Recognising neuroplasticity in musculoskeletal rehabilitation: A basis for greater collaboration between musculoskeletal and neurological physiotherapists

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Recognising neuroplasticity in musculoskeletal rehabilitation: A basis for greater collaboration between musculoskeletal and neurological physiotherapists

Nicola R Heneghan
Henry Tsao
Peter Stanwell
Darren A Rivett
Paulette M van Vliet
Corresponding author details: Suzanne J. Snodgrass
Email: rass@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.