How Stroke Recovery Actually Works
Recovering from a stroke is complex, and therapy can look vastly different from one survivor to another. However, the process of recovery remains the same for all stroke survivors and is pretty simple. In this post, we will dive into how stroke recovery actually works.
How stroke recovery actually works can be split into two parts: spontaneous recovery and neuroplasticity.
Spontaneous Recovery:
After a brain injury, there is a phase of rapid improvement called spontaneous recovery, where the temporarily affected brain functions start to return within a few weeks to months. This occurs due to several factors.
Decreased Swelling: Swelling, inflammation, and changes in blood flow happen after a brain injury. As the brain heals and the swelling subsides many temporarily affected functions will improve or return to normal as these issues are resolved.
Homeostatic Recovery: Following an injury, the brain activates its homeostatic processes to preserve internal equilibrium and mitigate the damage. These processes adjust the levels of neurotransmitters, the balance of ions, and the supply of energy. This regulation is crucial for protecting neurons and ensuring their survival.
Brain Plasticity
The main way that makes it possible to recover from a stroke is neuroplasticity, also known as brain plasticity. It refers to the brain's remarkable ability to reorganize by forming new neural connections.
While spontaneous recovery can lead to noticeable improvements, beginning formal rehabilitation as early as possible is crucial. Timely therapeutic intervention can take advantage of the brain's heightened level of plasticity during this phase, enhancing the overall recovery process and outcomes. There are several elements contribute to neuroplasticity, including:
Synaptic Plasticity: The brain's ability to strengthen or weaken synaptic connections becomes crucial after a stroke. These changes allow the brain to reorganize and modify the strength of connections between neurons, enhancing communication efficiency in the neural networks that remain intact or have been newly formed. The brain can form new synaptic connections between existing neurons, which is known as synaptogenesis. This process helps establish new pathways that can bypass damaged areas of the brain, aiding in recovery.
Axonal Sprouting: Axonal sprouting is the process of growing new axons from surviving neurons to create alternative pathways for neural signals and bypass damaged areas of the brain.
Cortical Remapping: Areas of the brain near the injury site may take over functions previously managed by the now-damaged regions. This reassignment is part of the brain's natural adaptability. Brain regions responsible for specific functions can alter their cortical representation. For example, suppose a part of the brain that controls hand movements is damaged. In that case, other areas that control arm movements also expand their role to include hand function.
Neurogenesis: Generation of New Neurons: Although more limited in adults, neurogenesis in response to a stroke can occur, particularly in the hippocampus and possibly the subventricular zone. These new neurons can migrate to damaged areas and integrate into existing neural circuits, potentially contributing to recovery.
Cellular Clean Up: After a stroke, the levels of various neurotransmitters and neuromodulators can affect the brain's ability to change and adapt, known as neural plasticity. The brain may adjust its sensitivity to these chemicals to aid in recovery. Glial cells, such as astrocytes and microglia, play a supportive role in neural plasticity. They can assist in clearing debris, releasing growth factors, and controlling the inflammatory response, aiding the brain's recovery process.
Wrap Up
While brain plasticity offers a powerful avenue for recovery, it also presents challenges. Most of these changes in the brain don't happen on their own. It requires specific stimulation of the brain to trigger neuroplasticity. I always tell my patients that stroke recovery is an active recovery, not a passive recovery like the healing of a broken bone.
Thankfully, there is abundant research on how you can trigger neuroplasticity, and in this blog post, I'll show you 3 of the most powerful evidence-based interventions you can do with your current home exercise program.
