http://www.sciencedirect.com/science/article/pii/S1356689X14000071
- Suzanne J. Snodgrass
, 
, - Nicola R. Heneghan,
- Henry Tsao,
- Peter Stanwell,
- Darren A. Rivett,
- Paulette M. van Vliet
- Discipline of Physiotherapy, School of Health Sciences, The University of Newcastle, Hunter Building, Callaghan, NSW 2308, Australia
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Abstract
Evidence
is emerging for central nervous system (CNS) changes in the presence of
musculoskeletal dysfunction and pain. Motor control exercises, and
potentially manual therapy, can induce changes in the CNS, yet the focus
in musculoskeletal physiotherapy practice is conventionally on movement
impairments with less consideration of intervention-induced
neuroplastic changes. Studies in healthy individuals and those with
neurological dysfunction provide examples of strategies that may also be
used to enhance neuroplasticity during the rehabilitation of
individuals with musculoskeletal dysfunction, improving the
effectiveness of interventions. In this paper, the evidence for
neuroplastic changes in patients with musculoskeletal conditions is
discussed. The authors compare and contrast neurological and
musculoskeletal physiotherapy clinical paradigms in the context of the
motor learning principles of experience-dependent plasticity: part and
whole practice, repetition, task-specificity and feedback that induces
an external focus of attention in the learner. It is proposed that
increased collaboration between neurological and musculoskeletal
physiotherapists and researchers will facilitate new discoveries on the
neurophysiological mechanisms underpinning sensorimotor changes in
patients with musculoskeletal dysfunction. This may lead to greater
integration of strategies to enhance neuroplasticity in patients treated
in musculoskeletal physiotherapy practice.
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