29 pages of useless generalities on neuroplasticity. Yes, we know it can work, but it is not repeatable on demand. No ones knows EXACTLY how to make a neuron drop its current role and take on a neighbor's function, or even harder switch it to the other side of the brain. Most of my motor and premotor cortex is dead so in my case I don't have any functioning neurons doing the movement tasks. I have to somehow create those movements in some neurons somewhere else with zero guidance from anyone in the world. Of the million upon millions of stroke survivors in the world someone has accomplished this and if we had anything other than fucking failures of stroke associations we would have that documented in a publicly available database so survivors can find and use it. The top down approach of getting rehab knowledge from doctors and therapists has completely failed, as proven by the appalling 10% full recovery rate.
Recognising neuroplasticity in musculoskeletal rehabilitation: A basis for greater collaboration between musculoskeletal and neurological physiotherapists
Suzanne J Snodgrass
Nicola R Heneghan
Henry Tsao
Peter Stanwell
Darren A Rivett
Paulette M van Vliet
Corresponding author details:
Suzanne J. Snodgrass Email: Suzanne.Snodgrass@newcastle.edu.au Discipline of Physiotherapy, School of Health Sciences The University of Newcastle Hunter Building Callaghan, NSW 2308 Australia Tel. +612 49212089 Fax +612 49217053
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.
Nicola R Heneghan
Henry Tsao
Peter Stanwell
Darren A Rivett
Paulette M van Vliet
Corresponding author details:
Suzanne J. Snodgrass Email: Suzanne.Snodgrass@newcastle.edu.au Discipline of Physiotherapy, School of Health Sciences The University of Newcastle Hunter Building Callaghan, NSW 2308 Australia Tel. +612 49212089 Fax +612 49217053
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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