Why is neuroplasticity needed? Session 301: Rerouting Neural Pathways: Advancing Pediatric Function Through Neuroplasticity Karen Pryor PhD, PT, DPT

Size: px

Start display at page:

Download "Why is neuroplasticity needed? Session 301: Rerouting Neural Pathways: Advancing Pediatric Function Through Neuroplasticity Karen Pryor PhD, PT, DPT"

Allen Blair
5 years ago
Views:

To comply with professional boards/associations standards: I declare that I (or my family) do not have a financial relationship in any amount, occurring in the last 12 months with a commercial

1 To comply with professional boards/associations standards: I declare that I (or my family) do not have a financial relationship in any amount, occurring in the last 12 months with a commercial interest whose products or services are discussed in my presentation. Additionally, all planners involved do not have any financial relationship. Requirements for successful completion are attendance for the full session along with a completed session evaluation. Vyne Education and all current accreditation statuses does not imply endorsement of any commercial products displayed in conjunction with this activity. Session 301: Rerouting Neural Pathways: Advancing Pediatric Function Through Neuroplasticity Karen Pryor PhD, PT, DPT Leading the Way in Continuing Education and Professional Development. Why is neuroplasticity needed? Approximately 95% of the children we treat have a neurological injury or abnormality. When there is an injury or an omission of part of the brain We have to treat and engage the lower centers to make changes, new connections 1

2 Frontal lobe damage Newtonian Physics To Quantum Physics Symptom Versus Cause Treating the symptoms only - is a slow process Treating the cause and the symptoms speeds development and function 2

Head to Toe Assessment History Images Primitive reflexes Tone Qualities Cranial nerves Balance Vision Symmetry Developmental level Neonatal Abstinence Syndrome Connected to Those That Formed Before

level cells Synapses form between the axon of one neuron and dendrite of another Connections to everything Skilled early treatment is vital Area X Neuroplasticity and Novelty Pasko Rakic Yale

3 Head to Toe Assessment History Images Primitive reflexes Tone Qualities Cranial nerves Balance Vision Symmetry Developmental level Neonatal Abstinence Syndrome Connected to Those That Formed Before During neuronal migration in a fetus, the 6 layers of the cortex are built Growth and development of the brain is from innermost to outermost Migrating neurons travel outward through nearby lower level cells Synapses form between the axon of one neuron and dendrite of another Connections to everything Skilled early treatment is vital Area X Neuroplasticity and Novelty Pasko Rakic Yale University School of Medicine Area 17 and 18 Primary visual cortex Area that must receive sensory information from the eyes before visual association cortex tells us what we see and how we feel about it. Rakic s team removing part or all of the optic nerve during development yeilds: Thalamus that relays information from retina to primary visual cortex is smaller Area 17 is smaller due to lack of stimulation Area 18 no change in area size Area X new area, hybrid of the two, capable of novel functioning 3

Neuroplasticity is a Tool We Can Use If you don t use it.

000 nerve cells per minute Can develop 100 trillion interconnections If activities are novel, synapses

neurogenesis, cells are generated in the subventricular zone of the brain Adult born stem cells travel

send novel information to the rest of the brain https://www.nih.

4 Neuroplasticity is a Tool We Can Use If you don t use it. Typical Infant is born with100 billion neurons Fetal brain grows nerve cells per minute Can develop 100 trillion interconnections If activities are novel, synapses feed connections Sense of smell and stem cell formation Sense of smell and stem cell formation Through neurogenesis, cells are generated in the subventricular zone of the brain Adult born stem cells travel the rostral migratory stream to the olfactory bulb Neurons in the olfactory bulb sort information and send novel information to the rest of the brain Smell and the Brain NIH 2014 The sense of smell Makes new stem cells Than means more connections can develop More function Champion mind champion body 4

Neurological Examination Find out what is

Rewire to promote function Hebb principle

brain is sensory We try to leave hands and

3-dimentional stimulation assists in the

to their neck and trunk If they know where

5 Neurological Examination Find out what is working Find out what is not working Rewire to promote function Hebb principle What fires together wires together Multi-sensational learning modes Therapists treat infants and children through sensation Correction is through feedback loops Information that enters the brain is sensory We try to leave hands and feet open to experience their environment unless there are misalignments or deformities 3 Dimensional sensation 3-dimentional stimulation assists in the child recognizing their body parts related to their neck and trunk If they know where they are Stimulate in sequence of development Head Neck Trunk Arms hands Legs feet 5

Constrain induced therapy Edward Taab If we

dysfunctional arm will improve This is through

Asleep Brain Conscious brain is asleep Changes in

The infant and child requires stimulation to add

The brain of an infant adds brain connections

6 Constrain induced therapy Edward Taab If we restrict use of the functional arm then the dysfunctional arm will improve This is through neuroplasticity Bracing and CIT? Asleep Brain Conscious brain is asleep Changes in spastic responses Covering hands, feet and ankles The infant and child requires stimulation to add connections for additional function. The brain of an infant adds brain connections through sensory and motor activities Rotation is one of the essential requirements to start and stop movements 6

Changing the Brain and the Use of Bracing If hands and feet are covered, stimulation is

functional movement Consider static and dynamic bracing principles The brain remembers what

Neonatal abstinence syndrome The sensation may be altered Learning may decreased due to poor

Intensive teaching to the caregiver is necessary PT phone home program Brain stem

7 Changing the Brain and the Use of Bracing If hands and feet are covered, stimulation is restricted and new connections are not formed Goal to increase strength and active functional movement Consider static and dynamic bracing principles The brain remembers what ever they experience the most 1 hour stimulation to hands and feet or bracing for 8 hours? Neonatal abstinence syndrome The sensation may be altered Learning may decreased due to poor interaction with therapist and environmental stimulation Sensation is key to learning Intensive teaching to the caregiver is necessary PT phone home program Brain stem Homeostasis Relay Sensory - Motor g 7

Strength is different than tone Low tone

and raise arms and legs while laying on back

gravity and touch Invisible restrictions hold

gangs Primitive reflexes We always have them

primitive reflexes Neuroplasticity techniques

the infant and child Change the Low Tone If we

develop at a typical rate Low and high tone are

techniques Neuroplasticity reinforces sensory

8 Strength is different than tone Low tone gravity takes over movements Difficult to move and raise arms and legs while laying on back High tone changes in position related to gravity and touch Invisible restrictions hold back movements Primitive reflexes travel in gangs Primitive reflexes We always have them Strength is present Children may retain primitive reflexes Neuroplasticity techniques assist in changing the voluntary function of the infant and child Change the Low Tone If we could just change the tone The child would develop at a typical rate Low and high tone are successfully treated through neuroplasticity techniques Neuroplasticity reinforces sensory integration and nervous system connections for development Child with Down Syndrome 8

High tone Stroke, Cerebral Palsy Cerebellum Connections Spinocerebellum

speech Plasticity: In a single cerebellar module can be as many as a billion parallel

adjustable in neuroplasticity. Boyden ES, Katoh A, Raymond JL (2004).

9 High tone Stroke, Cerebral Palsy Cerebellum Connections Spinocerebellum Cerebrocerebellum Vestibulocerebellum - coordinates information with vision and sensation. Motor learning and coordination of movements, spatial orientation, posture, balance and speech Plasticity: In a single cerebellar module can be as many as a billion parallel fibers converge onto a group of less than 50 deep nuclear cells nuclear cells are adjustable in neuroplasticity. Boyden ES, Katoh A, Raymond JL (2004). "Cerebellum-dependent learning: the role of multiple plasticity mechanisms". Annu. Rev. Neurosci. 27: Feedback loops Sensory and Motor corrections Primitive reflex responses Balance Tremors Nystagmus 9

10 Occipital Lobe Sight Vision Visual data Routes to other areas of brain for identification and memory Visual processing of the mammal brain Rerouting information for vision is through senses. Vision development Vision connects to 85% of all the brain connections Alignment of eyes allows 3 dimensional vision Visual tracking is important to safety and reading Vision impairment 10

decreased stimulation and connections of

11 Idiopathic Toe walking Where they are looking? Nose up Toes up / Nose down Toes down Helmets Covering peripheral vision decreased stimulation and connections of brain cells Firing pathways feeds nerve cells and helps them thrive Without novel stimulation they are pruned Parietal Lobe Integrates sensory information Sense of touch Mechanoreception Somatosensory cortex Proprioception spatial sense and navigation Dorsal stream from visual system Skin Touch Temperature Pain relay through thalamus Schenk, Thomas; McIntosh, Robert D. (2010). "Do we have independent visual streams for perception and action?". Cognitive Neuroscience. 1(1):

Temporal Lobe Primary auditory perception Visual

recognition of visual objects Language works in

comprehension Emotion association include

Nature Reviews Neuroscience. 8 (5): 393 402. doi:10.

12 Temporal Lobe Primary auditory perception Visual memory, interpret meaning of visual stimuli, recognition of visual objects Language works in tandem with frontal lobe (Broca s area) speech comprehension Emotion association include hippocampus Hickok, Gregory; Poeppel, David (May 2007). "The Cortical Organization of Speech Processing". Nature Reviews Neuroscience. 8 (5): doi: /nrn2113. PMID Retrieved 16 April Children That Experienced Strokes Strength of Primitive Reflexes Brain Hemorrhage Vision connects to 85% of the brain Low and high connections Key to disengage primitive reflexes 12

Frontal Lobe Emotion Executive function Primary motor cortex Similarities and differences between things and events safe?

The child can learn best when relaxed and calm Home visits are optimal because toys, blankets and towels can be utilized as part

through novel activities and repeated practice Mammal Brain Limbic system Record memories of behaviors that produced agreeable

13 Frontal Lobe Emotion Executive function Primary motor cortex Similarities and differences between things and events safe? Memories associated with emotion from limbic system conform them to a situation round memory in a square hole Learning moments The child can learn best when relaxed and calm Home visits are optimal because toys, blankets and towels can be utilized as part of the treatments PT phone home program video parent working with PT and exercises so they can be done at home daily Brain learns through novel activities and repeated practice Mammal Brain Limbic system Record memories of behaviors that produced agreeable and disagreeable experiences Responsible for emotions in human beings Main structures of the limbic brain hippocampus amygdala hypothalamus. 13

Sensory - incoming Suck and swallow relates to primary reflex and survival Primitive reflexes

The Development and Shaping of the Brain. Retrieved 041517. Chapter 6. https://www.ncbi.nlm.nih.

grasp Movement of legs and feet Early treatment is key Earlier treatment begins Faster the

14 Sensory - incoming Suck and swallow relates to primary reflex and survival Primitive reflexes See - Visual identification processing Objects hand to mouth 3 dimensions Feet on uneven ground The Development and Shaping of the Brain. Retrieved Chapter 6. Motor - outgoing Visual tracking Head and neck Movement arms Reach and grasp Movement of legs and feet Early treatment is key Earlier treatment begins Faster the changes occur Family involvement in home program Our goals are the same Change their lives for best function 14

15 Questions? Karen Pryor PhD, PT, DPT 15

Homework Week 2. PreLab 2 HW #2 Synapses (Page 1 in the HW Section)

Homework Week 2. PreLab 2 HW #2 Synapses (Page 1 in the HW Section) Homework Week 2 Due in Lab PreLab 2 HW #2 Synapses (Page 1 in the HW Section) Reminders No class next Monday Quiz 1 is @ 5:30pm on Tuesday, 1/22/13 Study guide posted under Study Aids section of website