The corpus callosum is a part of the brain that connects the left and right hemispheres. Some people think of it as like the blue ethernet cables that connect different parts of your computer network so they can talk to each other. People who have disorders of the corpus callosum either have all of their blue cables missing or some of them missing, and they can have been missing since birth or due to some sort of trauma as a child or adult.

Physiotherapists can really help people with disorders of the corpus callosum because our job is to encourage brains to “re-wire”. We have studied neuroplasticity, which is the ability of the nervous system to be like plasticine, moulded into different connections when guided by skilled hands. Just like a preschool teacher can make more complicated objects with playdough than the preschool children they teach, physios can work to maximise neuroplasticity to help make the most functional improvement for people with brain disorders, including strokes, traumatic brain injuries and, of course, disorders of the corpus callosum.

How do physios encourage neuroplasticity, though?

Well, luckily, there’s a lot of research that has taught us the best ways to encourage the brain to rewire. Firstly, getting our patients to start a session with a cardiovascular warm-up helps the brain to release a substance called “brain derived neurotrophic factor”. This substance helps set up the brain to learn, and the research shows that learning coordinated, steady movements is best done when the patient is motivated, when the environment is most conducive to learning, and when practice sessions are focussed intensely on the movements that are the most difficult and important for successful function. As people with disorders of the corpus callosum often have difficulty learning skills that involve both hands doing different things, one example of how we can use a cardiovascular warm-up to encourage neuroplasticity is to use hand pedals like the ones in this link: https://www.u-buy.com.au/catalog/product/view/id/4964230 (this is an example only – please do your own research into the best price and how to use them). Hand pedals not only help release brain derived neurotrophic factor by performing cardiovascular exercise, they help improve bimanual (both hands) coordination.

After this example warm-up, the physio’s next job is to motivate the person to do difficult movements in a well set-up environment and give them just enough help to be successful, as this is another key to neuroplasticity – if the attempt isn’t successful, the person will either become frustrated or learn the wrong technique – or both! Depending on the person’s skill level, examples of bimanual tasks might include:

• Taking the lid off a bottle of water with one hand and bringing it to the mouth for a drink with the other (most of us are a little thirsty after a cardiovascular warm-up, after all!) For our particularly difficult-to-motivate people, though, we might use a popper of their favourite juice and stab the straw through with one hand while the other hand holds the popper.
• Another fun one might be to sit the person in a quiet room at a table where their posture is well-supported (making the environment conducive to learning) and placing a bowl of jellybeans on one side of a placemat and an empty cup on the The person’s challenge might be to move one jellybean from the bowl to the cup with one hand, and then use both hands to raise the cup to their mouth to pop the jellybean in to eat.

With intensive practice of exercises like these, the brain adapts in a similar way to how when there’s a flooded bridge between work and home, we’ll look for a back road to drive on to make sure we get home to our nice warm bed! And the more we memorise that back road route, the quicker we can get home in future!

Other movements that can be difficult for people with disorders of the corpus callosum include ones like crawling and learning to walk. Crawling is actually a really important skill that has been linked to success with mathematics at school, so don’t be surprised if your physio gets you down on the ground crawling, even if you’ve long ago learnt to walk! To make it more fun, though, we might do things like crawl through lycra tunnels – the lycra stretches around your body, providing pressure to send what we call “proprioceptive” signals to your brain to help it work out where your body is. When your brain has a clearer picture of where your various body parts are, it has a much better chance of learning how to move them in a smooth, coordinated fashion. And when you think carefully about crawling, it’s really just a bigger movement version of getting one hand to do one thing (move forwards through the air) while the other does something else (supporting your weight and essentially moving backwards while your body moves over the top). The more we can get the “back road” neuroplasticity hard-wired into your brain, the easier it is to then build a pyramid of more and more difficult tasks upon the top.

There are so many other ways in which we can make physio fun to keep you motivated to succeed while strengthening your muscles and coordination – if you like bread, for example, kneading dough can be quite a work-out! Learning to ride a bike is also something a physio can help with, and is a great way of having fun while getting cardiovascular exercise and using both sides of the body at once.

If you’re interested in how physiotherapy can help a loved one who has a disorder of the corpus callosum, the Australian Physiotherapy Association has a “Find a Physio” function to help you find an expert near you: https://choose.physio/findaphysio

Helen Nicholson