Integrating neuroplasticity into rehabilitation

Understanding neuroplasticity and how repeated practice strengthens synaptic connections can make a major difference in the effectiveness of rehabilitation, as has been shown for strokes. Strokes are caused by blood clots or bleeding in the brain that can damage neuronal networks, leaving patients with physical and motor deficits. Numerous studies have shown that damage to the brain automatically induces neuronal network rewiring and formation of new synapses. Current stroke rehabilitation protocols aim to augment this rewiring by providing patients with structured exercises and drills to relearn lost skills. These protocols generally include intensive physical therapy to relearn motor skills and speech and language therapy to regain the ability to speak, as needed. These therapies may be supplemented with additional components in an effort to enhance neuroplasticity, such as mental practice with motor imagery. In this practice, the patient visualizes themselves successfully completing motor tasks. While scientists do not fully understand the biological mechanisms that make mental practice effective, one possible explanation is that visualization of a movement strengthens synaptic connections by repeatedly activating the motor circuitry necessary for that movement. Like with the mice, practice can rewire the brain – even if you’re only practicing in your head!

Aerobic exercise may also play a key role in stroke rehabilitation. In addition to helping individuals regain endurance and aerobic capacity, aerobic exercise – like brisk walking, running on a treadmill, or cycling – is thought to promote neuroplasticity. Specifically, aerobic exercise has been found to stimulate the release of special signals that facilitate synaptic strengthening; one group found that engaging in high-intensity cycling intervals immediately after learning a new skill enhanced long-term retention. While further research is needed to understand the mechanism by which aerobic exercise influences neuroplasticity and to determine the optimal type and amount of exercise for stroke patients, it holds promise as a tool to support brain rewiring.

While recovery from a traumatic event may feel impossible, neuroplasticity is a powerful ally. The brain is capable of incredible rewiring and there are many options for synaptic connections to regain what appear to be “lost” skills. For these skills, practice makes perfect – or, at least, enhances mastery – and leaves its mark within the networks of the brain.