Article

An update on brain plasticity for physical therapists

Physiotherapy Practice and Research 01/2013; 34:1-8. DOI: 10.3233/PPR-2012-0009

ABSTRACT The understanding that the human brain is capable of structural and functional change throughout life has significant implications for the future of physical therapy. Cortical plasticity impacts on many areas of physical therapy including clinical practice, research and education. Although the principles of plasticity underpin developments in neurological physical therapy, relevance to musculoskeletal physical therapy is still emerging. How will key areas of musculoskeletal physical therapy change as our understanding of plasticity advances? If cortical plasticity can be harnessed, new plasticity-based therapies, that enhance
performance in healthy individuals and improve pain and function in patient populations, have the potential to become the cornerstone of musculoskeletal physical therapy. In addition, common physical therapy techniques, such as electrical stimulation, require reconsideration of their clinical efficacy and application in light of new discoveries in neuroscience. The aim of this appraisal is to provide an update on brain plasticity for physical therapists in relation to clinical practice, research and education

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    ABSTRACT: It is becoming increasingly clear that, if reorganization of brain function is to be optimal after stroke, there needs to be a reorganisation of the methods used in physical rehabilitation and the time spent in specific task practice, strength and endurance training, and aerobic exercise. Frequency and intensity of rehabilitation need to be increased so that patients can gain the energy levels and vigour necessary for participation in physical activity both during rehabilitation and after discharge. It is evident that many patients are discharged from inpatient rehabilitation severely deconditioned, meaning that their energy levels are too low for active participation in daily life. Physicians, therapists, and nursing staff responsible for rehabilitation practice should address this issue not only during inpatient rehabilitation but also after discharge by promoting and supporting community-based exercise opportunities. During inpatient rehabilitation, group sessions should be frequent and need to include specific aerobic training. Physiotherapy must take advantage of the training aids available, including exercise equipment such as treadmills, and of new developments in computerised feedback systems, robotics, and electromechanical trainers. For illustrative purposes, this paper focuses on the role of physiotherapists, but the necessary changes in practice and in attitude will require cooperation from many others.
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