Phrenology, 1835 / Wellcome Images

Phrenology, 1835 / Wellcome Images

Several people have written in with stories of dismal therapists saying “If your walk hasn’t improved by X time, you will probably wear your ankle brace forever.” I got the same sort of comment. I switched therapists and hospitals. After years of work, I walk heel-toe.

Neuroplasicity is the brain’s capacity to create new pathways when there is damage. This is a major point of stroke rehab: to get your brain’s attention so that it can form these new pathways. “Right after a stroke you have a burst of spontaneous plasticity, when you can recover language, sensation, movement control, balance, simultaneously,” says Prof. Tom Carmichael, who studies brain repair after stroke at UCLA.

Plasicity slows down after a few months. Then it continues, differently. “If someone has trouble walking two years after a stroke, they can definitely improve their gait, get better control of their legs, but it takes a lot more work. And it occurs more slowly. It usually occurs with the focus on that one thing—walking—and it doesn’t occur while hand function will occur. The focus on one thing and work really hard on it in the chronic phase,” says Carmichael.

You can keep improving but it takes immense work. There is a lot of new rehab research going on, such as robots to help patients do thousands of reps.

Dismal therapists deserve second opinions.

8 Responses to “Neuroplasicity”

  1. dean reinke writes:

    Nina, Thanks for pointing out the Carmichael Lab. In my brief look at it it seems to contain vast amounts of information useful to us survivors. Now if we could only get our medical staff to read this and find some way to apply it to us. I look forward to neurogenesis taking over from neuroplasticity as the key to recovery.

  2. dlangendorf writes:

    The key word you noted is “work.” How much work did you do during recovery? And age. How old were you during this? Late 20s? 30s? Just wondering. Congrats on the improvement.

  3. Mike writes:

    @Dean: I do think that neurogenesis therapy is beyond our time. We are still looking at 100 years into the future, the time it will take to understand it, how to induce it, test it among different patients, and for the fFDA’s200 layers of bureaucracy to approve it. I’d rather depend on working hard to induce neuroplasticity. Plasticity is a habit of the brain pre-stroke, just that the brain has to remember what it can do. It only appears that neuroplssticity slow down. I met a late 50’s patient who is now fully recovered who used to be trapped in an AFO and with clawed fingers. There is hope beyond neurogenesis. His secret was he was so passionate about recovery, he worked 4-8 hours each day for 1 year.

  4. Nina Mitchell writes:

    @mike As defined here, plasticity is the creation of new brain pathways where old ones are damaged. You may relearn how to move your hand, but your brain will look different than before your stroke. Yes, plasticity does slow down in relation to the first few months after stroke. See Cambridge Press’s Brain Repair After Stroke. That doesn’t mean that it is dead, only that you have to work harder, like to man you mention.

  5. Garry writes:

    I suffered a stroke 6 years ago and rapidly improved in the first 9 mths. Since then I have been progressing slowly but still progressing. My attention span and dealing with complexity has improved. My thoughts on the brain is – everything is there where it was before except for the damaged part, it is a matter of gaining access to those areas of the brain through new pathways. The easiest way to stimulate brain activity is by learning new things, while keeping your B12 high and hormones balanced. The process of learning new things suddenly opens existing parts blocked off before. You find you know things that were not available to you before, even though you knew you must know these things because of your job or interests. I couldn’t operate my DSLR Except in auto (I’ve been using a SLR camera for over 30 years) so I just bought the latest and greatest and learnt the camera from scratch. After a while it all came flooding back. Now I can operate all my cameras in professional mode. Also my ability to use a windows PC was limited, so I bought a Mac and learnt something new. Once again as I learnt the Mac all came flooding back for the windows PC. I still have lost a significant part of my abilities; slower, tire rapidly, trouble maintaining concentration etc. But I keep learning new things and that is increasing my ability and access to pre-existing memory on how to do things. So pushing yourself to learn does continue to improve brain function after the first few months.

  6. Suzanne Bélanger writes:

    My familly doctor just told me that my spasticity is probably there to stay. He says that after 6 months if it is still an issue than it’s not going to go away. I immidiately started to cry since this mean I will never go back to my job with the children. Then I calmed down and said to myself I’ll show him.
    No way I am going to give up.

  7. Nina Mitchell writes:

    My spasticity has improved significantly since my first 6 months. Are you near a rehab hospital? They often have neurologists or rehab doctors who handle Botox or other cutting-edge spasticity treatments. has a lot of info. Don’t give up!

  8. Suzanne Bélanger writes:

    Hi Nina
    my neurologist has suggested botox. I might get it next time I see him in december.

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