Neuroplasticity Interventions

what is neuroplasticity believed to be?

the basis for both learning in the intact brain and re-learning in the damaged brain that occurs through physical rehabilitation

what is the difference between adaptive and maladaptive?

adaptive: associated with a gain in function

maladaptive: associated with negative consequences such as a loss of function or increased injury

what are some examples of maladaptive neuroplasticity and adverse outcomes that can occur?

muscle spasticity

neuropathic pain

autonomic dysreflexia

urinary bladder dyssynergia

bowel dysfunction

cardiac arrhythmia

sexual dysfunction 

what do maladaptive neuroplasticity dysfunctions arise from? 

imbalance between inhibitory and excitatory synaptic inputs to spinal neurons and a loss of coordination between autonomic and somatic control following SCI 

what is adaptive plasticity vs. compensatory behaviors?

adaptive plasticity: refers to restorative or beneficial reorganization within the original neural networks

compensatory behaviors: alternative strategies or neural pathways that enable task performance

who is plasticity greatest in?

developing, young brain

some degree of plasticity remains in adult brain

when does peak neuroplasticity occur?

early subacute phase (1 week to 3 months)

what are some things that are classified as early recovery? 

resolution of spinal shock

reduction of inflammation 

restoration of residual axonal conduction 

synaptic reactivation 

what type of rehabilitation should we be doing during the subacute phase while trying to get activity-dependent inputs

intensive, task-specific, repetitive training

sensory-motor stimulation and environmental enrichment

preventions of maladaptive changes

greater than 6 months what is challenging with injury?

focus shifts from restoration to optimization

harder to induce

brush up on functional reorganization of somatosensory cortex by training

how are cortical maps remodeled? 

experience, by the performance of specific, intensive and complex movements 

how is functional topography of motor cortex shaped?

the learning of new motor skills, not simply by repetitive motor use

more difficult tasks saw more neuroplastic changes

what is constraint induced movement therapy?

if you inhibit a limb from doing what it normally does, it can strengthen their synergistic patterns to their advantage

how are cortical plastic changes done?

repeated practice

use-dependent brain reorganization

improved motor function

what are 2 proposed mechanisms of action for CIMT? 

encourages the use of the affected limb 

repeated and sustained practice causes function-induced recovery (uses dependent cortical reorganization) 

what happens when we don’t use a limb?

decreased cortical thickness in the primary motor and somatosensory cortices to the immobilized limb

increased cortical thickness in the motor cortex

what does forced exercise pedaling exert?

both neurorestorative and neuroprotective effects

what does progressive resistance exercise show?

may lead to experience-dependent plasticity in the basal ganglia and corticomotor pathways

what interventions are best for neuroplasticity? 

impact when paired with optimal training and meaningful expereince

what is plasticity?

time senstive

experience and task specific

environmental dependent

training dependent

what are critical modulators that enhance and sustain adaptive plasticity

motivation and attention

what are some principles of experience-dependent neuroplasticity?

specificity

intensity

repetition (volume)

Salience

what are some neuroplasticity interventions? 

physical training and exercise 

cognitive training 

non-invasive brain stimulations 

deep brain stimulation 

neuropharmacology 

what are characteristics of physical activity and training that affect neuroplasticty

plastic changes are optimized when training skill learning and repeated

initial plastic changes are often temporary

practice and repetition are required to make neural changes

motivation enhances the efficiency and magnitude

what is the key point with experience-dependent plasticity and rehabilitation?

the amount of active, task-specific practice in rehabilitation is often too low to drive meaningful neuroplastic changes

what types of interventions need to be done to maximize neuroplactic changes? 

rehabilitation must involve higher intensity, greater repetition, and more task-specific practice