Lecture 4 - Clinical Practice 2 Flashcards
Some spontaneous recovery is possible within patients with brain damage, when does this usually occur and on what is the extend of recovery dependent?
It depends on the severity, location and type of injury and happens usually within 12-14 weeks after the injury
For the large majority of cases, is full recovery possible? Substantiate your answer
No, for most people functioning will never return to what they were used to before the trauma and are left with permanent neuropsychological disorders
In which time frame does most of the recovery happen?
3-6 months
Explain what neuroplasticity is and which two ways of it there are
The ability for the brain to modify itself
(functionally or structurally) in response to injury (spontaneous) or in response to stimulation and treatment (experience-dependent)
Does neuroplasticity happen only after injury? Substantiate
No, it happens throughout life because of development and learning
Neuroplasticity can happen functionally or structurally, what is the difference?
Functional = the function of one damaged area of the brain moves to a non-affected area
Structural = physical changes in the brain happen because of experiences
Spontaneous recovery can happen in two ways (within the brain), which two ways?
Diffuse and redundant connectivity - Recovery takes place by activating other areas in the network
Cortical reorganization - new structural and functional connections between cortical areas take over
The lecture mentions some “rules” to increase neuroplasticity, which are they and what do they mean?
- use it or lose it (aka stimulate the damaged brain area)
- Salience (important experiences = better processing)
- Repetition, intensity and time
The Kennard Principle is an outdated principle regarding brain plasticity, why do we no longer support this principle?
It is clear now that children don’t necessarily recover better/quicker from brain trauma, but certain cognitive skills that are affected by the injury were not yet learned by the child and thus deficit in this area did not show > growing into deficit
Restorative approach is one of the kinds of training used in rehabilitation, what method does this approach use?
Functional training; cognitive functions will recover through repeated exercise
There is a concept called “near and far transfer” + generalization, explain
Near transfer = to same/vert similar task only
Far transfer = to different tasks/context/domains
Generalization = Learned behaviour is applied to daily life
Does the restorative approach work? Substantiate :)
Not that we know, repeated training does not restore cognitive functions and thus solely focusing on the functions/structures part of the ICF model (impairments) does not seem to lead to improvement on activity/participation level
Another approach to rehabilitation is the compensatory approach, explainnn
Focuses on the activity/participation levels of the ICF model. This is about learning strategies to compensate for impairments
Name and explain the different types of compensatory approach methods
- Environmental adaptations (making the environment work for you!)
- Stimulus-response conditioning
- Skill training (task level through repetition, not aimed at improving cognitive functions or generalization)
- Strategy training (generalization goal)
Gross and Schutz (1986) have a model regarding different types of compensatory approaches- what is this model and what four “benchmarks” are there?
Which different methods within this approach need what type of cognitive functioning (which are; Learning, generalization, self-monitoring and goal setting).
