Rehabilitation And Recovery Flashcards
What is neural recovery?
Restoration of function in damaged neural tissue (i.e. same brain regions engaged pre and post injury)
What is neural compensation?
Adaptation to residual neural tissue to take on greater/additional function after brain injury (e.g. different brain region)
What is behavioural recovery?
Restoration of the ability to perform task/movement in the same manner as before brain injury
What is behavioural compensation?
Adaptation of task or movement performed in a different manner than before the brain injury
What does structural damage affect, and what does it result in?
Usually affects a combination of cortex and white matter, resulting in localised and remote effects
What is diaschisis?
it is the inhibition of electrical activity and loss of function in an INTACT brain region remote from the site of injury, but anatomically connected to it.
Tends to happen early on after injury but improves with rapid time scale
When does oedema peak?
2-3 days post injury
What does the growth of glial (support cells) cause?
Scar tissue
What is metabolic depression?
Chemical changes in damaged cells that impair function
What is neurogenesis?
Growth of new nerve cells
What is synaptogenesis?
Formation of new connections between neurons
What are the early mechanisms of recovery in an ischameic lesion?
Repurfusion (restoration of blood flow) in the ischemic penumbra
What is the early merchandise of recovery in a haemorrhagic lesion?
Breakdown/restoration of blood components and fluid
What are the remote mechanisms of recovery?
- Reduced disconnection effects due to local recovery at the site of the white matter lesions (improved neuronal conjunction through white matter pathway)
- Reversal of Diaschisis: Resolution of remote suppression (thought to account for a component of early functional recovery)
What mechanisms of recovery happen weeks/months after injury?
- Functional Adaptation (recruitment) - intact brain regions compensating
- Reorganisation of Neural Systems (retraining) - when intact brain regions take over (e.g. homotopic cortex involvement)
What is long term potentiation?
Enhancement of signal transmission between 2 neurones after repeated stimulation
About strengthening the synaptic connections by activating the receptors that allow activation of similar receptors
What is long term depression?
Opposite of potentiation - where it is harder for signals to cross
Together what do potentiation and depression do?
Provide a balance between strengthening new connections, and pruning connections that are no longer needed. This is the basis for memory and learning
Are recovery processes linear?
No
When does most rapid recovery tend to occur?
First 3 months
Factors that are involved in recovery speed/progress?
Age Genetics (how neurones adapt) Handedness (more bilateral representation is good Lesion site (smaller = better recovery) Co-morbidities
What is the aim of rehab and how is it achieved?
Aim: to engage and enhanced spontaneous mechanisms of recovery to achieve functional improvements
Through:
Enhancement of neural plasticity
Facilitation of compensatory reorganisation
Currently: task orientated but in the future looking toward drug therapy and cortical stimulation
What kind of training is best for neural plasticity?
Intensive and frequent training
How does errorless learning work?
By avoiding inadvertent strengthening of neural pathways to unwanted responses by avoiding errors
