Neuroplasticity After Stroke
Original Editor - Lucinda Hampton
Introduction[edit | edit source]
Following a stroke, the healthy areas of the brain around the damaged brain tissue region are able to compensate and develop new functions. Neuroplasticity is the term that describes this rewiring and reorganising process. This process includes: inter-hemispheric lateralisation, association cortical regions making new connections in the injured area, and re-organisation of cortical representational maps. Brain plasticity leads to a great degree of spontaneous recovery, and stroke rehabilitation plays an important role in modifying and boosting this neuronal plasticity process.
Physical Activity And Neuroplasticity[edit | edit source]
Physical activity (PA) can promote neural plasticity.
- PA effects in the peri-infarct site (post stroke): promotes cerebral angiogenesis, vasomotor reactivity, neurotrophic factor release; reduces apoptosis processes, excitotoxicity, and inflammation.
- PA provides neuroprotective effects capable of reducing adverse effects of brain ischemia, with pre-stroke physical fitness decreasing the severity of motor deficits.
- Stroke therapy combining physical training with pharmacological treatments, is known to promote neuroplasticity. 
- Brain-derived neurotrophic factor (BDNF) is a key facilitator of neuroplasticity. Evidence suggests that aerobic exercise is an important intervention for improving brain function, these effects are mediated partly by upregulation of BDNF. As such aerobic exercise–induced increases in BDNF help facilitate motor learning-related neuroplasticity for rehabilitation after stroke.
Physiotherapy[edit | edit source]
Utilising the brains' ability to create and lay down new pathways, the physiotherapist can play a big role in rehabilitation and improved quality of life. Physical therapy can positively promote neuroplasticity during stroke rehabilitation, approaches include:
- Constraint induced movement therapy (CIMT) for the arm and hand
- Task-oriented therapy and repetition of novel movements
- Gait training
- Aerobic exercises
- Dual-task training, involving Motor Dual-Task Training and Cognitive Dual-Task Training
- Vitual Reality
- Mental Imagery
- Action Observation Therapy
- Electrical Stimulation
- Mirror Therapy
References[edit | edit source]
- Hara Y. Brain plasticity and rehabilitation in stroke patients. Journal of Nippon Medical School. 2015 Feb 15;82(1):4-13. Available: https://www.jstage.jst.go.jp/article/jnms/82/1/82_4/_article(accessed 1.1.2023)
- Pin-Barre C, Laurin J. Physical exercise as a diagnostic, rehabilitation, and preventive tool: influence on neuroplasticity and motor recovery after stroke. Neural plasticity. 2015 Oct;2015. Available:https://www.hindawi.com/journals/np/2015/608581/?utm_source=bing&utm_medium=cpc&utm_campaign=HDW_MRKT_GBL_SUB_BNGA_PAI_DYNA_JOUR_X_X0000_WileyFlipsBatch2&utm_term=Acta%20Neurologica%20Scandinavica&utm_content=JOUR_X_X0000_WileyFlipsBatch2_ActaNeurologicaScandinavica (accessed 1.1.2023)
- Mang CS, Campbell KL, Ross CJ, Boyd LA. Promoting neuroplasticity for motor rehabilitation after stroke: considering the effects of aerobic exercise and genetic variation on brain-derived neurotrophic factor. Physical therapy. 2013 Dec 1;93(12):1707-16.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870490/ (accessed 1.1.2023)
- Penna LG, Pinheiro JP, Ramalho SH, Ribeiro CF. Effects of aerobic physical exercise on neuroplasticity after stroke: systematic review. Arquivos de Neuro-Psiquiatria. 2021 Oct 18;79:832-43.