Neuroplasticity is a big word getting a lot of buzz. It means the brain (“neuro”) can change (“plastic”). We hear a lot about it in stroke and brain injury rehab because it gives hope to survivors that their brains can heal, adapt, and rewire after they have been damaged. We also hear the word in advertisements for new treatments or programs. What exactly is neuroplasticity, and how does it work?Intuitively, we know that we get better at the things we practice, and we are shaped by our experiences. Therapy for a damaged brain is essentially no different. The best therapies exploit how neuroplasticity works by using repetitive positive experiences to forge and strengthen pathways in the brain. To better understand how this works, we look to the research published by Kleim & Jones that outlines the 10 principles of experience-dependent neuroplasticity.
1) Use it or lose it: The skills we don’t practice often get weaker.
2) Use it and improve it: The skills we practice get better.
3) Specificity: We must skillfully practice the exact tasks we want to improve.
4) Repetition matters: We must do a task over and over again once we’ve got it right to actually change the brain.
5) Intensity matters: More repetitions in a shorter time are necessary for creating new connections.
6) Time matters: Neuroplasticity is a process rather than a single event, with windows of opportunity opening for different skills at different times. In rehabilitation, starting earlier is usually better than starting later.Recent research shows that even 5+ years post-stroke, people with aphasia made significant progress in language skills using Language Therapy daily.
7) Salience matters: To change the brain, the skill we’re practicing must have some meaning, relevance, or importance to us.
8) Age matters: Younger brains tend to change faster than older brains, but improvement is possible at any age.
9) Transference: Practicing one skill can result in improvement of a related skill.
10) Interference: Learning an “easier way” of doing something (i.e. a bad habit or compensation) may make it harder to learn the proper way.
Whether you’re learning a new skill or re-learning a lost one, it’s clear we must practice the thing we want to get better at. Unfortunately, many stroke survivors, recovering but not yet ready to return to work, sit at home alone between therapy sessions. They turn to TV to pass the time, despite being willing to do the exercises they need to improve their skills. Fortunately, there are new technologies (such as an app that helps you practice talking or a video game that guides you through meaningful movements) that can help provide intense, meaningful, and skilled stimulation that will change their brains for the better. Understanding how neuroplasticity works can help you evaluate which methods can truly help you reach your goal.
Regrettably, there are some people who are exploiting the term neuroplasticity to give brain injury survivors false hope that they can get better with unproven treatments that require little to no effort. If the therapy does not have you directly practicing the skill it claims to improve, please be cautious. There are no quick-fixes (remember: intensity and repetition matter), and there is no one-size-fits-all solution (remember: specificity and relevance matter). Anyone who tells you otherwise, using brain-branding, neuro-marketing, or brain-training terminology while charging you for a service or product, is banking on you not knowing the difference. But now you do.