exercise Your Brain." Taos News, Sept. 25, 2009.
• Keyser T. "Use It or Lose It; Baby Boomers, Seniors Are Exercising Their Brains to Stave off Memory Loss - Maybe Even Dementia." Albany Times Union, June 19, 2007.
• Woods M. "Neurobics: Daily Exercise for the Brain." Toledo Blade, March 18, 2003.
• Zaldy S. Age-Proof Your Mind: Detect, Delay and Prevent Memory Loss—Before It's Too Late. Grand Central Publishing, 2005.
• Brooks JL, et al. Crossing the midline: reducing attentional deficits via interhemispheric interactions. Neuropsychologia, 2005;43(4):572-82

By Peter W. Crownfield, Executive Editor

The study involved 272 adults ages 18-65 with nonspecific mechanical neck pain of two to 12 weeks' duration. Participants were recruited from a university research center and a pain management clinic in Minnesota. Other inclusion criteria included pain equivalent to grade I or grade II according to the Bone and Joint Decade's Task Force on Neck Pain and Its Associated Disorders; and neck pain score of 3 or greater on a 0-10 scale. Exclusion criteria included cervical spine instability, fracture, neck pain referred from peripheral joints or viscera, progressive neurologic deficits, diffuse idiopathic hyperostosis, inflammatory or destructive changes of the cervical spine, previous cervical spine surgery, and blood-clotting disorders, among other criteria.

Subjects were randomized at their second baseline appointment to one of three groups for 12 weeks:

• A spinal manipulative therapy group, which received "manipulation of areas of the spine with segmental hypomobility by using diversified techniques, including low-amplitude spinal adjustments ... and mobilization." According to the study, six chiropractors, each with at least five years' experience, provided treatment, with the specific spinal level to be treated and the number of treatments rendered left to the discretion of the individual chiropractor.
• A home exercise advice group, "with advice provided [by six therapists] in two 1-hour sessions one to two weeks apart. Recommended mobilization exercises included "neck retraction, extension, flexion, rotation, lateral bending motions, and scapular retraction, with no resistance." Participants received a booklet and laminated cards of prescribed exercises, and were advised to perform 5-10 repetitions of each exercise six to eight times daily.
• A medication group monitored by a licensed medical physician, with nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or both serving as the first line of pharmacological therapy. With patients who did not respond to or could not tolerate these drugs, narcotic medications and muscle relaxants were prescribed. With each patient, the MD determined the type of medication administered and the number of patient visits.

Self-reported outcomes, including pain, were measured six times during the 12-week treatment period in all three groups: at both baseline appointments; two, four, eight and 12 weeks after randomization; and on two occasions post-treatment (weeks 26 and 52). Objective measures of cervical spine motion were measured at four and 12 weeks by seven trained examiners blinded to treatment assignment.

Of the 272 participants, essentially equally assigned to the three treatment groups (91 SMT, 91 home exercise and 90 medication), "improvement in participant-rated pain significantly differed with SMT compared with medication at 12 weeks ... and in longitudinal analyses that incorporated pain ratings every two weeks from baseline to 12 weeks. At 12 weeks, a significantly higher proportion of the SMT group experienced reductions of pain of at least 50% [compared to the medication group]. Differences in participant-related pain improvement between the SMT and [home exercise] groups were smaller and not statistically significant."

Specifically, at week 12, more than 82 percent of the SMT group reported a 50 percent or greater reduction in pain; 57 percent reported at least a 75 percent reduction and 32 percent reported a 100 percent reduction. By comparison, the home exercise group reported pain reductions of 77 percent, 48 percent and 30 percent, respectively, while the medication group reported reductions of only 69 percent, 33 percent and 13 percent.

In terms of long-term improvement, 75 percent of the SMT group reported at least a 50 percent reduction in pain after 26 weeks, while nearly 81 percent reported at least a 50 percent reduction at 52 weeks. At 26 and 52 weeks, 71 percent and 69 percent of the home exercise group, respectively, reported at least a 50 percent reduction in pain. In long-term follow-up, the medication group's improvement fluctuated from 59 percent reporting pain reduction of 50 percent or more at 26 weeks to 69 percent reporting the same reduction at 52 weeks.

"Spinal manipulation therapy and [home exercise advice] led to similar short- and long-term outcomes," stated the authors, "but participants who received medication seemed to fare worse, with a consistently higher use of pain medications for neck pain throughout the trial's observational period."