Week 1 - Neuroplasticity

PLASTICITY

the capacity of the central nervous system to adapt to functional demands and therefore to the system’s capacity to reorganize

default plasticity

Allows us to adapt to our changing environment

Other types:

- Functional plasticity

- Adaptive plasticity

NEUROPLASTICITY

the ability of neurons to change their function, chemical profile, or structure

- Essential for recovery from damage to the CNS

neuroplasticity encompasses three mechanisms:

• Habituation

• Experience dependent plasticity - learning and memory formation - long-lasting changes to synaptic connections

• Cellular recovery after injury - axons dont regenerate in CNS, but cortical reorganization can occur

this is why repetition is so important

Four major forms of functional neuroplasticity

• Homologous area adaptation-function that normally happens in the damaged area (ex: restoring language function after experiencing aphasia, it shifting to the right hemisphere)

• cross-modal reassignment, or plasticity - visual cortices of people with acquired blindness will begin to help with tactile, auditory, etc input (takes on a new job)

• Map expansion- function of the one dominant hand will be higher than the other dominant hand (cortical map of left hand will be bigger than right hand in a violinist bc left hand has more fine motor movement when pressing down on strings while right hand is moving bow with gross motor movement)

• Compensatory masquerade: brain injury patient has trouble operating a Keurig (procedural memory issues) so they use a strategy like a visual guides to compensate (using other parts of the brain to help them)

Neuroplasticity is dependent upon

- Severity of neurological damage

- Age Premorbid health status - if u were healthier, recovery may be easier

- Preinjury use of the damaged area - if u used ur right brain more than u have stronger and more established neural connections in that area so it’ll heal better

Summary of empirical evidence of neuroplasticity and functional recovery (Nudo,

2003)

- Injury to the motor cortex brings about functional changes in the spared cortical

- Neural organization and motor skill learning are optimized when people with injuries focus on engaging, meaningful, and challenging tasks

- Many repetitions are required to become skilled at complex motor tasks

- Repetitions of tasks that are too easy/not challenging enough will not produce long-term neural reorganization

10 PRINCIPLES OF EXPERIENCE-DEPENDENT NEUROPLASTICITY

1. use it or lose it

2. use it and improve it 

3. specificity 

4. repetition matters

5. intensity matters

6. time matters

7. salience matters

8. age matters

9. transference

10. interference

use it or lose it 

Failure to drive specific brain functions can lead to functional degradation

use it and improve it

Training that drives a specific brain function can lead to an enhancement of that function

specificity

The nature of the training dictates the nature of the plasticity

repetition matters

Plasticity requires sufficient repetition/practice

intensity matters

Plasticity requires sufficient training intensity

time matters

Different forms of plasticity occur at different times during training

salience matters

The training experience must be sufficiently salient to induce plasticity

age matters

Training-induced plasticity occurs more readily in younger brains

transference

Plasticity in response to one training experience can enhance the acquisition of similar behaviors

interference

Plastic changes as a result of one experience can interfere with the acquisition of other behaviors

Kielhofner -- Model of Human Occupation

 An acquisition of (occupational) competence

Schkade & Schultz -- Occupational Adaptation Model

A method of modifying activities or tasks, making changes to the environment,

and identifying the need for assistive equipment

Grajo, Goisselle & DaLomba

A transformative process, internal to the person while participating in

occupation and as an outcome of participation in occupation

Occupational adaptation is...

• A product of engagement, finding meaning and satisfaction in occupations

• Emerges from the transaction with the environment

• A manner of responding to change, altered situations, life transitions

• Formation of desired sense of self, competence, mastery, and identify 

OCCUPATIONAL ADAPTATION: A PROCESS

Allows a person to navigate challenges of daily occupational performance and interact with the occupational environment

OCCUPATIONAL ADAPTATION: An outcome

¡ An outcome of occupational participation

¡ Creates a desired sense of self, a sense of competence and mastery

¡ Reestablishes occupational identity

Functional plasticity and adaptive

responses:

Homologous area adaptation

Cross-modal plasticity

Cortical map expansion

Compensatory masquerade

Example interventions:

Transcranial magnetic stimulation

Constraint induced movement therapy

Task-specific training

Mental practice

Sensory-rich environments

THE LIVED EXPERIENCE

¡ Phenomenological research aims to capture subjective, ’insider’ meanings and what the lived experience feels like for individuals (Finlay, 2009)

¡ The lived experience is not questioned or reflected upon (Erikson, Karlsson, Tham, 2004; Johansson & Tham, 2006)

WHY IS IT IMPORTANT TO UNDERSTAND THE LIVED EXPERIENCE

OF CLIENTS?

To understand the essence of the unique and common experiences of

people after disease/injury when the changes in their body affect their lived experience