Why We Work Hard, Play Harder, and Rep the Hardest in Neuro Rehab

If you’ve ever felt like you’re just "going through the motions" of a morning ADL routine while your neuro-brain is screaming for more evidence-based intensity, this episode is your permission slip to change the game.

Today, I’m joined by Jenna Barber, MOT, OTR/L, BCPR, a neuro specialist who lives in the tension between high-level stroke research and the grit of acute care. We’re pulling back the curtain on why "just doing the ADL" isn't enough for cortical rewiring. We’re talking about the 300-rep goal, the controversy of compensation vs. restoration, and how to stay client-centered when the system just wants you to check a box.

In This Episode, We Discuss:

• The 17-Year Gap: Why it takes nearly two decades for research to hit the clinic floor and how we can bridge that gap today.
• Restoration vs. Compensation: Navigating the controversy—when do we use "hemi-techniques" and when do we demand more from the affected side?
• The 300 Rep Rule: Why Jenna aims for hundreds of repetitions (even if it’s just rubbing a washcloth on a thigh) to drive real neural change.
• Neuro-Priming 101: How to use high-intensity mobility, aerobics, or mirror therapy to "warm up" the brain before you ever touch a functional task.
• The $30 Amazon Hack: Creative ways to simulate expensive mobile arm supports when you’re working in a rural facility or on a tight budget.
• OTs as the "Walking" Experts: A "high horse" moment on why functional mobility is firmly in our scope and how it acts as a motor primer for upper extremity work.

Key Takeaways for the Practitioner:

1. Repetition is King: If the brain is going to rewire, we have to move beyond one or two attempts at a shirt. Pick a sub-component of the task and hit it 100 times.
2. Be the Team Player (with a Bias): We are the upper extremity experts. If we don’t advocate for the arm, who will?
3. Clinical Judgment > Textbooks: Use FES, robotics, or even a simple towel on a table to grade the task so your patient can get those reps in, regardless of their impairment level.

Resources Mentioned:

• @neuro_otpt_nerds (Jenna's content for evidence-based insights)
• Salia Rehab (Jenna’s continuing education courses)
• Equipped Me OT (Shoutout to Lindsay for the computer arm assist hack!)

If you’re an OT Accelerator member, don’t forget to log in and complete the post-course quiz for a CEU.

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Also, be sure to check out the free resources available at OTflourish.com, including quick references, documentation and goal writing guides, treatment ideas, and helpful tools to support you in your OT practice working with older adults.

And if you’re ready to take your practice to the next level, the OT Accelerator is here for you! It’s the #1 resource and OT mentorship community for OT practitioners and students working in geriatric settings. Inside, you’ll get access to evidence-based resources, treatment ideas, and a supportive community to help you feel confident and capable in your practice.

Learn more and join today at OTflourish.com/membership

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