Neuroplasticity and musculoskeletal rehabilitation
Physiological or environmental changes or experiences trigger reorganization of the central nervous system (CNS), a process that is often pointed to as neuroplasticity. As neuroplasticity is typically reversible, it provides a potential entry point for physiotherapeutic intervention strategies; it increases understanding of underlying dysfunctional mechanisms and effectiveness of treatments targeting the musculoskeletal system.
In the presence of pain, the so-called “pain matrix” (a set of brain regions including the somatosensory cortices, insula, anterior cingulate cortex, amygdala and prefrontal cortex and thalamus) shows increased activation levels that ultimately lead to cortical reorganization. When pain is reduced, maladaptive cortical changes can be reversed with specific exercise training or manual therapy.
Neuroplasticity can specifically be targeted with intervention strategies such a mental imagery and task-specific training. Moreover, a shift of attention from an internal focus to an external focus can contribute to improvements in motor performance and therefore may enhance the effect of musculoskeletal interventions. In the future, neural adaptations resulting from musculoskeletal disorders and rehabilitation modalities specifically addressing these adaptations must be further investigated.
> From: Snodgrass et al., Man Ther (2014) (Epub ahead of print). All rights reserved to Elsevier Ltd. Click here for the Pubmed summary.