Week Two Part 2

Question 1

What are the 10 principles of neuroplasticity?

Answer 1

1. Use it or lose it
2. Use it and improve it
3. Plasticity is experience specific
4. Repetition matters
5. Intensity matters
6. Time matters
7. Salience matters
8. Age matters
9. Transference
10. Interference

Question 2

Describe the principle of “use it or lose it”

Answer 2

If a motor programme or neural substrate is not used, it will degrade.

Example: a patient being tube feed and expectorating their saliva

Question 3

Describe the principle of “use it and improve it”

Answer 3

Simply swallowing will not necessarily improve swallowing in a person with dysphagia

Therefore, the aim of treatment should not only to use a function, but to use it with improved competence

BISCUIT/manommetry may be helpful for feedback of improved swallowing function

Question 4

Describe the principle of “plasticity is experience specific”

Answer 4

Rehabilitation tasks should be functionally specific i.e., swallowing rehabilitation should include swallowing.

Classification of exercises:
Exercises that utilize swallowing during practice
- effortful swallow, Mendelsohn, tongue hold

Swallowing-related exercises, done outside the context of swallowing
-Head lift, tongue strength

Non-swallowing related exercise
- EMST, LSVT

Question 5

Describe the principle of “repetition matters”

Answer 5

Extensive and prolonged practise = induced change + maintain change

Question 6

Describe the principle of “intensity matters”

Answer 6

Variable response depending on time since injury

e.g., It is possible to overuse impaired extremities in a manner that worsens function. BUT there also appears to be a threshold of intensity to induce plasticity (not enough will also not induce plasticity)

Also resources of SLP (time) may be a limitation

Question 7

Describe the principle of “time matters”

Answer 7

Optimal timing of rehabilitation after stroke remains controversial

Many studies report benefits of early rehabilitation compared to later intervention for stroke, but quality of evidence is limited (differing definitions of “early”)

Question 8

Describe the principle of “salience matters”

Answer 8

Learning is related to the importance of the stimulus and frequency of occurrence

Use relevant stimuli

Question 9

Describe the principle of “age matters”

Answer 9

Younger nervous systems are more responsive to training and adaptive neural plasticity than older ones

However, neural plasticity does continue to occur over the lifespan

Question 10

Describe the principle of “transference”

Answer 10

The ability of plasticity within one set of neural circuits to promote concurrent or subsequent plasticity

Target one part of swallowing that will have a positive impact on another

Question 11

Describe the principle of “interference”

Answer 11

The ability of plasticity within a given neural circuitry to impede the induction of new, or expression of existing, plasticity within that same circuitry

Learning a skill acquisitions may be hampered by something else.

Wagon wheel tracks in the road, disrupting these tracks means the wagon won’t be able to drive down anymore.