Our designated driver Carlos takes us to the clinic, we have started the tactile program and Simen was super happy with crossing his midline, Olav has been shopping and Mathea met her new sister!
CROSSING THE LINE
Entering the US through customs have given us some frights over the years. The officers are strict, you are asked questions about your stay and if you try to take pictures you are yelled at, and if you reach for your passports on the counter, the officer rises his voice and says with an angry face: Do not cross this line!
Having a brain injury can cause challenges to move across the midline of your body for many reasons. If you are interested in the neurological explanation and how to work on improving this skill you can read further on the accordion here.
Simen and I can not remember if he ever has, or at least when the last time he managed to do this - until today! We are celebrating that HE CROSSED THE LINE! We will practice more tomorrow and show you more soon!
AI has contributed to the information about the midline.
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1. Midline Crossing and the Brain’s Motor Control
• Midline refers to an imaginary line that divides the body into two halves (left and right). Crossing the midline involves moving the arm, leg, or head across this line from one side of the body to the other.
• The brain’s motor cortex (in the frontal lobe) and somatosensory cortex (in the parietal lobe) play critical roles in controlling motor functions. Damage to areas of the brain that help integrate sensory and motor information, such as the corpus callosum (which connects the left and right hemispheres), can make it difficult to coordinate movements that cross the midline. -
The Role of the Corpus Callosum
• The corpus callosum is a bundle of nerve fibers that connects the two hemispheres of the brain. When this structure is damaged (due to stroke, traumatic brain injury, or other conditions), communication between the left and right hemispheres is disrupted.
• This disruption can result in difficulty in coordinating motor actions between the left and right sides of the body, especially when movements require crossing the midline. For example, reaching across the body with one arm may be impaired, as the brain’s hemispheres cannot effectively collaborate.
3. Right Hemisphere and Left-Handed Movements
• In most individuals, the right hemisphere of the brain is responsible for controlling movement on the left side of the body, and vice versa. The left hemisphere typically controls right-side movements.
• Damage to the right hemisphere, specifically the area controlling the left side of the body, can make it difficult for someone to perform movements on the left side of the body that cross over the midline. Similarly, if the left hemisphere is damaged, crossing the midline with the right side may be difficult. -
Diagonal Movements
• Diagonal movements require cross-body coordination (e.g., bringing the right hand to the left knee or vice versa), which involves complex integration between the motor control centers of both hemispheres.
• Lesions or damage to areas such as the premotor cortex, motor cortex, and parietal lobe, which are responsible for planning and executing coordinated movements, can impair these diagonal movements. Additionally, damage to subcortical structures such as the basal ganglia, which help with smooth and coordinated movements, can cause difficulties in performing diagonal movements. -
Improving diagonal movements, like touching the right knee with the left arm, can be challenging for someone with brain damage, but neuroplasticity allows for progress through targeted exercises. For individuals who cannot move voluntarily, neuromuscular re-education can still be beneficial through passive exercises, sensory stimulation, and assisted movement techniques. Here are some adapted approaches:
Here are some strategies to help:
1. Start with Simple Movements
• Begin with assisted movements.
• Perform slow, controlled repetitions focusing on quality over quantity.
2. Break Down the Movement
• Step 1: Move the arm across the body.
• Step 2: Lift the knee.
• Step 3: Gradually combine both steps into a smooth motion.
3. Use Visual and Verbal Cues
• Use verbal prompts like “left hand to right knee” to reinforce coordination.
• Practice in front of a mirror to see the movement.
4. Engage in Cross-Body Activities
• Lay and/or or move in homolatteral and cross pattern positions
2. Sensory Stimulation
Applying vibration, tapping, or brushing to stimulate proprioception.
Using temperature contrast therapy (warm/cold cloths) to engage nerve responses.
5. Visualization & Mental Imagery
Even imagining movement can activate neuromuscular pathways.
Example: Visualizing lifting an arm while breathing deeply.
7. Use External Supports If Needed.
• Use a therapist or caregiver’s assistance until confidence improves.