Neuroplasticity for Stroke Paitents' Rehabilitation
If you have been in rehabilitation for a brain injury, such as trauma or a stroke you have probably heard the term neuroplasticity. It might sound intimidating, but it is one of the most important concepts related to recovery.
Neuroplasticity is simply a catch-all term to describe the many ways that the brain and nervous system change, both in our everyday lives as well as in recovery after an injury.
A Brief History
The word “plasticity” first appeared in an 1890 textbook called The Principles of Psychology, written by esteemed philosopher and psychologist William James. He describes the brain as a collection of pathways through which information must travel. The information the brain needs to move the hand, for example, must travel from point A in the brain to point B before the hand actually moves.
Usually, that information takes a specific path, one that is deep-seated that path is tread many times just in the course of an hour; the brain learns to use that path as the fastest way to get the hand moving. However, when something happens to block that path, such as an injury or stroke that interrupts blood flow to the brain, the information at point A still needs to find a way to point B, just on a different path.
It’s a bit like Google Maps. If a traffic accident causes delays on your normal commute home, Google Maps may direct you to take different streets in order to get you home earlier.
How Times Have Changed
Studies on neuroplasticity and the brain’s ability to change itself are still very new, having only started 50 years ago. Back then, the idea that the brain could change in any way was unheard of. It was believed that we were born with all the brain cells that we would ever have, and the brain was incapable of regenerating itself. The medical community believed that any damage to the brain was irreparable.
Unfortunately, this school of thought still exists in the world of neurologic recovery, even though scientific discovery continues to show that we can indeed make changes and recover from damage to the brain and neural pathways, even years and decades after the initial injury.
Patients still hear from their doctors and therapists that whatever improvements they’ve made after a certain time (typically 6 months to a year) is all that would ever be possible. Patients then feel like there is no reason to continue with rehabilitation because it is simply “too late.”
Is It Ever “Too Late?”
Admittedly, the brain is best primed for re-wiring shortly after the injury or stroke, meaning those new pathways are much easier to develop the closer rehabilitation starts from the actual injury.
However, there are always opportunities for continued recovery. Research done on our RAPAEL Smart Glove and other therapy devices has shown that patients can achieve improvements even 20 years after the incident! The adult brain is not only capable of changing, but actually does change continuously throughout life, in response to everything we do and every experience we have.
What Does This Mean for Me?
Now that you understand the theory and science behind neuroplasticity, here are the three most important principles of neuroplasticity that affect your recovery.
It absolutely is possible to see physical improvements years and decades after the stroke or brain injury. New brain mapping technology and rehab studies continue to provide scientific support to this notion.
Effective training is mostly about how many repetitions of task-based movements a patient performs in any given session; how those repetitions are performed matters less. In other words, just do it!
Studies have shown that patients need far more training repetitions during rehab sessions in order to maximize functional improvement after a stroke or brain injury. Average practice in clinical studies is about 30 minutes per day and recent research (Schneider et al, 2016) demonstrates that 80 minutes per day is actually ideal to maximize results.
You may now be wondering how you can fit in the required amount of repetitions needed in your day-to-day life. The outpatient therapy that most people can access through insurance, typically 2-3 visits per week for 30-60 minutes, simply isn’t enough.
As you may have guessed, the RAPAEL Home Smart Rehab program was designed with repetitions in mind, and making the best use of the time spent in training activities.
How, you ask? We’ll go over ways to increase repetitions and practice, and how our products can help, in our next blog post!
Reference: J Physiother. 2016 Oct;62(4):182-7
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