Introduction
There is growing evidence that therapists working in rehabilitation field should prescribe task-specific training to the patients with neurological disorders to accelerate their rehabilitation (1). Task-specific training is defined as the intervention where the patient is required to do specific motor skills and get feedback about their performance (1). This feedback will motivate patient to continue or modify their performance and hence reaching specific goals (1). There is evidence that neuroplasticity occurs as a result of learning new motor skill using task-specific training (3). Neuroplasticity is defined as the ability of the brain to change or reorganise itself as a result of sensory-motor input, and learning (3). This essay explains the importance of task-specific training for learning new motor skill which is an integral part of rehabilitation process, and the neuroplastic changes that underpin this learning. Furthermore, it will also discuss whether task-specificity is sufficient on its own, which is controversial, or it needs some other strategies to be used.
Effects of immobilisation of limb on neuroplasticity
In a longitudinal study conducted by (4), 10 right-handed persons who required right arm immobilisation for at least 14 days due to injury underwent two magnetic resonance imaging (MRI) examinations. The first MRI examination was after 48 hours of injury and the second one was after 16 days of immobilisation of right arm. The results revealed that there was a decrease in cortical thickness in the left somatosensory and primary motor area and decrease in white matter (fractional anisotropy [FA]) in the left corticospinal tract (4). Therefore, immobilisation of a limb for a period of time wil...
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...d rewards (1). However, these rewards should fade out over time to avoid dependency (1). The feedback should be always positive as suggested by some researchers (1).
Conclusion
To summarise, the evidence has showed that task-specific training is better than general training or other conventional stroke rehabilitation for learning and training for new skill. In other words, the best way to learn a new task is to train specifically for this task. Task-specific training results in enduring motor learning and neuroplastic changes such as sensory or motor function recovery. However, task-specific training should be coupled with some other strategies to be valid in the clinical practice. Accordingly, it should be: relevant and meaningful to the individual, repetitive, randomly ordered, supported with positive feedback, and aimed to reconstruction of the whole task.
I intend to explore the effects of a parietal brain injury from the perspective of a neuropsychologist; ranging from types of tests that are employed when trying to determine the extent of the damage, to gaining an understanding of how this damage will affect the rest of the brain and/or the body. I will also explore the effects of a brain injury from the perspective of the family members, and their experiences with the changes that occur during the rehabilitation process. According to The Neuropsychology Center, “neuropsychological assessment is a systematic clinical diagnostic procedure used to determine the extent of any possible behavioral deficits following diagnosed or suspected brain injury”(www.neuropsych.com). As mentioned previously, a brain injury can be the result of many types of injuries or disorders, thus a broad range of assessment procedures have been developed to encompass these possibilities.
Scientists are on the brink of doing the unthinkable-replenishing the brains of people who have suffered strokes or head injuries to make them whole again. If that is not astonishing enough, they think they may be able to reverse paralysis. The door is at last open to lifting the terrifying sentence these disorders still decree-loss of physical function, cognitive skills, memory, and personality.
It is frequently expressed by stroke patients and caregivers that they have not been afforded the suitable information related to stroke, treatments, or post discharge management and recovery, and that the information conveyed is perceived as insufficient and complex. The problem is that there is a failure of healthcare professionals in identifying the learning needs of stroke patients associated with a deficiency in knowledge of just how to access and communicate this crucial information. Indeed, while patient education can be time consuming and nurses may not be properly trained in stroke education it is a nursing duty to provide these teachings to patients and caregivers prior to discharge. This paper will propose an educational plan intended to train, assist, and support nursing staff responsible for stroke patient education, in providing accurate, individualized, guideline based stroke education to patients and families prior to discharge. This plan
...ter screen an arm that was placed onto his stump. When Ture Johanson saw his arm on the computer screen, he was able to control his own movements using his own neural command. In this particular study, Johanson was asked to perform numerous movements with his phantom hands such as driving a racecar. By driving a racecar, Catalan found that the subject moved muscles at the end of his existing arm to show the intent of moving his missing hand. From this study, subjects who had been experiencing PLP for several years had longer periods without pain and had shorter periods of intense pain. In addition, the phantom hand was relaxed from a tight fist to a half-open position. This study is different from others because the control signals are retrieved from the arm stump, and thus the affected arm is in charge. Moreover, it uses the signals from the damaged limbs itself.
Valent, Linda J.M. Et al. "Effects of Hand Cycle Training on Physical Capacity in Individuals With Tetraplegia: A Clinical Trial." Physical Therapy 89.10 (2009): 1051-060. Print.
... damaged neurons. (Mayo clinic, 2014). This is called neuroplasticity, the ability for the nerves to compensate for damage caused by some outside force. Because of neuroplasticity physical training works to cure some of the paralysis left by the virus and allows us to walk again after the legs or another appendage is deformed or damaged.
In closing, the normal functioning of the brain and nervous system is vital for basic bodily functioning and processes. Injury, disease or abnormal structure of the brain will greatly affect one's behaviour, emotional regulation, mental processes and functioning. The brain will respond to any trauma, injury or abnormality to accommodate the dysfunction. During this response, the brain will physically change, the process called neuroplasticity, and attempt to "rewire" the brain to return to normal functioning. In the treatment of many cases as previously discussed, the aim was to reconnect neurons and the theory of neuroplasticity was the foundation behind it.
People have created a hectic and busy world, that includes careers and daily activities that require physical activity. While attempting to attain the required physical conditioning, people often take chances with their personal health as they try to stretch their physical limits. Sometimes, people can surpass their current limits and form new boundaries; however, other times people are not so fortunate. These unfortunate times often lead to injury, including workplace accidents, sporting incidents, disease afflictions, as well as others; any or all of which could bring about the need of rehabilitation services. Many of these require physical therapy, which includes assisting injured or otherwise impaired patients as they recover to their pre-injury status or to recover as much as is physically possible. The field of physical therapy is a choice career for those who enjoy helping people recover from injury, and the following text will provide reason for choosing this profession.
...on that patients with Parkinsons can decrease their reaction time and somewhat increase the speed of the task if they consistently practice. I have seen this first hand and now more clearly understand the importance of patients with Parkinsons practicing tasks on a regular basis. Though patients with Parkinsons may have trouble retrieving how to complete a task from their long term memory, they can practice the task at hand on a regular basis to lessen the effects of the disease when it comes to completing action goals and movements. Stone 3 Works Cited Rostami, Hamid Reza, and Hassan Ashayeri. "Effects of Motor Skill Practice on Reaction Time and Learning Retention in Parkinson's disease." Neurology India 57.6 (2009): 768-771. Web. 20 Apr.2010..
716). Characteristic features of Parkinson's disease include “motor impairment (bradykinesia, rigidity, tremor, gait dysfunction, and postural instability), cognitive impairment (frontal lobe executive dysfunction), and mood disorders” (p. 716). Normally, motor performance depends on the interaction between automatic (unconscious) and volitional (cognitive) control of movement, however those with Parkinson's disease, experience an “early and preferential loss of dopamine in the caudal regions of the basal ganglia (dorsal regions in rodents), which leads to diminished automatic and increased cognitive control of movements that include frontal lobe circuitry” (p. 716). Consequently, those with Parkinson’s disease must sustain a larger cognitive load to execute either motor or cognitive tasks, such as working memory. In the past decade, increasing evidence has accrued for the role of exercise in the improvement of motor performance, which may help both the cognitive and automatic control of movement. Thus, exercise interventions can help those with Parkinson’s disease incorporate goal-based motor skill training, which then helps in engaging circuitry important in motor learning. Individuals with Parkinson's disease become cognitively engaged with the practice and acquiring of movements and skills that were formerly automatic and unconscious. In addition, aerobic exercise is also observed as important for improvement of blood flow and assistance of neuroplasticity in the elderly, which may also play a role in the improvement of behavioral function in those with Parkinson's disease. Petzinger et al. additionally states that exercise also uses goal-based training and aerobic activity which can improve “both cognitive and automatic
Neurodevelopmental theory (NDT) informs clinical reasoning through the concepts of motor control, brain plasticity, motor learning and an understanding of functional human movement (Meadows & Williams, 2013). By identifying atypical movement patterns the therapist is able to select interventions, which will facilitate Sue in developing greater symmetry in her body and correct movement patterns. (Barthel, 2009; Feaver & Ezekiel, 2011). This influences the practice of interventions in NDT by applying moment-to-moment observations of Sue throughout treatment, in order to gage her reactions and adjusting interventions accordingly (Barthel, 2009). Barthel (2009) and Case-smith, Law, Missiuna, Pollock and Stewart (2010), defines NDT as a hand’s on approach to intervention, focusing on physically assisting Sue in the development of active and passive movement using key points of control during activities. This is used to facilitate Sue to engage in more normal movement patterns
R.M. Lehman & G.L. McCormack, 2001. Neurogenic and Myopathic Dysfunction pp. 802-803. In L. Pedretti and M Early Occupational Therapy Skills for Physical Dysfunction 5th ED St Louis MO: Mosby
Although the brain lies just below the surface of the human body, it has intrigued and puzzled neuroscientist for decades. …..There are numerous complex processes that are involved in brain recovery after attaining an injury or experiencing some sort of trauma. This essay will examine the concepts of neural networks, neuroplasticity and how exercise, surgery or therapy assist in the brain repair process by referring to a number of case studies.
“Motor learning is a field of study that addresses the development, acquisition and performance of movement” (slide 5 ml). Motor learning is not a theory, but a wealth of knowledge comprised of many years of clinical practice and research that can be used to help a myriad of patients, especially those with neurological deficits aimed at the reeducation of functional tasks. With that being said, there is a sequential order of research backed concepts and principles on how to rehabilitate patients with neurological deficits, with some variations along the way. It is the job of the skilled therapist to acknowledge the patients deficits and pick key components of the motor learning strategy in order for the patient to reap the greatest benefits.
As a future health professional it is vital to be aware of where one will fit into the multi-professional team within the health care system, what one has to offer as a health professional within the comprehensive care model of Primary Health Care and be reflective of the journey to your future career. Therefore, in the following essay, I will be focussing on a brief definition of comprehensive care and the role a physiotherapist plays in the model. I will also express the reflective thoughts and feelings of a practicing physiotherapist regarding these points as well as my personal reflections and experiences as a developing health professional.