International patients for  concussion

The Brain Rehab Concussion Treatment Plan  

After 30 years of clinical experience and over 35 years of education (neurology, movement, chiropractic, neuroscience), I can reasonably say that I know a thing or two about brain injury. As you may know, I have personally experienced the devastating results of several concussions in my mother’s life. This turned out to be my big reason I am doing this: it’s why I made finding better solutions for the effects after brain injury my life’s purpose. 

 The neurologist or family physician may say “based on your scan and medical testing, nothing is wrong with you. You have to be patient and everything will be alright over time.”

 Really? 

Why then do you still have extreme tiredness, fatigue, low energy levels, balance problems, tinnitus, you cannot stand light and sound, you can’t sit behind your computer for very long, still have headaches and cannot get back to work or social situations, just to name but a few...? 

 I get so frustrated when my clients (and I mean 95% of them) tell me that the medical professional told them bluntly, after minimal investigation: “we cannot find anything wrong with you”.

What they should have said instead is:

“It is our job to rule out permanent damage or life threatening situations or any underlying disease. We have done so and luckily we couldn’t find any. However that does not mean that nothing is wrong. In a significant number of people that suffered a brain injury there is a lot of scientific evidence for low grade brain inflammation, circulation problems (decreased neurovascular coupling), micro damage in white matter, cellular energy problems to name a few of the things that can give lasting problems. Because these are mostly functional problems we cannot do something at this time. Please find someone to address these issues who can help you further."  

 If you search the scientific literature it becomes crystal clear that there is no such thing as a clear cut one size fits all solution. That is probably also the frustrating part that you, as someone with brain injury, can experience on a daily basis. 

 Better solutions will in most cases come in the form of a multi-disciplinary approach addressing interplay between neck, balance system, eye functionality and head, weak brain areas, issues like circulation problems, brain inflammation, energy problems but also stress management (because the fight or flight system is overactivated) and believes and attitudes towards recovery. 

 Although we are always limited to the knowledge and insights that are available at any time, this is what’s underlying the science based concussion improvement program that we have developed over the years. Although we literally have helped hundreds of people overcome the lasting symptoms  after brain injury such as concussion, we also are very aware that we still do not have the perfect answer yet to solve everyone's problems. This for us is an ongoing process. We believe strongly in the Japanese word “Kaizen”, meaning “continuous improvement”. And that is exactly what we have done: we have continuously improved this program. All is based on the latest cutting edge science, new insights and improvement comments that we get from our clients. 

What can you expect

Here is in short how the program is designed:

 STEP 1: Preparation for the training  

 In fact this is pretty vital. The basis for brain survival are oxygen, activation (in the form of movement), fuel (in the form of slowly released sugars), water and light (believe it or not, light is essential for your body and mind to thrive).

First of all, we advise to cut down on sugar (high carbohydrate content), dairy wheat and other foods which are proinflammatory and hinder recovery of function. Also increase hydration (crucial for overall health and recovery) in the form of at least one and a half liters of water, herb teas next to what you are already taking in (not fruit juices because they are very high in sugar) are ideal. Fact is that most of us are dehydrated. Next to this we will advise you to invest time in posture and breathing correction, one of the easiest ways to change your state no matter what shape you are in. 

Because circulation to the brain and nervous system often becomes compromised we also suggest to do at least some form of regular low grade exercise (like two or three small walks or sitting on a stationary bike for 5-10 minutes). To enhance this and because even low grade exercise can be hard for some, we suggest that you take the following supplements for circulation, vascular health and oxygenation (check with your doctor or pharmacist first).  

Gingko Biloba 

Huperzine A 

There is also, for example, a product called "Vibrant mind", you can Google it or get it from Amrita nutrition in the UK. You can get this product through our clinic as well. 

You can take this to a next level by taking an advanced DNA test which will give valuable additional insights into what types of food, exercise are best for you as well as which potential health weaknesses you should focus on. Ask for this test if you are interested. 

STEP 2: Brain testing 

This is where it all starts. Where do you stand? What is not functioning well? Why do you still have problems? This information will provide the insights on where to make the next step and which trainer to do this with. 

• Advanced personal analysis based on the following activities:

•  QEEG (brain activity measuring)

• EyeQ (eye functionality measuring)

• Saccadometry (targeted eye function and prefrontal cortex activity measuring) 

• PROPRIO 5000 (active balance, body stability and reactive proprioceptive measurement)

• Interactive metronome (timing and coordination).

• Functional neurological research

• Functional neuro-orthopedic research (FNOR, core stability, surfaced pain analysis)

• CAPS, stability and falling chance measurement 

• Audiogram 

• Tilt table testing (POTS analysis) 

• Cambridge Brain Sciences cognitive (at home) testing (45 minutes) 

STEP 3: Personal plan  

 Arjan makes a PERSONALISED RECOVERY PLAN based on your test results. Basically, through the testing we get confirmed where your weakest spots are and we train and strengthen those in order to recover its functions. 

 STEP 4: Training

Of course we adapt the program so it does not exceed your systems capacity to handle it. But this we can to do with you:

Sessions with HeartMath:  

HeartMath™  

Stress in our daily life influences our heart rate.  

The time intervals between heartbeats vary constantly in all of us. This is called heart rate variability. When stressed, this gives a restless picture. This unconsciously disrupts our energy levels and increases the stress hormones that affect many areas of the body.

Why?

If we adjust our breathing and mindset to what gives us energy, the heart rhythm stabilizes. That is heart coherence. The stress hormone level drops and we can work on our recovery with more resilience.

By practicing breathing techniques we are easily able to get more out of daily life.

For Brain and Spine Rehab, experience expert Nienke van Bezooijen offers the basic principles, whereby you can train your heart coherence at home on a daily basis.

Sessions with our physical therapists:  

Why? 

 Our physical therapists are trained to work with the Brain Rehab Concussion program, and know exactly which training to give or where to adapt training when necessary. 

Specialized treatment updates with one of our functional neurologists (Arjan):

Why? 

Because physical problems like neck instability, neck dysfunction or jaw problems often appear after brain injury it is important to spot the physical problems that cannot be helped by training alone. Only a highly trained functional neurologist/ chiropractor knows which problem areas to treat in a way that supports the recovery of your brain and improves interplay between balance, neck input and eye functionality. The functional neurologists will at the same time monitor how you are doing with training and can adapt the training program accordingly. 

Sessions with EMS  

Why?  

EMS (electro muscular stimulation) is an excellent (clinically seen) way to enhance functional capacity and prevent deterioration of muscle function. Although there are limited studies available on the validity of EMS for concussion or whiplash. We do know that through graded electro-muscular stimulation we greatly enhance the feedback of the body to the brain, which is often a problem after whiplash associated disorders and brain injury in general.  

Sessions of HYPERBARIC OXYGEN THERAPY (HBO2) 

This is the safe medical use of oxygen in a pressurized environment. 

Principal mechanisms of HBO2 are based on intercellular and  generation of reactive species of oxygen and nitrogen. Reactive species and good forms of nitric oxide are recognized to play a central role in cell signaling which are vital for recovery after injury, enhanced cellular function and improved vascular health, resilience and oxygenation (all of which can become compromised after head injury). Systematic reviews and randomized clinical trials support clinical use of HBO2. 

Why? 

Clinical and mechanistic data support use of hyperbaric oxygen for a variety of disorders. Especially when you cannot bring exercise efforts up to a reasonable level because of your condition this becomes extra important. 

Sessions with  Feldenkrais or Neuromovement 

A system designed to promote bodily and mental efficiency and well-being by conscious analysis of neuromuscular activity via exercises that improve flexibility and coordination and increase ease and range of motion. Above all it helps raise awareness of movements and where movements are compromised. A well known fact after whiplash or head trauma is that movement patterns become disturbed and disrupted. You often are physically limited in movement patterns or regress to more inefficient primitive movements which further halt optimal function and recovery of the brain. 

The Feldenkrais and Neuromovement techniques use, among other things, subtle and varying movements with the intention of forming (re)new(ed) connections between the body, nervous system and brain in order to improve physical, mental and cognitive functioning.

Why? 

“The aim of the Feldenkrais Method and Neuro movement (a derivative of Feldenkrais) is that a person becomes organized to move with minimum effort and maximum efficiency, not through muscular strength, 

You could argue that Feldenkrais and Neuromovement are practical applications of the principles of neuroplasticity, or the brain's capacity to form new connections.

Sessions with adapted Yoga  

Scientists have known for decades that aerobic exercise strengthens the brain and contributes to the growth of new neurons. Scientific reviews indicate evidence that yoga enhances many of the same brain structures and functions that benefit from aerobic exercise. 

Why? 

Yoga is often touted for its ability to improve flexibility and strength, reduce stress, and boost mindfulness. Flexibility and strength of movement greatly enhances the feedback to the brain. Since these feedback mechanisms can easily become compromised through head and neck injury, adapted Yoga (to your specific situation and capacity) is an excellent way to help the musculoskeletal system to recover. Next to this, new research suggests it might have benefits for your brain as well: Not only can yoga enhance your brain function, but it can also change the structure of your brain in some notable ways. 

Sessions with REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (RTMS) 

This is, literally, together with specific low level intensity red light laser, the cutting edge of treatments and stimulations when there is a brain injury. Nothing matches its accuracy and direct effectiveness of this stimulation where magnetic fields are used to enhance brain function in areas where brain function is decreased. 

 Why? 

RTMS utilizes electromagnetic waves to directly stimulate neuron pools that have been weakened by for example a concussion or stroke, within the brain. 

Low level intensity red light laser (Photobiomodulation) 

Light therapy is rapidly gaining interest from the medical community, especially after many studies have shown its potential to dampen the so-called cytokine storms during active COVID. Red, infra and near infrared spectrum laser therapy is therapeutic and should never be confused with surgical or other applications of laser. Much research at this moment is focused on the efficacy of laser therapy after stroke and brain injury. Most studies indicate that the use of laser therapy with brain injury is a safe and very valuable adjunct to other therapies or can be used as stand alone therapy in case of acute or chronic brain injury.  

Why? 

We use low level intensity laser for all types of injuries (for brain & body) and recovery processes). The unique SHED laser that we use in our clinic not only supports energy production at the cell level, lowers inflammation (brain inflammation is often a very important factor why recovery does not take place) in short sessions, but also a multitude of other recovery processes.

Mindset coaching & meditation guidance  

Some of our physical therapists are very experienced in meditation techniques and will guide you in the practice of meditation and or mindfulness 

 Why? 

Meditation and mindfulness have been, without a doubt, proven to regulate and assist in recovery of brain injury. One of the biggest things with mindfulness and meditation is that, in contrast to popular belief, it is not hard to learn. Fact is that it only takes a minimum of three minutes a day (which means everyone can do it) and that there is no such thing as a perfect meditation. Since stress management is one of the fundamentals for real recovery (the stress system is often over and permanently activated after brain injury) We highly recommend the practice of some form of meditation or Yoga nindra. 

Home exercise program  

In order to have a continuous effect on your recovery and to keep costs for the training programs in check, you will receive instructions for further home training whenever you visit our clinic. If you want, you can additionally make use of Arjan’s concussion.coach program as well (for example if you live too far away to comfortably travel to the clinic when you have additional questions or issues). You can schedule an appointment via Zoom with him. 

1 session: Medical Massage (Tuina therapy, as a reward to end the training program). 

Why? 

As well-established as the physiotherapist is in the Netherlands, the Tuina therapist is just as common in China. Most hospitals in the country have special Tuina departments, where both children and adults are treated for acute and chronic health problems.

Tuina is pronounced as 'twiena' and literally means 'to push' (Tui) and 'grab' (Na). Tuina Therapy is characterized by a wide variety of massage, mobility and manipulative techniques in which the skin, muscles, tendons, joints and acupuncture points are stimulated. Unlike acupuncture, however, no needle is used.

Nutrition and Guidance 

If you decide to do an advanced DNA test or other nutritional, immunological or metabolic testing with us, and you had the follow up Zoom call with Arjan to explain the results, we can additionally set you up with a Zoom phone call to our Nutrition specialist in Switzerland. She can give important advice on what to eat and, more importantly, what you should not eat. 

Scientific references

All our data is based on thorough scientific research and years of experience. Below you will find the corresponding scientific references.

Arjan Kuipers

Specialization: Brain Injury

International consultant in the clinical application of neuroscience,  
(ACNB, Board-certified functional neurologist).

sie also his international coaching program