Neuroplasticity Principles PDF

[00:00:00] >> [MUSIC] [00:00:10] Okay everyone, this lecture is about neuroplasticity principles. The objectives for today are to name and describe the ten principles of neuroplasticity. Okay, so what is neuroplasticity? We hear about it all the time, right? So neuroplasticity defined is the abilit...

[00:00:00] >> [MUSIC] [00:00:10] Okay everyone, this lecture is about neuroplasticity principles. The objectives for today are to name and describe the ten principles of neuroplasticity. Okay, so what is neuroplasticity? We hear about it all the time, right? So neuroplasticity defined is the ability of the nervous system to change activity in response to intrinsic or extrinsic stimuli By reorganizing its structure, functions or connections. [00:00:43] Blah, blah, blah, fancy words, neuroplasticity is learning, right? And more specifically, its effect that your brain changes as you learn. It forms new connections. It's able to change its structure at a basic level as you learn. Now, of course, the capacity of the different people might be different for neuroplasticity depending on a whole lot of factors. [00:01:04] But everyone has some element of neuroplasticity. Okay, so let's talk about the principles of neuroplasticity. There are 10 of them and they're listed here. And these really are very, very important to know. They're going to apply to pretty much anyone you treat and anything you do in physical therapy to some degree, whether it's neuro, orthopedics, cardiopulmonary, whatever it might be. [00:01:29] Now, I really suggest reading the original article by Clim from 2008. The references here and you should have access to the article printed out too. But essentially let's go through them. One, use it or lose it, two, use it and improve it, three specificity. So these three are really about the type of activity that you're doing, right? [00:01:52] So to do something or to get better at something, rather, you need to do that thing. If you don't do that thing, you won't get better at that thing, those are the first two. And specificity, do the thing that you want to get better at specifically, right? So the nature of the training dictates plasticity. [00:02:11] Then we have repetition matters, intensity matters, and time matters. These are all characteristics of your practice and what you're doing, right? So, repetition, plasticity requires that you repeat things over and over. You can't do something once and suddenly, things change in your brain, right? Intensity matters, so you need relatively intense training, right? [00:02:33] You can't just do something really, really casual and effect great changes in the brain. And time matters, so kind of the course of your training or your practice in matters, right? The type of classes that you're going to get when you're really really expert at something is very different from the type of plasticity you get when you're really nervous at something. [00:02:54] Salience matters is by itself. I like to call it invest a strength ,but essentially, the person has to care about the training that they're doing for it to actually affect change in the brain. This seems silly, but it really is important in a lot of conditions, right? And in general, if the person's not buying in to what you want to do, change is not going to happen, most likely. [00:03:18] And then, Some modifiers age matters. It is easier to have neuroplasticity in a younger brain. Transference, so plasticity in response to one training experience can enhance the acquisition of similar behaviors. That's really positive transfer of learning, which we will talk about later. Interference is negative transfer of learning. [00:03:38] So if you learn one thing they'll get really good at one thing it might actually make it a little bit difficult to learn something different. So just to hammer things home a little, right? So think about the attractor states that we talked about in dynamical systems theory, right? [00:03:54] So the brain is lazy and likes to do things that are easy and stable. You will tend towards things that are easy, stable, or familiar. And if you want to get better at something, you should practice that thing. If you practice that thing, you will improve. And if you don't, you will get worse. [00:04:09] Your brain can actually change. There's plenty of evidence of actual cortical remapping after stroke or in general, just with learning, right? But essentially you have to practice what you want to get better at specificity, right? If you do something, you will get better at that thing. Let's say you have a stroke and you can't use your right arm. [00:04:28] If you practice using your right arm, it will get better. We don't know how much better but it will get better. If you don't practice using your right arm, you will lose the ability to use your right arm right? So essentially you kind of have to really structure your practice to affect change. [00:04:44] You have to structure your practice in a way that pushes you towards what you really want to do. And I put the homunculus here just because it's really important to remember that if in terms of cortical remapping that area of the brain that represents say the head hand or the arm we were talking about earlier will actually shrink. [00:05:01] And change if you don't use it and will get larger if you do use your arm. Okay, I highly recommend reading the article, that's referenced here, GU at all from 2004 challenge point, a framework for conceptualizing the effects of various practice conditions in motor learning. But essentially here as we already talked about how much you do, when you do it, and how hard you do it are very important. [00:05:27] So if you look at the bottom here, right things will look different learning curves will look different and depending on whether you're an expert or beginner and intermediate skill. So the neuroplasticity, you'll get Will be different. You'll get a lot more big changes early on when you're learning a skill and the changes will be more more subtle or smaller but still important maybe when you're an expert. [00:05:50] How much you do and when you do do it sorry and how hard you do it, rather, are very important too, right? So, if you look at this difficulty curve, right, you want to kind of achieve a difficulty in the task that you get a good amount of performance and a lot of practice, right? [00:06:07] You don't want something want something so hard that you get essentially no repetitions at it, and you also want it hard enough that the intensity is high. So if you have a really low difficulty, you'll get tons of repetitions at a really low intensity. You won't really affect much change. [00:06:20] And if the difficulty is too high, you'll get really high intensity, but essentially no repetitions, and so you don't really get the same change again. There's this challenge point, and we don't know this for every task, right? That's kind of your skill. There's this optimal challenge point where you want to hit high intensity and still get a lot of repetition, and that's where you'll get the most neuroplasticity. [00:06:43] Okay, so this one kind of merits talking about by itself, right, investment or salience. The limbic system is pictured here because it's really important, right? We have emotional responses to movement, to what we do, everything is tied into what we care about, right? So it's crucial for neuroplasticity that someone be invested and find that the activity is salient. [00:07:06] Consider if you have someone do something that's totally irrelevant or they don't understand why it relates to what they're doing. They're not going to be as invested and the brain is not going to make as much change. So this is very, very important. There are some individuals of course, second, understand importance in an abstract way or an indirect way. [00:07:23] You do it a piece of thorax, and they know that this will somehow down the line lead to improvement, and so they're invested. But for individuals that don't understand that bit of thorax, they probably won't do that as much as you want and it won't make as much change for them. [00:07:40] Okay, so I do want to stress here that you can, in fact, teach an old dog new tricks. But it is harder to teach an old dog new tricks, right? So your age does matter. And that kind of goes in general for the quality of your brain tissue, right? So, if you've had a massive brain injury, it's, of course, going to be harder to get good neuroplasticity, right? [00:08:00] If you're a lot older, it's going to be harder to learn a skill or get better at a skill, so that's important. And know that we said earlier and we'll talk about a little bit later too. There's positive and negative transfer of learning. So practicing a skill a lot might make you better at another skill, but practicing one skill a lot If it has nothing to do with another skill might make you worse at a different skill right? [00:08:24] So you have to consider the changes if you're getting a lot of positive neuroplasticity towards one thing it might make it harder to learn a different thing that doesn't really coincide with what you just learned. Okay, so as usual, pause here and reflect. What can you remember and what questions do you have? [00:08:47] Bring at least one to class. Okay as a little bit of application, and we won't go through this completely, but it's kind of a thought experiment for you, right? So imagine that you're getting a client or a patient back into running after a knee surgery, you've decided that they can walk on the treadmill 3.5 miles an hour that's safe, they can do it. [00:09:54] It's within protocol for whatever surgery they had right? Take every aspect of this exercise and think about how it fits into one of the principles. Let's think about salience does that person want to get back into running? Okay, then they're going to be invested in whatever you're doing, and you need to tell them, okay, 3.5 isn't running yet, but if you do this enough, this will definitely get you towards running. [00:10:16] Thinking about intensity, is this intense enough that you'll get a lot of changes? And I know we're talking about an orthopedic condition, but neuroplasticity is still relevant here, right? Because you still get brain changes and you get neuro muscular reeducation as you're recovering from an injury, it's not all just orthopedic right? [00:10:32] So where are they in the course of the injury? Think about the fit principle, like frequency, intensity, time and type. Like I said, is the intensity high enough? Is the frequency and repetition high enough? Is the type what they should be doing? Should they be fast walking right? [00:10:47] So all these are elements of neuroplasticity that will play into how they recover. And it applies even in more orthopedic conditions or even in cardiopulmonary conditions. Okay, so putting it all together, remember that for someone to learn movement, you have to consider how the brain learns. And this is true in neuro, ortho, or any kind of area of PT. [00:11:07] To know how the brain learns, remember your principles of neuroplasticity. Everything about motor learning and what we'll talk about in motor learning really has a foundation in neuroplasticity.