Recovery of Function Flashcards

1
Q

what is plasticity?

A

the ability to show modification

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2
Q

what are the three mechanisms of neuroplasticity?

A

collateral sprouting, functional reorganization, neuronal regeneration and changes in synaptic efficiency

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3
Q

what is collateral sprouting?

A
  • 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)
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4
Q

what is functional reorganization?

A
  • 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
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5
Q

what is neuronal regeneration and changes in synaptic efficiency?

A
  • 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
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6
Q

under what two conditions does plasticity occur?

A
  • 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
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7
Q

what is recovery?

A
  • 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
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8
Q

what is compensation?

A
  • 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)
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9
Q

what are some factors that can affect recovery?

A

age, lesion factors (size, speed), genetics, braintrophic factors, gender, weight, premorbid factors, environmental factors

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10
Q

what are pre injury factors?

A
  • 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
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11
Q

what are post injury factors?

A
  • 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
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12
Q

what are some intervention parameters that can affect neuroplasticity?

A
  • task selection
    – specificity (task specific practice), patient preference (salience), resources
  • dosage parameters
    – frequency, intensity, duration
  • practice conditions
    – feedback, practice schedules, motivation, reinforcement
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13
Q

what are the 10 principles of experience dependent neuroplasticity?

A
  • use it or lose it
  • use it and improve it
  • specificity
  • repetition matters
  • intensity matters
  • time matters
  • salience matters
  • age matters
  • transference
  • interference
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14
Q

what is use it and improve it?

A

need skilled training to improve function, improves synaptogenesis

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15
Q

what is specificity?

A

task specific, skilled training

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16
Q

what is repetition matters?

A

need to perform the skill repeatedly over time (practice makes perfect)

17
Q

what is intensity matters?

A
  • high intensity of a skilled task improves synapses
  • timing of intensity depends on pathology
18
Q

what is time matters?

A
  • initiating therapy in the acute stages is better than waiting
  • compensatory patterns may become habitual if wait too long to initiate therapy
19
Q

what is salience matters?

A
  • task needs to be important to the patient
  • pt goal driven (not therapist goal)
  • task oriented
    – motivation
    – attention
20
Q

what is age matters?

A
  • cortical remapping is refused with age
  • the older brain does react to experiences as quickly or as well although may respond slower
21
Q

what is transference?

A
  • previous experience drives function
  • can transfer one skill to another environment
22
Q

what is interference?

A
  • compensatory strategies may interfere with recovery
  • explicit instruction may interfere with learning (intrinsic feedback)