The brain’s ability to adapt processes and pathways throughout the body – a rewiring, of sorts, to overcome the body’s changing neurological abilities – is truly extraordinary.
This neuroplasticity, as it’s called, often occurs naturally throughout our lives. But, following a traumatic brain injury or stroke, the presence of neuroplasticity gives people hope that recovery is possible, said Chandler physical therapist and neuro clinical specialist Jefferson Holm.
The pathway to recovery, however, isn’t necessarily an easy one.
“Regaining movement and function following a traumatic brain event like a stroke requires discipline, intensity and repetition on a very large scale,” said Holm, owner of Advanced Neurologic Rehabilitation in Chandler. “Rehabilitation involves creating and strengthening neuro-connections for certain movements and tasks, and this takes time and determination.”
As neuro clinical specialists like Holm guide patients through such rehabilitation, he and his patients are guided by the following 10 tenants, known as the Principles of Neuroplasticity:
1. Use It or Lose It
If you want to keep or regain a particular motor pattern in the body (i.e., gripping a cup), you have to use it. You must keep your neuro circuits engaged or you could lose patterns you once had.
2. Use It and Improve It
Using such efforts as constraint-induced therapy, a therapist may constrain a patient’s “good hand” in order to force them to use and improve the other – a natural progression from the previous principle.
You’re only going to get better at specifically what you practice. If you want to get better at tying your shoe, for instance, you must practice that specific act. Simply improving general hand function won’t cut it.
To improve a specific movement or function, it must be practiced thousands of times. The more you do it, the better you’ll be.
5. Intensity Matters
Rehabilitative tasks must be challenging and difficult. If they’re not, you won’t fully engage and strengthen the brain and its neurological pathways.
6. Time Matters
The natural healing process takes time, as do improvements. It takes time for the swelling in damaged (not destroyed) cells to go down, allowing them to recreate the circuits required for improvement.
7. Salience Matters
Improvements and goals must be salient and meaningful to the patient. Actions, like walking, putting on shoes or using their hands have to matter. The therapist will tailor exercises accordingly.
8. Age Matters
Younger brains typically do better than older brains. The older we get the harder it is the achieve changes through neuroplasticity.
This is the ability of plasticity within one set of neural circuits to transfer to similar patterns of movements. For instance, relearning to walk can build up toward walking on uneven ground, or even up the stairs.
The goal is to avoid interference. For instance, if a stroke patient always just turns to their “good side” to get something done, it can interfere with their ability to regain neuro pathways on their other side.
“These are tried, true and tested principles found to be incredibly important when recovering from stroke or learning a new skill following a brain trauma,” Holm said. “It can help patients understand why we as neuro professionals do certain things and why we push so hard”
“It’s because it all really matters,” he added. “And, it’s our passion to guide people through this sometimes rigorous process so they can continue to live their best lives post-stroke.”