Neuroplasticity + Gait

Question 1

Failure to drive specific brain function can lead to functional degradation

Answer 1

Use it or Lose it

Question 2

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

Answer 2

Use it and Improve It

Question 3

The nature of the training experience dictates the nature of the plasticity

Answer 3

Specificity

Question 4

Induction of plasticity requires sufficient repetition

Answer 4

Repitition Matters

Question 5

Induction of plasticity requires sufficient training intensity

Answer 5

Intensity Matters

Question 6

List types of intensity

Answer 6

• length of time of a session
• frequency of sessions
• number of sessions
• CV Intensity

Question 7

Different forms of plasticity occur at different times during recovery and earlier = better

Answer 7

Time matters

Question 8

The training experience must be sufficiently salient (important) to induce plasticity

Answer 8

Salience Matters

Question 9

What are some things patients that have neurological disorders want to commonly work on?

Answer 9

Transfers
Balance
Gait

Question 10

Training induced plasticity occurs more readily in younger brains because they are more plastic and able to change

Answer 10

Age matters

Question 11

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

Answer 11

Transference

Question 12

Plasticity in response to one training experience can impede acquisition of similar behaviours

Answer 12

Interference

Question 13

why are the 10 principles of neuroplasticity important?

Answer 13

Because they should form the foundation of our POC for our patients

Question 14

According to the CPG, what should clinicians do for Individuals w/chronic stroke?

Answer 14

Walking training at moderate to high aerobic intensities
Walking training w/VR

Question 15

According to the CPG, what may clinicians consider doing for Individuals w/chronic stroke?

Answer 15

• strength training at >= 70% 1 RM
• circuit training, cycling, or recumbent stepping at 75-85 HR MAX
• Balance training w/VR

Question 16

According to the CPG, what should clinicians NOT do for Individuals w/chronic stroke?

Answer 16

• static/dynamic balance activities including pre-gait
• BWSTT w/emph on kinematics
• Robot-assisted gait training

Question 17

What is FITT for mod-hight IGT

Answer 17

3x week, 30-50 min per session at 60-80% HRR/75-85% HR max for 12 weeks - 6mo duration

Question 18

What are possible outcomes of M-HIGT

Answer 18

Increased gait speed and 6MWT results

Question 19

What is the FITT for VR Implementation

Answer 19

20-30 min sessions, 3x week for 3-6 weeks

Question 20

What are possible outcomes from VR Implementation

Answer 20

Gait speed, 6MWT

Question 21

What is the FITT for strength training

Answer 21

70-100% 1RM for multiple sets and reps w/focus on mm groups that contribute to locomotion

Question 22

What is true of cycling and pts w/chronic stroke?

Answer 22

Better outcomes can be achieved at higher intensities - may not be as effective as walking but can be good to increase CV endurance

Question 23

What kind of circuit training should be used w/pts w/chronic stroke?

Answer 23

Strength
Balance
Locomotor

Question 24

What are the principles of locomotor training

Answer 24

• maximize reps (Less rest and more stepping)
• maintain HR 70-80% HR Reserve w/RPE 15-17
• increase demands w/error augmentation

Question 25

How does locomotor training work?

Answer 25

• increased CP activity leads to increase in neuromuscular activity