In the first part of a 2-part article, Chris Mallac explores the concept of neuroplasticity, and how a better understanding of its underlying principles improves rehab outcomes.
Reinjury rates following return to sport are often quite high. In under-25 athletes for example, the incidence of another anterior cruciate ligament (ACL) rupture (or ACL failure) run as high as 23%(1). The reasons for reinjury when returning to sport are multifactorial. One of the commonly identified factors is a failure to target and retrain motor control resulting in aberrant movement patterns in the recovering athlete. Despite attempts at best practice rehabilitation of athletes, the utilization of motor control principles - specifically the principles of neuroplasticity - is frequently neglected.
The Polish neuroscientist Jerzy Konorski most likely coined the term neuroplasticity. In 1948, he described the adaptive cellular mechanisms of learning. He observed that learning occurred through a change in the quality of the connections between neurons in the brain. Those connections which were strengthened through frequent activation allowed encoded memories (see figure 1)(2). Many additions and revisions of this concept transpired over the next few decades. Ultimately rehabilitation professionals harnessed the concept of plasticity, or the ability of the brain to change the wiring of neural networks, in the recovery of central nervous system disorders. Indeed, many of the current modern-day rehabilitation programs used for traumatic brain injury and cerebral vascular accidents (strokes and aneurysms) have their roots embedded in the original theories proposed by Konorski.
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