Authors: Rhonda Felice
Hi I am Rhonda. I am the Stroke Therapy Manager at Brooks Rehabilitation Hospital. Those studying rehabilitation are frequently asked questions about the types of therapies that should be included when treating a stroke patient. In neuroscience research, the approaches to improving function after a stroke fall into two major categories:
- limiting the severity of the initial injury to minimize loss of function
- reorganizing the brain to restore and compensate for function that has already been compromised or lost
Neuroplasticity refers to the brain’s flexibility to adapt to changes and learn new experiences and the ability for an affected brain to relearn lost behaviors. There is overwhelming evidence to indicate that the brain continuously remodels its neural circuitry in order to encode new experiences and enable behavioral changes.
Some of the factors that researchers have found to be of significance to rehabilitation outcomes are some of the following principles based on their control of neuroplasticity on the brain.
- Use it or lose it- If you do not work the brain, it is likely going to result in a decline in functionality; the more a person attempts to use the affected extremities, the greater the chance of recovery.
- Use it and improve it – By training the brain to perform a specific function, it can also result in an improvement of that function.
- Specificity- The way one is taught, is the way in which he will learn.
- Repetition matters- To promote relearning in the damaged/stroke brain, high repetition is required.
- Intensity matters- The rehabilitation training has to be intense for neuroplasticity to occur.
- Time matters- Research indicates that rehabilitation is much more effective if it is implemented right after the accident than if the same program is started 5 days post-stroke.
- Salience matters- For plasticity to occur, the task or action has to be important or relevant to the patient for what he has to relearn. Research has shown that when the task is of importance to the patient, there is an increase in the release of acetycholine which helps to stimulate neuroplasticity.
There is still much that needs to be done to fully understand how the brain works when faced with something like a stroke, however research is pointing us in the direction that the brain is capable of adapting to changes. In order to receive the most effective rehabilitation services, we still have to learn more about neural reactions to the brain affected by a stroke.