Three Questions with Meghann Koppele Duffy

Episode 18 - Three Questions About Multiple Sclerosis

• Meghann • Episode 18

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What if the missing piece in MS rehab isn’t the exercise… but the input that comes before it?

In this episode of Three Questions, I share the three questions I wish more people would ask when working with, or living with, Multiple Sclerosis. You’ll hear how a single Google search changed the course of my career, why no two cases of MS are ever the same, and what it really takes to create meaningful neuroplastic change.

I break down:
 ✅ Why understanding sensory preferences is critical for motor output
 ✅ What neuroplasticity actually looks like in practice (hint: it’s not just “do more reps”)
 ✅ How prevention might not be sexy but it can be empowering

Whether you’re a movement professional or someone navigating MS in your own body, this episode will help you rethink what “progress” really means and how to stop settling for okay.

Resources mentioned:
Episode 2: Sensory Preferences and How They Dictate Who We Are!
Neuro Studio Advanced Neuro Techniques For Movement Pros
Dealing with MS? Find a Neuro Studio Teacher Near You
Connect with me on Instagram
Connect with me on Threads

Meghann Koppele Duffy: Welcome to Three Questions where critical thinking is king, and my opinions and research are only here to support your learning and deeper understanding. Hey, I'm your host Meghann, and I'm so honored you clicked on Three Questions today so we can talk about Multiple Sclerosis. Now, if you're new to my podcast or um, don't know my background, I work primarily with people with neurological conditions and multiple sclerosis kind of has a special place in my heart because that was really the first neurological condition I started working with. And it's, it's not a real profound story. It actually goes like this. A physical therapist reached out to me when I had my first Pilate studio in Hoboken, New Jersey, and she asked me if I worked with MS.

And you know, I guess the arrogance of a 24-year-old. I said, of course I do. And as soon as I got off the phone, I had a Google What is MS? And that Google search sent my career, my business, my expertise, my interest, my drive to figure out the whys in a totally different direction because that Google search came up pretty fruitless.

And what was interesting to me is when I read about Multiple sclerosis and the condition and then looked at the suggestions, it almost felt like there was like a disconnect. I'm like, okay, I could understand why stretching was suggested, but is that really the best solution? And with my first MS client, we were only able to do 30 minute sessions.

Why? Because she would get very fatigued. And at that time in, um, was that 2006? I don't know. I'm 20. I'm 43 now. So when I was 24, you guys can do the math. Um, I didn't really know how to manage MS fatigue. And while I can't make any promises, what I have really found is there are solutions and we need to be better as practitioners to help individualize.

For each person living with MS. Now let's all get on the same page because maybe you're thinking, oh crap, I don't know what exactly multiple sclerosis is or, or maybe you work with it, but you know, sometimes we forget things. So multiple sclerosis is a neurological condition. It is also considered an autoimmune condition because what happens is your immune system actually attacks the myelin sheath on your nerves.

So if we think about our nerves, we have sensory and motor nerves. So, you know, when I touch something hot, the sensory receptors in my hand, tell my brain, move that damn hand. It's gonna be problematic if you don't move it quick. Okay? Um, I actually have a burn right here on my wrist. This is why I don't cook.

Very dangerous. I touched something that was hot. But anyway, um, so that myelin really protects the sensory and motor nerves. Sorry, I didn't finish my thought there. The motor nerves are then the opposite. So sensory goes to the brain and the motor nerves are the nerves that come from the brain and actually execute the movement.

So if we're looking at this, um, if you're watching on YouTube, I'm kind of just holding a cord. A charger for my phone. And if you're not, you know, what your, uh, iPhone or phone charger looks like and what happens over time. You know, that like nice plastic or whatever it's made out of. Coating on the outside if it gets bent or you ever step on and it rips and then the wires are exposed.

Now you'll notice, like sometimes you plug the phone in and it charges. Other times you plug it in, you think it's charging, it's not. Then you go back an hour later and like, dammit. You just gotta wiggle it. One of my chargers, if you plug it in one way, it works, but if you turn it the other way, so it's like a top or bottom situation, it doesn't charge.

So why is that? Well, there's probably damaging in the wiring that is not letting that signal go through, and that's what happens with MS. So there could be damage on the sensory nerves or the motor nerves. So you could be having problems feeling sensations. Processing those sensations or creating a motor output based off those sensations.

That's kind of why, um, MS is called one of those snowflake diseases. Um, and if you don't know what I mean, like every snowflake is apparently very different. Interesting. And that's the same with MS. So something that, um, my business partner in, um, the Neuro Studio Mariska, who also happens to have MS. Would say, when you've worked with one case of ms, you've only worked with one case of MS.

But that's not to diminish your experience or what you know, or if you're listening to this living with MS, your, your situation is very unique. What is not unique is how these sensory and motor nerves work. How the brain works in like, I mean like I'm making air quotes like a perfectly healthy model, right?

Every brain and body is super unique, so none of us like the same sensory. Like right now I am wearing, uh, more tight fitted yoga pants 'cause I have to demo some stuff later where you're gonna have to see my legs move. But they come above my belly button, and that is really annoying to me. So if you're watching on YouTube, maybe this should be like a drinking game.

How many times do I adjust my shirt or pants today? Because the sensory information to my skin is a little uncomfortable. So when my brain is gonna get distracted with that sensory information, I have to make an adjustment, or I will be very uncomfortable. Okay, now think about how this will affect our MS clients.

Okay. A lot of times there'll be distal weakness. What we mean by distal is, you know, further away from the brain, so at the feet or the hands. So if you're having lack of sensation at your feet or you're having uncomfortable numbness, tingling, burning, which is very common when you have damage to the sensory nerves that is.

How, I don't want to put a word in people's mouths on something I don't experience, but how my clients experience it worse than pain. What does that mean? They'll say to me, it's just, it's constant. I can't get my brain to focus on anything else. It's distracting, it's uncomfortable. I think it's painful. I don't know.

But Meg, it's not painful. Like if you cut yourself, it's a different type of pain. And to me as a movement practitioner is to hear that information. So right now I want everybody to listen and think what sensory information bothers you the most? So that's question one. What sensory information bothers you the most?

Is it too much information at your feet? Do you hate wearing shoes and socks? Do you hate tight socks? Do you hate tight pants? Do you love tight pants? Do you like a looser top? Are you picky about your bra? Are you picky about how you wear a watch? Are you picky about how you wear your hair? Are you picky about wearing a hat or are you picky about your underwear?

I believe it was episode two about sensory preferences. So if you're listening to this episode, I would love for you to go back to episode two about sensory preferences. It is so important no matter the condition you're living with had might have all the above. If you're human, you need to understand your sensory preferences.

Maybe it's too much noise, maybe unfortunately, it's the sound of my voice. This accent how I talk, it ain't for everybody, I'll tell you that much. What bothers you? I want you to yell it out right now. Yell it out. Okay. We already know one of my sensory preferences. I hate things touching my belly button.

I'm also super picky about my underwear and I'm super picky about noises. One noise at a time. It was one of the many reasons why I chose not to have children. Okay. Um, I don't always talk about my reasons why not to have kids because it really is nobody's business, but auditory sensory input, um, can make, how do, how can I best say this?

It could make me want to punch somebody in the face. Now, I don't punch people in the face. That's a good thing, but it really aggravates my nervous system to a point where it's not manageable sometimes. Now, you might maybe have somebody who's neurodivergent or autistic in your life, and you might be able to see their sensory preferences more clearly.

If there's too much auditory, if there's too much light, if there's not enough. Their nervous system is going to react in a way that they might not have control over, or maybe they don't have the emotional connection to that, so they don't think it's a problem when they yell at or do something like that.

Um, my, uh, a person in my life who is autistic. He doesn't get why that would bother other people, which I guess I understand from his perspective. So if you're living with MS or working with people with MS, you have to understand their sensory preferences and not assume more is better. I'd like to give you an example.

Yesterday I was working with one of my MS clients who was diagnosed when she was 18. She's now 65. There's been multiple times in her life where she's been bedridden. When she was diagnosed, she was told you'd be in a wheelchair in 20 years. Don't do anything. Don't over exercise. Don't overdo it as if you had this limited amount of energy and if you use it up, you're done.

Well, that's pretty terrifying. She, I don't know if I can individualize this to her. All my MS clients are pretty fricking badass. I have to say. I mean, all my clients are, especially my MS clients. I don't know how she didn't let that stop her. I'm sure she had Downies, but she's been able to overcome that.

She can still walk. She does need a walker for assistance, but she's doing it. And when we were doing an exercise called footwork, so if you're not a Pilates teacher, that's when you see people on that Pilates reformer and they're straightening and bending their legs almost like a leg press. My hand position mattered.

So at first I had my hand on her foot and on her knee to try to help the interaction with the knee and foot. She is a knee hyper extender. She has to, she doesn't have the ankle mobility or the hip mobility, so in order to stand up, well, the joints above and below can't move as much. So the knee's like, I got this.

Okay. It wasn't helping. It wasn't helping at all. And then I tried to like dictate more with my hands and she was like, oh, okay, yeah, I see. I see what you mean. But her brain could not change. So the sensory information I was giving her foot and innate information to her brain. Her brain was not able to create a different motor pathway.

Now it's easy to blame that on her MS, but I don't give up so easily. She might have sensory damage at the knee and foot. She might also have damage to the motor nerves down to the knee and foot. So guess what? Screw those pathways. Yeah, you heard me? I am not trying to yell at a deaf person. Right. So if those sensory and motor pathways are damaged, I'm not going to go that way.

I'm gonna find a new one. So what I did instead is I took my hand on the top of her quad, so the top of her, the front of her leg, and her shin, and I put them both there and I said to her, can you move both of my hands together? So moving her femur, her upper leg bone, and her tibia, her lower leg bone, and man, she did so much better.

So rather than touching bones, I touched soft tissue. I used pressure. She said, Meg, I feel that. Am I doing better? So she asked me a question, and you know me, I'm all about the questions. As soon as the client asked me a question, I know we are on the way to success, but we're not there. If you have to ask yourself if this is good sensory input, it isn't.

Good enough. I know I'm picky, but I believe you, all my clients and anybody listening deserves the best not. Okay. So I did the same thing on the underside of her leg touching her hamstring and her calf still on soft tissue because let me explain to you my goals here. So you're not like, why'd she touch those parts?

Well, when your knee hyper extends. For this client, her tibia was shooting back more. Okay? So if I could get those, both those leg bones to move together up and down in a knee bend, she would be at less risk for hyperextending. And my goal was to get that hip to do more because she's got sensation at the hip, just not so much at the foot.

When I put my hands on her hamstring and calf, I kid you not, didn't look like she had MS. Straightened and bent her leg. She did not hyper extend her knee once, and she straightened her leg all the way. This is something that's critical. My friends, I hate when people say, well, if you hyper extend your knee, just don't straighten your leg all the way.

That's not helpful. It's you try to, everybody stand up right now. Try to stand with your knee slightly bent and not comfortable, so we almost need that end range reflex to get the whole body to work together, but I understand if your knee hyper extends and it's hurting, that's problematic. We have a saying at the Neuro Studio, we add, we don't subtract.

Instead of saying, don't hyperextend your knees. It's my job to get my clients and all our subscribers to move their ankle, their foot, their hip, their shoulder, their spine. I just need other joints above and below to do more so than knee can do less. Right. So going back, what was this client's sensory preferences she preferred?

Sensation, not at the joints, but at the belly of the muscle. That's the middle of the muscle, my friends. So you might like sensory input right at the joint, right at the folds, okay? Right at the knee. Right at the hip crease where your underwear would be. Or maybe you like sensory information at the belly of the muscle.

Now let me tell you something I observed. This client I'm talking about is very tall. I have had the hiccups for like two days. Very tall, very long legs, so I noticed being in the belly of the muscle, it kind of brought information between the two joints. It was filling sensory gaps for the brain. Maybe her knee and hip were so far away from each other.

The brain couldn't navigate. I don't know. Okay, so if you're listening to this and you're a practitioner, move your hands around. Be curious, work with pressure. Give a little pinch, do a skin glide. Figure out your client's sensory preferences, and what creates the motor response in the brain. To me, it's not about the exercise.

It's how can we change the sensory environment to give your client a new and different motor output. Now if you're listening this and you have MS, please don't settle for, okay? But I'm gonna allow you to settle for, okay? 'cause some days it ain't the day I call those 3:00 PM days with my clients. Some days you can't get the motor running till 3:00 PM or maybe you can't get the motor running at all.

Those are not the days to try to learn a new moving pattern and work neuroplasticity. Those are days. To ask your brain and body what it needs and gives give and give it to it, it them without judgment. Man, that's hard. I have 3:00 PM days from my post-concussion. My yellow light is I get pain in my left shoulder blade, and if I ignore it, that can lead to a down, uh, very upregulated nervous system in a bad way and can lead to depression.

Okay, so I know if I get to that point, I didn't listen to my yellow lights. Remember, this is personal. I'm not saying everybody with depression is the same thing, but my depression is different in the sense of it's my body saying we are working too hard to, to do what you need to do, you've gotta go back to step one.

Okay? And that's hard because on those days. Sometimes I feel really guilty. I should myself, I should do this, I should do that. I should do this. Screw it. Stop shoulding yourself. I should do a lot of things. I'm probably not gonna do them all. This is what I'm gonna do. So together, let's all stop shoulding ourselves and on 3:00 PM days or days you're feeling a little depressed or down, give your brain and body the grace to be like.

Today is not the day and I am not the one. Tomorrow will be a better day, or another one will be around the corner. Okay? But when you're feeling pretty down like that, when your symptoms are bad, it's hard to remember that. Send me a message, gimme a call. I'll talk you through it. We can do this together, okay?

So don't settle for, okay? Sensory, don't settle for just exercises. This is why in the Neuro Studio I'm having you touch or move or see specific things. If I want to create a new movement pattern, me telling you to replicate, marching, or just do a movement that you actually can't do and it's frustrating, will not lead to neuroplasticity.

That's why it's hard to get better. The shit ain't easy. That's gonna lead me to question two. What does it mean to actually use neuroplasticity? Right? If you know anything about me, I hate buzzwords. The reason why I hate buzzwords, I do this to my students all the time. It kind of makes them crazy.

They'll say something and I'll say, word salad. Word salad. Now you're throwing croutons on it and they're, I, I know their faces, they gimme that.

I know she's right, but I don't know what I mean. Yes, you do know what you mean. This is where it gets hard. Why I don't like buzzwords is because what does it actually mean to us? So you hear neuroplasticity and a lot of people say it's all about repetition and focus, but what does that actually mean?

Something that my research is very specific on is what does it mean for a repetition to actually count? There's been studies saying that you have to do like a thousand reps of something to count, and I believe that is because they are not assessing it. Off a specific sensory neuro focus. I'll explain what I mean.

Stay with me. Okay, so if you are just doing, if you're lifting and lowering your arm, do it right now. Just lift and lower your arm. Each rep might be a little different, okay? But if I say to you, take your left arm, make an L with your hand, touch your left shoulder. Or your left clavicle and your head with your other fingers.

So if you're watching me on YouTube, I'm touching like this. Or if you're like, what the hell did she just say? Just put your left hand on your head. Okay. Now what I want you all to do is lift your arm up and down with without changing the distance between your fingers if you're doing the L, or changing the pressure between your head and your hand.

So I've changed your sensory focus from the moving limb. To a non-moving part. Why is that important? Because when we move, we move parts together, but sometimes we're giving a prescribed exercise for our shoulder, for our hip, and we do it as prescribed. Okay? This is exactly what Meghann said. However, you are not actually initiating or moving from your hip.

You might be moving your hip and your spine, or your hip, or your lower back, or your hip and your opposite shoulder. Which can confuse your brain map. Stay with me. When you are walking or moving, your brain needs to know what's available and it needs to know the difference between doing this or doing that.

So if we're always moving our spine and our hip, that is what has to happen during walking. During walking. I don't want things to have to move together. I want them to move together when is appropriate and when is needed based off how you're walking and what you need. Okay, that was a lot. I promise. Let me circle back.

Okay. So what I did for you guys there is I gave you a sensory focus. So every time you lifted your arm, each repetition was moving your right arm. Without moving your head or moving that opposite shoulder, what those cues were. The goal of those was to keep your cervical spine stable and your opposite shoulder stable so that we could isolate the right arm.

So now your right arm feels what it means to just move the right arm. This is critical 'cause when we walk, our arms move in opposition. Okay, so if you, when you swing your right arm back in a gait cycle, if your left shoulder head does something kooky, that could inhibit your gait cycle. So what does it mean to you during neuroplasticity?

Does it mean just doing repetition? Okay, but what are you measuring? Those repetitions? How are you making sure it's the same in air quote, repetition rather than a thousand different options?

Let me explain it to you in a different way. If you are trying to learn French,

I don't really know many words in French. Let me, let me do Spanish. So if I wanna learn Spanish and they say, how do I say hello in Spanish? Ola. Okay. So every time I say hello to someone, I've gotta say, Ola. Ola, Ola.

Now if I start saying Yo Bon or other ways to say Hello, thens, I don't know. I, I think that's welcome. I don't, sorry. My languages are limited to English. I'm not gonna learn how to speak Spanish. So if you wanna learn how to speak Spanish, you have to speak Spanish and you have to learn how to do it correctly.

So if I start saying S right with like kind of a New York accent, Spanish people might be like, I think she's trying to say, pardon, that was me trying to do a Spanish accent. So they might kind of understand me, but it's not exactly correct. So someone who speaks Spanish should say, Meghann. Say it like this, roll the R more, and I'm gonna have to keep saying it.

No, no, no. Meghann roll the R like this. They're giving me an auditory sensory input and I'm trying to replicate it. It's the same shit with movement. So if you wanna strengthen you hips so you're not swinging your leg and your spine together in every gait cycle, you need to do repetitions that ensure that you're not moving your spine.

Now, here's where neuroplasticity gets a little more confusing.

What do we focus on?

You should focus on the thing that facilitated the change, not the motor output. This always happens with my clients. I give them a great sensory input. Maybe it's a touch base cue where I have them touch their lumbar spine to a towel or I have them touch their pelvis and a, a specific rib and they do it and they lift their leg for the first time in years and they can't believe they just did it.

And I kid you not, I over worked with thousands of people with MS. I still see patients every day because that is what I love to do. And seeing somebody move for that first time, oh my God, am I gonna like cry on my podcast? I'm gonna curse. It's fucking amazing because they now have hope because for years they thought they were too weak.

It wasn't actually just a weakness, their brain wasn't getting set enough sensory information in. Okay. One of my MS clients, God, I, I only wish I met her sooner. She's done everything she was supposed to do, physical therapy, went to the best doctors and is bedridden at this point. When I first started working with her, she couldn't move any of her limbs, only her right arm.

And when I would ask her to move other limbs, she would just move her right arm. And what I realized was. Okay, what can I do with her over Zoom? So I would have her husband touch specific limbs, and the first one made my dot jaw drop. I said, Hey, do you feel your husband's hand on your leg? And she's like, yeah.

I go move his hand. And she literally lifted her leg up. So the point where I said to her husband, oh, don't help. And he goes to me, I didn't, what did you just do? And I had to sit back and go, I don't know. And then I go, oh my God. It was a brain mapping issue. She could not feel her leg until her husband touched it.

So we use different temperatures, different positions. Sometimes she moves better when he touches her with a cold hand, because that changes the sensory input. Okay. So, for example, when we're talking neuroplasticity, I always circle back, I go off tangents. I, I, I know I'm gonna come back. If it was his cold hand.

Hey, do you feel that cold thing touching that other thing? Yeah. Move both those things together. I need her to move her leg with the cold thing as many times as she can, and then sometimes I'll have to ask my clients husband to go in the refrigerator to grab a cold drink again to make it cold because the more the hand sits on the leg, it's gonna warm up, it's gonna lose the sensory input.

Okay. You might use a visual target. Let's do another fun arm drill right now. Take your left hand and put it on your head. Find something to look at in front of you. Make sure you can see your left elbow and your peripheral vision. So don't look at your left elbow. Look at something straight ahead. Now, just move your left elbow towards and away from whatever you're looking at, so it's just kind of moving towards your nose in a way.

Make sure you can see that happening in your peripheral vision. Now, stop moving your elbow. And I want you to lift and lower your right arm, but do not let your elbow get closer or further to your visual target. Don't let it move diagonally away. Keep it locked in. Now, if that changed how you moved your right arm in a positive way, where the range of motion increased, pain went away, you isolated your shoulder more.

Well, we found a sensory input that improved your movement accuracy. Good job for us. But how are we gonna replicate that by focusing on how it felt moving the arm? No, we're gonna keep focused on the visual target and our elbow. We're activating what's called our cranial nerve three using peripheral vision.

Our eyes aren't fixing our arm. Our eyes are giving our brain sensory information. About our left shoulder position and our spinal position to help them stabilize so we can move our right arm better. And guess what? I want you doing as many reps as you can, staying focused on that visual target and, and then your right arm's gonna start to get crappy again.

Not because your arm is weak. It might be a little weak, but that's not the primary reason. Close your eyes. Open them again. Give your eyes a rest. You've just been staring at a visual target for like 15 seconds. Your eyes are tired. We should be able to ga stabilize without blinking or getting aggravated for a minute.

Most people, it's like 10 seconds max. So we should also practice that. Okay, so what does neuroplasticity mean to you? Hopefully now you have a deeper understanding. What neuroplasticity means to me is finding a specific sensory input. Whether it's a touch base cue, a visual cue, a cranial nerve drill, an auditory cue, a pressure based cue, which would also be touch.

What makes my movement better? What makes my pain go away? What decreases my spasticity? What helps me move a limb I couldn't move before? Depends on what your symptoms are from MS. Whatever that is, I need to replicate that movement. In that position and other body positions based off the sensory input.

So guys, stop trying to be Jedi. Don't focus on what it felt like doing the movement. Focus on what made the movement occur. And last but not least, our last question. How can we make prevention more empowering and sexy? We can't. Nobody cares until they have to. I work with. People with neurological conditions, professional athletes, people who have just aches and pains, and people only do their homework when they have to.

I know when my husband's foot's bothering him, it's when he asks me to work on his foot and I said, go do your hip exercises first. He goes and does his hip exercises. His foot often feels better and it's much less work for me. I remind my husband if you wanna continue playing golf with the knee, he has.

He tore his ACL mcl, LPCL, complete meniscus. His t uh, femur kind of his tibia came off his femur completely playing football. Um, and he's gonna get a knee replacement eventually, but it doesn't hurt him, but it limits his golf swing, so he has to over mobilize his foot. I said if you wanna play golf at the level you are, you've got to do your hip exercises.

So maybe what I just said about my husband resonated with you. Maybe you're thinking I'm the opposite. I have lack of range of motion in my foot from MS. Maybe if I work on my hips, my shoulders, joints up the chain, it will help support my foot better. So I'm not gonna try to convince anybody to make prevention sexy.

Instead, can I empower everybody? To pick the parts of your body that are hurting, working the hardest, or getting the least amount of sensory input and do exercises to support them. Our body works as a whole. Foot drop is not just about the foot. I had a bit of a screaming argument with the top in quotes, MS

physical therapist in New York. I was invited to lecture at a well renowned university where he worked and he told me, but I cannot recommend your work. Um, until you make changes on your website. And I was like, excuse me. He's like, you, you're teaching spinal and upper body exercises for foot drop. That's a waste of time.

And I told him, I disagree. If your upper body cannot stabilize and move effectively with your lower body, it's going to affect your gait cycle. If you don't have proximal stability or control at your hip, you are never gonna get great range of motion at your foot.

He rescinded my invite, but I stand by my approach. Everything is connected and if people say it's not connected, I'm not gonna argue with them, but I'll leave you with this. Your lat, that big ass muscle on your back originates at the top of your pelvis, connects to your thora columber fascia. That's that low back area, touches your shoulder blade and attaches to your arm.

So telling me that your upper body does not affect your lower body in the gait cycle is completely inaccurate from a musculoskeletal, biomechanical standpoint. Don't even get me started on the neuro. Okay. So if your lat, if your glutes can't activate and your arm fully mobilized and your arm can't stabilize, you're limiting your glutes potential, your hip's potential, and ultimately your foot's potential.

So to wrap up today's episode about MS, I want you to think about what are your client's sensory preferences? What are your sensory preferences? Understand if you wanna create a new motor output, a new movement patterns, there is no shortcut to success. We have to identify the sensory input that speaks to your brain so it can create a new motor pathway.

Use interesting exercises, get excited about different exercises, but in every exercise there needs to be a focus on a sensory input, especially if you wanna talk neuroplasticity. Neuroplasticity is creating a new movement pattern, but if there's not neuro focus where you feel a shift, a pain, decrease spasticity, decrease, whatever your symptoms are, if you don't feel that, aha.

It is not enough neuro focus and awareness to release three neurochemicals in the brain. Acetylcholine from two location epinephrine from one. Yeah. That's what has to happen for neuroplasticity to occur, and it doesn't occur when you're doing the exercise. It occurs during rest and when the brain rebuilds, and the more you can do that pattern.

So spend more time. Understanding your sensory preferences, figuring out what works so you can actually replicate that new motor pathway that you just connected with, because that's what's gonna make it most efficient. That's going to lead to strength, that's going to increase your mobility, and that is going to give you the biggest bang in your gait cycle.

The bad news guys is there is not one exercise that is going to fix your gait cycle. Any exercise can make your gait cycle better. And that's what we look at at the Neuro Studio, A full body approach, and taking the time and the workouts to help you identify what is working and what isn't working. And if that peripheral vision key worked for you with your arm, I want you to do that 20 times today.

Sitting, laying down washing dishes when you're on the toilet, when you're in the shower, in different sensory environments. Because what that will do is help your brain create a movement in your arm, no matter based on what your peripheral vision is telling you. And last but not least, prevention isn't sexy.

I get it. But I would like to encourage everybody to take ownership. On their bodies don't settle for. Okay. And recognize if you can support your body and strengthen the connections between areas that are working good to support the areas that are not working as well, you'll have more fluent fluency. Is that a word?

Uh, coordination. More fluent movement in your gait cycle. I'm gonna put some resources in the session notes for this so you can know where to go to learn how to do this if you're a movement professional. Um, because in our courses we teach you how to assess sensory input because I don't throw shit against the wall.

There's specific assessments so you know where to assess your client. Now, in the group classes. We kind of give a bunch of sensory approaches, but at the Neuro Studio. So if you're someone listening that has MS, I'm gonna put some resources below where you can look to learn. We do this in a group class setting so you can explore on your own time.

But we also do movement assessments where you can submit videos and ask questions. So this past month we talked about strategies to standing up taller. And one of the, um, women with MS one of our subscribers asked me to assess her hips. And what was actually pretty cool was with one sensory input, her hip movement improved significantly.

All the teachers were floored, but she didn't feel the difference. So it was a really great moment between the teachers that are observing and the the patients, because just because we see something and like something that doesn't mean there's enough awareness in your brain. To really bite onto it and replicate it.

So we found some strategies. I gave her some options. I asked her to practice, and then next month, so I'm talking about July, 2025. I don't know when you're listening to it. So then in August, 2025, we're gonna revisit those exercises. I asked everybody to try these and we're gonna find more strategies for everybody because for me, everybody deserves the opportunity to move.

I know if you have a neurological condition or MS, some things feel impossible. But it is not impossible. It is also not easy. It takes hard work, dedication, and a partnership. So if you are ready to kind of join that partnership with your brain and your body, I'd love to be here to support you. So thanks everybody who listen today, and I will see you next time, or you will hear me next time.