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How is it really that a person can learn to move again after a debilitating injury? When a neurological injury such as a stroke or spinal cord injury occurs, people are left wondering how to function again. It can seem like the end of movement as they know it, a death in the way that a person has adapted to navigating their environment for years.

Depending on the type and severity of a neurological injury, the results of such an event can vary greatly. A brain injury such as a stroke disrupts the way that the brain serves as a command center for muscles, altering the way a person has learned to move and feel. A traumatic brain injury can completely alter movement, perception, and personality, depending on the area of the brain affected. Degenerative diseases such as Multiple Sclerosis slowly attack a person’s central nervous system, causing them to have a gradual decline in physical and sensory function.

In physical therapy, clients and their families are understandably scared and frustrated after such injuries. How does a person move forward with a life-changing disease or event? The hope lies in the power of adaptation, and the ability of the human neural circuitry to rewire and allow someone to learn to navigate the world in a new way. This is called neural plasticity, and it is a powerful survival tool which optimizes our resilience in life.

The nerves in our bodies communicate with biological electrical signals much like common electrical wires. When one nerve wire is faulty, our body finds a way to establish a signal through a new route so that a message can be delivered. This is absolutely amazing, and allows people to move forward in life after a debilitating disease or injury.

People often wonder how long it will take until they feel ‘normal’ again, and the beauty of neural plasticity is that our bodies find a new ‘normal’ through rewiring the neural circuitry. The key in this recovery is that the body and brain must be forced to find the new normal through practice and repetition. Encouraging someone to use their arm after a stroke, for example, fosters new signals in the body which recover upper body movement. Practicing walking after a stroke is vital in recovering walking ability.

The central nervous system recovers by creating new synapses. Where there was a blockage in communication from the injury, new receptors and new active signals are created. This requires increased stimulation in the brain, meaning that a person must be encouraged to do an activity which may seem difficult and new given their injury. It will initially feel like a new, uncoordinated task and will slowly become more efficient with practice as the brain and central nervous system adapt.

Peripheral nerves, the ones that transmit signals from the spinal cord to the rest of the body and back, also recover in several ways. The tail of the neuron, the axon, can regrow. In addition, a number of events are set off to create new signals and stimulate recovery.

Neuroprosthetics and technologies that force a person back into movement early may stimulate this mechanism of neural plasticity for an injured person. In general, the sooner that someone can start moving, the better. More time without movement means more muscle atrophy, as well as more of the body forgetting how to move through disuse.

The body responds to the commands and stresses that are placed on it, and devices and therapies that foster a plastic response are not only positive and productive, but what allow people to survive and adapt after a life-changing injury.