Neuroplasticity After Stroke: Difference between revisions

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== Introduction ==
== Introduction ==
[[File:Neural Network.jpeg|thumb|Neuroplasticity: re wiring neurons]]
[[File:Neural Network.jpeg|thumb|Neuroplasticity: rewiring neurons]]
Following a [[stroke]], the healthy areas of the [[Brain Anatomy|brain]] around the damaged brain tissue region are able to compensate and develop new functions.  [[Neuroplasticity]] is the term that describing this rewiring and reorganizing process.   This process include: interhemispheric lateralization; association [[Cerebral Cortex|cortical]] regions making new connections in injured area; a re-organization of cortical representational maps. Brain plasticity leads to a great degree of spontaneous recovery, with stroke rehabilitation able to modify and boost this neuronal plasticity processes.<ref>Hara Y. [https://www.jstage.jst.go.jp/article/jnms/82/1/82_4/_article 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<nowiki/>(accessed 1.1.2023)</ref>   
Following a [[stroke]], the healthy areas of the [[Brain Anatomy|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 [[Cerebral Cortex|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.<ref>Hara Y. [https://www.jstage.jst.go.jp/article/jnms/82/1/82_4/_article 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<nowiki/>(accessed 1.1.2023)</ref>   
== Physical Activity And Neuroplasticity ==
== Physical Activity And Neuroplasticity ==
[[Physical Activity|Physical activity]] (PA) can promote neural plasticity.  
[[Physical Activity|Physical activity]] (PA) can promote neural plasticity.  


* PA effects in the peri-infarct site (post stroke): promotes cerebral angiogenesis, vasomotor reactivity, [[Growth Factors|neurotrophic factor]] release; reduces [[apoptosis]] processes, excitotoxicity, and [[Inflammation Acute and Chronic|inflammation]].
* PA effects in the peri-infarct site (post stroke): promotes cerebral angiogenesis, vasomotor reactivity, [[Growth Factors|neurotrophic factor]] release; reduces [[apoptosis]] processes, excitotoxicity, and [[Inflammation Acute and Chronic|inflammation]].
* PA provides neuroprotective effects capable of reducing adverse effects of brain ischemia, with prestroke physical fitness decreasing the severity of motor deficits.<ref name=":0">Pin-Barre C, Laurin J. [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 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)</ref>
* PA provides neuroprotective effects capable of reducing adverse effects of brain ischemia, with pre-stroke physical fitness decreasing the severity of motor deficits.<ref name=":0">Pin-Barre C, Laurin J. [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 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)</ref>
* Stroke therapy combining physical training with pharmacological treatments, is known to promote neuroplasticity. <ref name=":0" />
* Stroke therapy combining physical training with pharmacological treatments, is known to promote neuroplasticity. <ref name=":0" />
* 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|aerobic exercise]]–induced increases in BDNF help facilitate motor learning-related neuroplasticity for rehabilitation after stroke.<ref>Mang CS, Campbell KL, Ross CJ, Boyd LA. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870490/ 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)</ref>
* 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|aerobic exercise]]–induced increases in BDNF help facilitate motor learning-related neuroplasticity for rehabilitation after stroke.<ref>Mang CS, Campbell KL, Ross CJ, Boyd LA. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870490/ 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)</ref><ref>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.</ref>
[[File:M&P Training.jpeg|center|thumb|532x532px|Mental and Physical training increases neuroplasticity ]]
[[File:M&P Training.jpeg|center|thumb|532x532px|Mental and Physical training increases neuroplasticity ]]
{{#ev:youtube|f1vIAyEhvaE}}  
{{#ev:youtube|f1vIAyEhvaE}}  
== Physiotherapy ==
== Physiotherapy ==
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:
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|Constraint induced movement therapy]] (CIMT) for the arm and hand
* [[Constraint Induced Movement Therapy|Constraint induced movement therapy]] (CIMT) for the arm and hand
* Task-oriented therapy and repetition of novel movements
* Task-oriented therapy and repetition of novel movements
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* [[Virtual Reality for Individuals Affected by Stroke|Vitual Reality]]
* [[Virtual Reality for Individuals Affected by Stroke|Vitual Reality]]
* [[Mental Imagery]]
* [[Mental Imagery]]
* [[Action Observation Therapy]]
* [[Electrical Stimulation - Its role in upper limb recovery post-stroke|Electrical Stimulation]]
* [[Mirror Therapy]]
See also [[Stroke: The Evidence for Physiotherapy]]
See also [[Stroke: The Evidence for Physiotherapy]]



Revision as of 15:10, 20 February 2023

Introduction[edit | edit source]

Neuroplasticity: rewiring neurons

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.[1]

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.[2]
  • Stroke therapy combining physical training with pharmacological treatments, is known to promote neuroplasticity. [2]
  • 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.[3][4]
Mental and Physical training increases neuroplasticity

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:


See also Stroke: The Evidence for Physiotherapy

References[edit | edit source]

  1. 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)
  2. 2.0 2.1 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)
  3. 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)
  4. 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.