Principles of Neuroplasticity

Original Author - User:Dinu Dixon

Top Contributors - Dinu Dixon and Kim Jackson  

Experience Dependent Neural Plasticity

1. Use it or lose it

Patient has to actively participate in the sessions of functional practice and therapist aims and set goals towards enabling the patient for active practice of motor skills. Target active movements and engage the patient in active practice of specific goal-directed activities that are funtionally relevant and important to the individual.

2. Specificity matters

The nature of the training experience dictates the nature of plasticity. select tasks that are important to the patient and through which enhance the patient's function. The tasks selected should be meaningful and it should challenge the patient.

3. Repetition matters

Focus on sufficient repetition to stimulate brain reorganization using high levels of practice both in-therapy and out-of-therapy and a carefully developed home exercise program (HEP).

4. Intensity matters

Focus on sufficient intensity of training to stimulate brain reorganization, carefully matching the dynamic and changing needs of the patient and also balancing the need for rest with activity.

5. Timing matters

Different forms of plasticity occur at different times during training. Very early training may be harmful in some cases of neural injury, for example early intense training after Traumatic Brain Injury (TBI) may cause exaggeration of cellular injury. Delayed or absent training limits recovery and results in neural degradation and “learned non-use”.

6. Age matters

Training- induced plasticity occurs more readily in younger patients. plasticity and experience dependant brain changes in older adults may be slower and less demonstrable than younger brains.

7. Use it and shape it to the patient’s ability (Transference)

Focus on modifying motor skills. Continually challenge the patient’s movement capability with acquisition of new skills to ensure continued learning and progressively modify skills to ensure transference and achieve functional outcomes.

8. Enhance selection of important stimuli

Reinforce behaviorally important stimuli to enhance skill learning. create the best possible environment for learning.

9. Enhance attention and feedback

Actively engage the patient in evaluating goal-achievement and in making accurate adjustments of motor skills based on appropriate use of feedback.

10. Target goal-directed skills

Select skills that are functionally relevant and important to the patient. focus on enhancing patient motivation and commitment and allow for success, select activities that are engaging and fun which enhance the active participation of the patient.

11. Interference

Plasticity in response to one experience can interfere with acquisition of other behaviors.

References

Kleim, Jeffrey A, and Theresa A Jones. “Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage.” Journal of speech, language, and hearing research: JSLHR vol. 51,1 (2008): S225-39. doi:10.1044/10924388(2008/018)