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Neuroplasticity and all things rehab

Notes from the Neuro Café on 19th May 2021.

Everyone was looking forward to some sunshine to enjoy the outdoors. People caught up about what they had been planting in recent days with the most recent trend being attempting to plant tomatos, some being more successful than others.

We then got into the very interesting topic of neuroplasticity!

What is neuroplasticity?

In its most simple form neuroplasticity is the brain's ability to chanage and adapt.

It was once thought neurogenesis, or the creation of new neurons, stopped shortly after birth. Today, it's understood that the brain possesses the remarkable capacity to reorganize pathways, create new connections, and, in some cases, even create new neurons.

How does this happen?

Is it thought that this occurs in two ways; functional plasticity and structural plasticity.

Functional Plasticity: The brain's ability to move functions from a damaged area of the brain to other undamaged areas.

Structural Plasticity: The brain's ability to actually change its physical structure as a result of learning

10 principles of neuroplasticity

1. Use it or lose it

Your brain is a network of neural connections. Every thought or action or skill you practise has a specific set of connections that fire in the brain – but these connections only stay strong if they’re used. If you don’t use them, they fade and weaken over time.

2. Transference

Learning a skill in one situation can transfer to another situation – and this is a good thing. Clinicians may talk about “generalizing” (or using) the skills you practise in therapy to daily life activities outside therapy. This is transference.

3. Time

As your brain relearns skills after an injury, there are times during recovery when you’ll see a faster rate of improvement and times when it will seem slower. This is normal neuroplastic healing.

4. Repetition (which we love to speak about in class)

Practising rehab therapy frequently and consistently is key. Just like if you are strength-training by lifting weights and you go to the gym once a month, you won’t see much improvement. If you go more frequently, you will. Our brains work the same way.

5. Use it and improve it

The flip side of “use it or lose it” tells us to practise a skill often (which means you are firing those brain connections more often) to strengthen neural connections over time.

6. Interference

When you practise and improve skills in one area, it can interfere with your ability to improve skills in another area. Don’t worry; your clinician knows how to work around this.


Our brains are more plastic when we are young, which is why children pick up skills so rapidly. However, neuroplasticity absolutely occurs in adulthood too! In fact, at any age, we have the potential to learn new skills or relearn lost skills.

8. Specificity

The cells in our brains are called neurons and each is responsible for actions or skills. In order to promote neuroplastic changes, your therapy exercises need to target parts of your brain in a specific way; you can’t just do any old exercise. In rehab, your evidence-based exercises are

rooted in research and will improve a specific skill or area of the brain.

9. Salience

A fancy way of saying that your exercises should be meaningful to you. Research shows that motivation helps facilitate neuroplastic changes. Try to do exercise that are meaningful to you!

10. Intensity

Intensity works hand-in-hand with repetition. Intensity can be the number of times you do an exercise, how long you do it, or how difficult the exercise is. Play around with different intensity parameters to keep your homework interesting.

Neuroplasticity is positive!

Some members in the group worried that if they had not achieved one of their rehab goals in a certain timeframe they would lose the ability to achieve that goal. However, the reality is that neuroplasticity can happen at any age and at anytime.

It is OK for things to progress slowly at times and this is a normal part of the healing process but it is important that we remain positive and trust the process. There is a lot of things that we cannot control in our rehabilitation journeys so it is best that we focus on the ones we can control, such as our exercise and rehab.

One member made the really helpful suggestion for when you are struggling to stay positive: think back to where you began and think of all the things you have achieved as a way to stay motivated.

Other members were also shocked at how easily you can lose function if you are not challenging yourself (use it or lose it) and it is important that we continue to challenge ourselves as we move forward.

It is also OK to rest and have recovery days. These are an important part of the process.

Neuro Café next week is at the new time of 6pm on Wednesday 26th May, when we will be joined my the LaughterLab.

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