What is a stroke and how can physiotherapy help?
Neuroplasticity is the brain's ability to reorganize itself in order to learn and change. It is essential to healing post-stroke. There are two main types of strokes - a hemorrhagic stroke and a ischemic stroke. In a hemorrhagic stroke there is a significant loss of blood through a damaged vessel in the brain. An ischemic stroke is the more common type of stroke and it involves the blockage of one or more of the brain’s vessels so that little to no blood is able to pass through. The impact of a stroke varies greatly from one person to the next as there are many contributing factors. That being said, everyone who has experienced a stroke has one important thing in common; the importance of neuroplasticity and its role in aiding in the person’s ability to improve post-stroke impairments!
Neuroplasticity, sometimes referred to as brain plasticity, is the brain’s ability to reorganize itself in order to learn or relearn skills throughout our lives. Stroke rehabilitation is founded on this concept of the brain being able to relearn skills such as walking or grasping an object. There are 10 main principles of neuroplasticity that are used in order to achieve this:
Use it or lose it—The connections built from learned skills will only remain strong connections if we continue to use them. If we don’t use them, they will weaken over time and we will lose that particular skill.
Use it and improve it—The opposite of #1 also applies. If we use a skill often and continually fire the brain connections required for that skill, we can strengthen them.
Specificity—Each of our brain cells, also known as neurons, requires activation in a specific way in order to achieve neuroplastic changes.
Salience—Your exercises should be meaningful to you in order to facilitate learning.
Transference—A learned skill in one situation or environment can be transferred to another situation or environment. An example of this is taking the exercises you practice in therapy and using them in your daily life outside of therapy.
Interference—Practicing and learning skills in one area of the rehabilitation process may interfere with your ability to improve skills in a different area. This is ok and we know how to work around this!
Time—The brain learns or relearns skills at different rates. Sometimes improvements may come about faster than other times and this is a normal part of neuroplastic healing.
Age—Our brains are more plastic when we are young. This is why kids learn so quickly.
Repetition—Frequent and consistent practice of exercises and learned skills is key.
Intensity—Practice must be an appropriate level of challenge in order to optimize learning. This can be managed by adjusting many different exercise parameters.
Our clinic offers treatment with neurophysiotherapists specifically trained to work with people post-stroke to rehabilitate their impairments. Our treatment methods and techniques are based on the principles of neuroplasticity - our neurophysiotherapists specifically use Bobath therapy and/or Neuro Developmental Treatment (NDT) as their main treatment approach to neurological rehabilitation post-stroke. These treatment approaches focus on facilitating neuroplasticity through postural alignment and normal movement patterns, which have been shown to be central features to neuroplastic treatment due to its focus on optimizing function.
Some of the things our neurophysiotherapists can help to improve include:
Gait pattern and walking endurance
A joint’s range of motion whether it be related to high tone (spasticity) in the muscle, instability in the joint, pain, etc.
Postural alignment and trunk control
Grip and general hand control
Hemineglect
Balance disturbances
Bed mobility and safe transfers
At NeuroLogic Physiotherapy, our neurophysiotherapists are passionate and experienced in providing post-stroke rehabilitation based on these neuroplasticity principles. In one-on-one treatment sessions, our stroke neurophysiotherapists will focus on your goals and helping you achieve them while also working to improve functional outcomes. Physiotherapy can also be provided in home or in a long-term care residence.