Friday, April 15, 2011

OT A to Z: N is for Neuroplasticity

Neuroplasticity - while not a concept unique to OT - holds tremendous application for neurorehabilitation provided by OTs. Neuroplasticity refers to the brain's ability to adapt and change over the course of one's life - not just in the period of development. This is particularly important when considering rehabilitation following a neurological event such as a stroke.

When I was in OT school in the early 1990s, the accepted thought was that a person with a stroke would see maximum recovery within 6 months following the stroke. Consequently, if a person was seeking therapy several years post-stroke, it was thought that the person had limited rehabilitation potential and it was often difficult to receive approval to provide services. With the improved understanding of neuroplasticity that has occurred in more recent years, it is now accepted that the brain has the ability to modify itself even years after a stroke. More specifically, following a neurological event such as a stroke, it has been demonstrated that the brain has the ability to "rewire" itself.

This understanding has provided the explanation as to why interventions such as constraint induced movement therapy provides such notable results. In this approach, "forcing" the use of the affected upper extremity appears to unmask neural pathways that reorganized or sprouted following the stroke. However, the person learned not to use the affected upper extremity based on their unsuccessful attempts initially following the stroke.


  1. Hi

    I have worked in stroke rehab. Constraint induced movement therapy was just starting to be looked at when I moved to the uni, will have to look at some of the research on this, sounds interesting.

    One note of caution about neuroplasticity is that 'incorrect' pathways can be developed so it is important for clients to have OT and Physio in the early stages to help develop good techniques of movement. This is one case achieving function by any means possible is not always healthy in the long run and we need to inform clients of this.

    Congrats Bridgett, over half way with your excellent posts.

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