Recovery of Function (Exam 2) Flashcards
What is plasticity?
- ability to show modification
What is collateral sprouting?
- New connection are formed via axonal sprouting
- Brain continues to make neurons
- Pruning (neurons that are used frequently develop stronger connections)
What is functional reorganization?
- Area of the brain can take over lost function of another
In regards to functional reorganization what happens if Broca’s area is damaged in adults? Or infants?
Adults: aphasia
Infants: little to no effect
True or False: Remaining supplements motor and sensory areas could be reorganized to take over function of the affected side
True
- This is functional reorganization
What is synaptic plasticity?
- Experience dependent long lasting changes in strength of neuronal connections
- Neurons are able to modify their strength and efficacy of synapse
What are some components of synaptic plasticity?
- Experience and environment impact plasticity
- Habituation & Sensitization
- Long term potential
What is the effect of long term potentiation?
- Lower threshold needed to stimulate the pre synaptic neuron enhancing the synapse
What are the three mechanisms of Neuroplasticity?
- Collateral sprouting
- Functional reorganization
- Neuronal regeneration and changes in synaptic efficiency
Plasticity can occur under what 2 conditions?
- Typical development & learning (beginning of life throughout adulthood)
- Recovery of function following neural pathology (relearn, compensate, maximize function)
How is plasticity a 2 way street?
- Positive changes with activity
- Negative changes with inactivity
What is recovery?
- Restore function to tissue lost in injury
- Restoring the ability to perform movement in 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
How can age affect recovery of function?
- Young vs old
- If injured area is matured injury will typically cause same damage in infants and adults
- Immature area is injured another immature area can take over
How does the extent and characterization of lesion affect recovery of function?
- Greater functional loss seen with large single lesion vs smaller serial lesions (damage sam area but smaller little lesions allow more recovery between)
- Slowly developing lesions cause less functional loss than if happen quickly
How does level of exercise prior to injury affect recovery?
Exercise: protect against aging, neurodegeneration & brain injury
- Oxygenate the brain (promote angiogenesis to support collateral blood flow
- Exercise induced neuroplasty
- Decrease apoptosis, edema, & inhibition of neurite growth inhibiting molecules
How does environmental enrichment affect recovery?
- Varied, full, active
- Functional neural circuity that is more varied which allows for a greater ability to reorganize the nervous system after a lesion
What are the pre injury factors that can affect recovery?
- Exercise
- Environmental enrichment
- Diet
How does neurotrophic facts post injury affect recovery?
- Involved in neural survival & neural plastic changes
- Nerve growth factor (NGF), Brain Derived Neurotrophic Factor (BDNF)
- Therapeutic strategies used during rehab can stimulate local neurotrophic production to modulate neurotransmitter system and enhance sprouting of compensatory networks
How can pharmacology post injury affect recovery?
- Amphetamines (enhance & stimulate neurotransmitters)
- Medications that replace lost neurotransmitters
- Meds that restore blood circulation
How does exercise post injury affect recovery?
-More
- Impact related to location of injury, dosage, task & practice conditions
What should be considered in task selection?
- Specificity (task specific)
- Patient preference (salience)
- Resources
What should be considered in dosage parameters?
- Frequency
- Intensity
- Duration
What should be considered in practice conditions?
- Feedback
- Practice schedules
- Motivation
- Reinforcement
What are two things to keep in mind when selecting a task?
- Every activités (use natural environment)
- Salient, meaningful activities for the patient
What are the 10 principles of 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 an example of the use it or lose it principle?
Patient can’t do activity so they compensate to do activity, they keep doing activity using compensation so the loose the ability to perform the activity efficiently
What is the use it and improve it principle?
- Need skilled training to improve function, improves synaptogenesis
Describe the task specificity principle?
- Task specific
- Skilled training
Describe repetition matters principle
Need to perform the skill repeatedly over time
Describe intensity matters
High intensity of a skilled task improves synapses
Describe time matters principle
- Initiate therapy in acute stage is better than waiting
- Compensatory patterns may become habitual if wait too long to initiate therapy
Describe salience matters principle
- Task need to be important to patient
- Patient goal driven
- Task oriented
Describe age matters principle
- Cortical remapping is reduced with age
- The older brain does not react to experience as quickly or as well although may respond slower
Describe transference principle
- Previous experience improves function
- Can transfer one skill to another environment
Describe interference principle
- Compensatory strategies may interfere with recovery
- Explicit instruction may interfere with learning (intrinsic feedback)
What type of feedback should be given in early rehab?
- Extrinsic feedback
- Immediate
- Concurrent
What type of feedback should be given in later rehab?
- Intrinsic feedback
- Delayed
- Intermittent
- Bandwidth feedback
- Self controlled
- Faded feedback
What are the practice conditions that should be used during early rehab?
- Distributed
- Blocked
- Guided
- Part to Whole
- Constant
- Closed environment
What are the practice conditions that should be used during later rehab?
- Massed practice
- Random
- Discovery
- Whole
- Variable
- Open environment
