What Works to Encourage Brain Plasticity and Recovery after Stroke?

Did you know that your brain is always re-organizing? Even in very old people being treated for advanced cancer there is still some brain re-organization taking place.  Brain plasticity or neuroplasticity are the terms used when the brain changes and adapts to experiences, environmental challenges, or the changes from stroke and brain damage.  From Johnasson’s (2011) review, what is important?

Early after stroke:

1. Admission to a dedicated multidisciplinary stroke unit (rather than a general medical unit).  
2. Rehabilitation that starts very quickly after stroke. 
3. Rehabilitation should be intensive, frequent, and functional.
4. You need to be interested and engage in the rehabilitation activities. 

For Arm and Hand:

1. Constraint-induced movement therapy—where a mitt or splint is put on the “good” or unaffected hand and the person is forced to use the affected hand combined with “shaping” to make activities progressively more difficult. 
2. Robot assisted therapy shows a significant amount of motor recovery, but it had no significant effect on functional ability. In other words, people may have been able to move their arm, but not to do activities like drinking from a cup. 
3. Bilateral training - rehabilitation training using both arms (not just one arm). 
4. Mirror Box Therapy—In This Inexpensive Therapy, where you trick the brain into thinking the affected arm or hand is moving. 
5. Transcranial brain stimulation is a new technique. It is a non-invasive stimulation of the brain which causes activity in specific or general parts of the brain. This brain stimulation facilitates functioning and interconnections of the brain. 

Speech and Language Rehabilitation: (There is large variability in language recovery after stroke).

1. Multiple- modes—listening to speech and music, reading, reading aloud, singing, using gestures, and actions seem to be useful.  
2. Constraint induced aphasia therapy—In this therapy people are forced to use speech while playing language games for 3 hours per day. Results were more significant than standard training of 1 hour a day.  People encouraged by relatives to be more verbal during the 2 week training period had more communication 6 months later. 

Link to:

• Johansson, B.B. (2011). Current Trends In Stroke Rehabilitation. A Review With A Focus On Brain Plasticity. Acta Neurologica Scandanvica, 123, 147-159.
• Can we improve motor recovery using repetitive transcranial magnetic stimulation?