Therapeutic Background

Neuroplasticity – how does it work?

According to the Oxford Dictionaries (1), Neuroplasticity is: “The ability of the brain to form and reorganize synaptic connections, especially in response to learning or experience or following injury”.New cortical connections are formed in areas that are not directly affected by the infarct. They start to receive information from nearby areas. (2) More than 40 Years of research (3) show that not only lifelong learning is possible but also the structural development of our brain throughout our lifespan is as well. Studies also show that Plasticity in the motor cortex (M1) plays an essential role in learning and memory. (4)

Can we influence the construction site in our brain?

Due to external stimuli like emotions or training, certain areas of the brain can be enhanced. New connections can be made and even reorganizing of brain functions is possible. One important factor is repetition. The quantity and intensity of a stimulus are crucial to the impact. Also, the emotional connection to a stimulus can have an effect. Meaningful tasks are more likely to start an ongoing process than emotionless exercises.

How to use this knowledge in therapy

After a stroke, the brain is in a state of exception. Crucial areas for the brain’s workflow are no longer reachable. Function loss, like weakness of one body side and trouble speaking, can be the outcome. Because of neuroplasticity, unharmed areas in the brain are able to compensate for a certain amount of functions. Some functions are not lost, but only temporarily “offline”. Some areas recover from the trauma over time, but there is also function gain that we can influence using therapy.Studies(5) show that the principles of neuroplasticity can be used to retrain the brain through activity. The so-called activity-dependent plasticity describes the ability of the brain to relearn a certain amount of function through continuous purpose and use. This reorganization is most likely to happen shortly after the incident but can continue throughout a lifetime.

What I experience in my work as a therapist

In my daily work with post-stroke patients in the early phase of rehabilitation, I witness that there are only so many things I can affect as a therapist.Meaningful activities, motivation, and repetition are crucial factors to the functional outcome that I can influence. Using evidence-based methods combined with client-centered approaches and the knowledge of ongoing reorganizing of the brain, I can maximize my influence as a therapist.So what is your experiences with neuroplasticity? Do you find it as fascinating as I do?


  2. Fuchs, E., & Flügge, G. (2014). Adult neuroplasticity: More than 40 years of research. Neural Plasticity.
  3. Buma, F., Kwakkel, G., & Ramsey, N. (2013). Understanding upper limb recovery after stroke. Restorative Neurology and Neuroscience.
  4. Cantarero, G., Lloyd, A., & Celnik, P. (2013). Reversal of Long-Term Potentiation-Like Plasticity Processes after Motor Learning Disrupts Skill Retention. The Journal of Neuroscience, 33(31), 12862 LP-12869.
  5. Robbins, J. (2008). Swallowing and Dysphagia Rehabilitation: Translating Principles of Neural Plasticity Into Clinically, 4388(March 2015).