Repeat, Intensify… But without Unnecessarily Complicating Things

In neurological rehabilitation, two pillars guide our daily interventions: repetition and intensity. These are what determine the effectiveness of motor learning and, consequently, functional recovery.

But beware of a common trap: confusing intensity with difficulty.

Intensity ≠ Difficulty

An exercise that is too difficult is not always more effective.
On the contrary, it can quickly become counterproductive:

• It generates compensations, limping, or the adoption of poor motor strategies.
• It quickly becomes hard to repeat, as it tires or discourages the patient.
• It sometimes leads to negative learning… which the brain consolidates just as much as correct learning.

Most of the time (70%), the patient must successfully complete the exercise correctly.

Conversely, a simpler, better-targeted exercise can be repeated more and reach a level of intensity that is far more beneficial in the long term.

It is the quality and quantity of movement that shape recovery, not the complexity of the challenge.

Clinical Example: Walking without Assistance

Let’s take a classic case: a post-stroke patient who wants to walk “without assistance”.
It’s an understandable goal, but this premature autonomy can become a hindrance to recovery.

Without technical assistance:

• Walking is unstable.
• The patient compensates (trunk, hip, shortened steps…).
• He tires quickly.
• He repeats an asymmetric, sometimes dangerous movement.

With a well-chosen mobility aid:

• Walking is of better quality.
• Balance is secured.
• The patient can walk longer.
• He can repeat the movement dozens of times, until reaching a real intensity (30 minutes non-stop, for example).

And it is this controlled intensity that generates the desired neuroplasticity.

The Brain Learns… Everything

A fundamental principle in neurological rehabilitation:

The brain learns everything, even “poor” strategies.

That’s why it’s crucial to build the right motor patterns from the first sessions.
The right balance to find is as follows:

• Too difficult: compensations and limping.
• Too easy and not intense: stagnation.
• Adapted, repeated, intense: sustainable progression.

Technical Aids as Adjustment Levers

Walking aids play a central role in this equation.
They allow for fine-tuning the level of difficulty while maintaining the intensity of the work.

The Wheeleo®: a Tool for Controlled Intensity

The Wheeleo® is a unique walking aid, designed as an intermediate step between the rollator and the cane.

• It supports the patient without restricting natural movement.
• It allows for smooth and stable walking with one hand.
• It promotes long sequences, conducive to intensity.
• It limits compensations while respecting the patient’s clinical constraints.

In summary: it allows for reducing difficulty without sacrificing intensity, while maximizing repetitions under correct conditions. And this profoundly changes the impact of rehabilitation.

Conclusion

Effective rehabilitation does not seek to complicate things.
It seeks to repeat better, longer, more intensely, in realistic and secure conditions.

And if we want to build strong automatisms, we must offer the brain quality, quantity, and consistency.

Repeat, intensify… without unnecessarily complicating things.

Are you a physiotherapist or occupational therapist and want to test the Wheeleo®?

http://www.wheeleo.eu/espace-pro