Throughout most of the 20th Century Neuroscientists believed that the brains structure was fixed and did not change after childhood development. Modern neuroscientific research indicates that experience, also known as practice, can actually change both the brain’s physical structure (anatomy) and functional organisation (physiology).
A great example of this is in brain injury. Parts of the brain controlling a particular movement, such as moving your foot, can be damaged by lack of blood supplying it from a stroke, contusion from injury or a bleed in the brain. As a consequence of neuroplasticity, brain activity associated with moving your foot, can be taken over by another part of the brain when this function is practiced or ‘experienced’. Patients who have suffered a stroke often see improvements with intensive therapy as the body drives neuroplasticity and so ‘cortical re-organisation’. Cortical re-organisation has moved the brain area which now controls the movement of the foot. This may not be as strong as the previous area prior to the stroke but can be strong enough to control the foot when walking.
And so what is cortical re-organisation? In the brain, neurons can die and cannot be created. However, there is now ample evidence for the active, experience-dependent re-organisation of the networks in the brain; re-wiring of the brain.
Paul Bach-y-Rita a famous American Neuroscientist was an expert in brain plasticity. Bach-y-Rita explained plasticity by saying, “If you are driving from here to Milwaukee and the main bridge goes out, first you are paralysed. Then you take old secondary roads through the farmland. Then you use these roads more; you find shorter paths to use to get where you want to go, and you start to get there faster. These “secondary” neural pathways are “unmasked” or exposed and strengthened as they are used. The “unmasking” process is generally thought to be one of the principal ways in which the plastic brain re-organises itself.
Hundreds to thousands of repetitive experiences, that is ‘practice’, are required to drive this cortical re-organisation. As physiotherapists here at the Advance Rehab Centre we incorporate various treatment modalities to increase practice following brain injury. Examples are; Constraint Induced Therapy, Pablo upper limb interactive training software, Saebo upper limb training device, Functional Electrical Stimulation, Wii-habilitation and Body Weight Support Harness Treadmill Training. Last but not least we strongly believe in setting our clients an intensive home exercise program. A home exercise program multiplies the amount of practice that has taken place in the clinic and optimises cortical re-organisation.
Are you doing enough?