A traumatic brain injury is defined by the Brain Injury Association of America as an alteration in brain function caused by an external force. A non-traumatic brain injury is caused by internal factors, such as stroke or lack of oxygen due to other internal factors such as a hemorrhage in the brain or a brain stem stroke. all of which inhibit the normal flow of oxygen through the brain.But the good news is plasticity or Neural plasticity, also known as neuroplasticity or brain plasticity, that is defined as the ability of the nervous system to change its activity in response to intrinsic or extrinsic stimuli by reorganizing its structure, functions, or connections.

These are some interesting points about plasticity

  1. 1.                  Use it or lose it

    Failure to drive specific brain functions can lead to loss of abilities.

    2.                  Use it and improve it

    Training that drives a specific brain function can lead to improving abilities.

    3.                  Specificity

    The nature of the training experience dictates the nature of the change in the brain (plasticity)

    4.                  Repetition

    Change (plasticity) requires sufficient repetition.

    5.                  Intensity

    Change (plasticity) requires intensive training.

    6.                  Time 

    Different forms of change (plasticity) in the brain happen at different times during training.

    7.                  Salience 

    The training experience must be meaningful to the person in order to cause change (plasticity).

    8.                  Age

    Training-induced change (plasticity) occurs more readily in younger brains.

    9.                  Transference

    Change in function as a result of one training experience can even lead to learning other similar skills.

    10.            Interference

    Brain changes (plasticity) that result in bad habits can interfere with learning good habits.

    While we don’t know how many reps of practice need to be done to improve your skill at doing something, we can be pretty sure that the number is large. Simply put, you probably need to do hundreds of repetitions of practice to see significant changes in skill. Counting and recording your reps of practice is a good way to monitor how much you are doing and try to increase your amounts of practice.


    Thus, clearly,  items of focus for rehabilitation professionals should be the number of reps and type of activity performed in each session.  Current research, however, shows that most therapy sessions do not contain the proper amount of repetitions per session to cause actual changes in the brain.  Typical therapy sessions, whether physical, occupational, speech, or cognitive, last about a half hour per session with the therapist employing various tasks and exercises throughout the session.

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