brain behavior mechanisms Flashcards
What are some outcomes of ACL reconstruction?
- 1in 3 patients fail to return to sport after ACLR
- Increased levels of injury-related fear
- individuals with fear of reinjury were 13X more likely to suffer a second ACL tear withing 24 months of Return to sport
What do we know about injury-related fear and reaction time?
- increased levels of injury-related fear have been associated w/ slower lower extremity reaction time
- Slower reaction time is associated with musculoskeletal injury-risk
- Neuropsychological response to injury!
What is the negative response in the fear-avoidance model?
after injury –> pain response –> catastrophizing –> fear of pain (increased arousal) –> Defense mechanisms (avoidance or using body part and escape- avoidance of sport all together) –> pain anxiety (prevention motivation, increased arousal, and hypervigilance) –> disuse of the injured body part, disability, and depression –> reinjury
What is the better response in the fear avoidance model?
injury –> pain experience –> low fear –> confrontation –> recovery
What is neuropsychology?
a branch of psychology concerned with how the brain interacts with the rest of the nervous system influences a person’s cognitions and behaviors
What is neuroplasticity?
general ability of nervous system to continuously change and adapt in a context-dependent manner throughout life
- injury changed brain chemistry
What happens in the brain during an injury?
the prefrontal cortex (what to do in a situation, thinking and logic) –> hippocampus (regulates memory and emotions) –> amygdala (turns on fight or flight and stores memory events)
What is the role of the thalamus in injury?
- receives all sensory input from brian stem
- sends input to subcortical and cortical structures
- Direct link to amygdala
What is the role of the amygdala in injury?
- responsible for emotional responses and learning
- connects to the hypothalamus
- leads to fear expression
What is the role of the hypothalamus in injury?
- responsible for threat assessment
- links nervous and endocrine system
- facilitates the release of cortisol
What is the role of the hippocampus in injury?
- processing and storage of memory
- holds spatial memory (what we know of environment and surroundings)
- initiates and processes fear response
What is the role of the prefrontal cortex in injury?
- associated with the production of emotions
- associated with motivation and executive functions
- ## can STOP fear response (active coping)
Can fear be adaptive?
yes, you can eventually reduce or eliminate the fear response
- exposure
- prefrontal cortex (changing thought process changes memories about the situation which will then change amygdala response)
Steps for musculoskeletal rehab
Plan - start with a clinical exam. Develop a plan together so the athlete knows what to expect and they can make unique goals to aid in motivation (creating a plan reduces fear response)
Train - should reflect what the patient needs to do to be successful. mediates disappointment when relearning movement patterns
Retention - schedule the patient follow-up to determine if the effects are sustained
Re-check - repeat clinical assessment and adjust if needed (check on movement and also injury-related fear)
What is the goal of rehab?
change in sensory input to have a desired motor output
- Rehab = adaptive neuroplasticity
