This is part of our on-going series of exploring neurological and degenerative conditions that can affect a number of individuals and specifically how Physical Therapy can help”
Today’s topic is Neuroplasticity. This week we explore this concept and next week we will discuss effective activities, exercises and rehab strategies that can help make new connections thus making the recovery road more efficient with conditions such as Stroke, Traumatic Brain Injury, Multiple Sclerosis exacerbation or other degenerative conditions.
Neuroplasticity is also know as brain plasticity and it describes both non-synaptic and synaptic plasticity which affects changes in neural pathways. It was long believed that you were born with a certain number of neural cells and we could not generate new ones. So if you damaged them via a stroke or traumatic brain injury then your damage was irreversible. However, this theory has changed as we have seen the brain suffer tremendous loss in neural activity from a trauma or chronic condition but with certain rehabilitation, we can see improvements and great gains in functional activities. With this evidence and more and more research coming out every year, it is now evident that the brain has the capability to reorganize by creating new cells and thus new pathways.
When looking at neuroplasticity in rehabilitation there are ten key principles:
#1. Use it or Lose it! If neural circuits are not actively engaged for an extended period of time, they will degrade.
#2. Use it and Improve It! New pathways can be induced in specific areas of your brain with lots of training.
#3. Specificity! Training in a specific manner may change part of the neural circuitry involved in more general function which impacts the potential for learning in non-trained activities.
#4. Repeat, Repeat! Repetition of newly acquired skills is essential for lasting changes.
#5. Intensity Matters! Just like repetitions, the more intense the stimulation is, the longer that changes are.
#6. Time Matters! Basically, training soon after brain injury is very important but time windows can vary based off of ones’ condition.
#7. Salience Matters! You have to care and participate in activities/training at home and in rehab.
#8. Age Matters! Like most injuries, the younger the brain is, it generally responds better to stimulation and rehabilitation.
#9. Transference! Participation in exercise results in creation of new vessels in the motor cortex providing good support for learning.
#10. Interference! Stimulation outside of training may disrupt the memory process and lead to development of compensatory behaviors.
These key principles were discussed in a position paper published in The Journal of Speech, Language, and Hearing Research (vol 51, p. S225-239).
With these principles in mind, next week we will discuss strategies, activities to tackle tasks such as picking up a brush to as complex as walking down the street.