Oefeningen bij traumatisch hersenletsel — progressie onder symptoomdrempel, vestibulair-bewust, alcohol VERMIJDEN

Hellweg 2014 + Wise 2012 established that structured aerobic + balance + vestibular rehabilitation improve outcomes post-TBI. The Berlin Consensus 2017 + 2023 CISG (Concussion in Sport Group) set the graded-return-to-activity protocol after concussion — sub-symptom-threshold progression, NOT push-through. Persistent post-concussive symptoms (PPCS) lasting >3 months require multidisciplinary collaboration: vestibular PT + neurology + ENT + sometimes psychiatry for mood + sleep. Lewis 2013 + Bailes 2014 established omega-3 EPA+DHA 2-3 g/day TBI-recovery + mood benefit; Sakellaris 2008 documented creatine 3-5 g/day TBI-recovery evidence (especially pediatric, adult signal too). The exercise priorities are therefore: gentle aerobic progression below symptom threshold, vestibular rehab + gaze stabilization when vestibular component, posture + posterior chain, breath/parasympathetic anchors for sleep + headache management. AVOID sub-symptom-threshold progression too fast; AVOID alcohol post-TBI (lowers seizure threshold + worsens cognitive recovery); AVOID high-stimulant pre-workouts (cognitive + headache + seizure risk).

Volya's catalogue carries the foundation moves: diaphragmatic-breathing for parasympathetic regulation + headache + sleep + autonomic recovery, supported-glute-bridge for posterior chain, supine-knee-to-chest for low-back release, wall-push-up for upper-body strength scaling, scapular-retraction for posture against chronic forward-headed posture, cat-cow for spinal mobility, gaze-stabilization for vestibular component (critical post-blast or impact TBI — common in veterans, athletes), standing-march for cardio at sub-symptom-threshold pace, sit-to-stand for functional strength. The AI coach also knows the nutrition side — Lewis 2013 + Bailes 2014 omega-3 EPA+DHA 2-3 g/day for TBI + mood, Sakellaris 2008 creatine 3-5 g/day TBI-recovery evidence, Mediterranean / anti-inflammatory backbone, alcohol AVOID post-TBI (seizure threshold + cognitive recovery + comorbid PTSD/SUD), caffeine moderate (morning OK; AVOID late-day for sleep + headache), protein 1.2-1.4 g/kg/day + choline (eggs, soybeans) for neural membrane recovery, B-complex + vitamin D + magnesium + zinc, AVOID megadose supplements (vitamin E megadoses post-TBI controversial), AVOID ketogenic diet without neurology supervision (acute TBI seizure risk), individual headache triggers (caffeine, nitrates, tyramine, alcohol common). CRITICAL: neurology + concussion specialty clinic + Brain Injury Association of America + LoveYourBrain + 988 + post-concussion vestibular PT + cognitive rehabilitation. This is NEVER a replacement for neurology care.