Recovery of Function Flashcards
what is plasticity?
the ability to show modification
what are the three mechanisms of neuroplasticity?
collateral sprouting, functional reorganization, neuronal regeneration and changes in synaptic efficiency
what is collateral sprouting?
- new connections are formed via axonal sprouting
- the brain continues to make new neurons
- pruning: neurons that are used frequently develop stronger connections (use it or lose it)
what is functional reorganization?
- area of the brain can take over last function of another
- functional MRI: remaining supplemental motor and sensory areas could be reorganized to take over function of the affected side
- brocas area
– affected in adults –> aphasia
– affected in infants –> little to no effect
what is neuronal regeneration and changes in synaptic efficiency?
- synaptic plasticity: experience dependent long-lasting changes in the strength of neuronal connections
- neurons are able to modify their strength and efficacy of synapses
- experience and environment impact plasticity
- habituation and sensitization
- long term potentiation
– lower the threshold needed to stimulate the pre-synaptic neuron enhancing the synapse
– rehab impacts this
under what two conditions does plasticity occur?
- typical development and learning
– beginning of life and throughout adulthood - recovery of function following neural pathology
– re-learn, compensate, maximize function - positive changes w/ activity, negative changes w/o activity
what is recovery?
- restore function to tissue lost in injury
- restoring the ability to perform movement in the same manner as performed before injury
- task accomplished in same way using same structures
what is compensation?
- neural tissue acquires a function it did not have prior to injury
- perform an old movement in a new way
- task accomplished using alternate structures (walker, orthotic, etc)
what are some factors that can affect recovery?
age, lesion factors (size, speed), genetics, braintrophic factors, gender, weight, premorbid factors, environmental factors
what are pre injury factors?
- exercise: protect against aging, neurodegeneration, injury
– oxygenate brain: supports collateral blood flow
– exercise induced neuroplasticity
– decrease cell death, edema, inhibition of neuritis growth inhibiting molecules - environmental enrichment
– varied, full, active
– functional neural circuitry that is more carries –> allows for greater ability to reorganize the nervous system after a lesion - diet
what are post injury factors?
- neurotrophic factors
– involved in neural survival and neural plastic changes
– nerve growth factor, brain derived neurotrophic factor
– rehab strategies can stimulate neurotrophic production - pharmacology
– amphetamines enhance and stimulate neurotransmitters
– medications that replace lost neurotransmitters
– meds that restore blood circulation (some can be bad though, antihypertensives and sedatives are not good post CVA) - more exercise training
what are some intervention parameters that can affect neuroplasticity?
- task selection
– specificity (task specific practice), patient preference (salience), resources - dosage parameters
– frequency, intensity, duration - practice conditions
– feedback, practice schedules, motivation, reinforcement
what are the 10 principles of experience dependent neuroplasticity?
- use it or lose it
- use it and improve it
- specificity
- repetition matters
- intensity matters
- time matters
- salience matters
- age matters
- transference
- interference
what is use it and improve it?
need skilled training to improve function, improves synaptogenesis
what is specificity?
task specific, skilled training
what is repetition matters?
need to perform the skill repeatedly over time (practice makes perfect)
what is intensity matters?
- high intensity of a skilled task improves synapses
- timing of intensity depends on pathology
what is time matters?
- initiating therapy in the acute stages is better than waiting
- compensatory patterns may become habitual if wait too long to initiate therapy
what is salience matters?
- task needs to be important to the patient
- pt goal driven (not therapist goal)
- task oriented
– motivation
– attention
what is age matters?
- cortical remapping is refused with age
- the older brain does react to experiences as quickly or as well although may respond slower
what is transference?
- previous experience drives function
- can transfer one skill to another environment
what is interference?
- compensatory strategies may interfere with recovery
- explicit instruction may interfere with learning (intrinsic feedback)
