EXSC239 - Research Proposal by https://padlet.com/chorsley2/vnikgy84elyb Neuroplasticity subserving Athlete's Skill Acquisition Post Injury Rehabilitation en-us 2019-04-10 23:55:06 UTC 2023-05-18 13:34:48 UTC hello@padlet.com https://padlet-assets.s3.amazonaws.com/icons/Pictureland.png Neuroplasticity subserving Athlete's Skill Acquisition Post Injury Rehabilitation chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/350588187
  • It is important to understand neuroplastic involvement in motor learning to assist in skill acquisition post injury rehabilitation. 
  • Injuries affect an individual psychologically, physiologically and neurologically.
  • It is important to understand when and how to implement rehabilitative treatments and its impact on neurological organisation of the brain (e.g. the more you engage in an activity the stronger the neural path)
  • Understanding the concept of neuropathic pain how it interacts with an individuals attentional focus for learning
  • Understanding that neuroplasticity plays a role in compulsive worry and potentially fear of re-injury

    • ]]>     2019-04-11 00:01:44 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/350588187     Fitts & Posner 3 Stage Model chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/350588615 Cognitive Stage: Gaining an understanding of the basic movement pattern through: breaking the skill down into parts, Conscious movement (high cognitive load and focus required during this stage of learning) and trial and error.
    Associative Stage: Less cognition is required as the athlete understands the movement pattern becoming more fluid and begins deliberate practice of the skill.
    Autonomous Stage: Minimal cognitive effort required as the athlete has put many hours of deliberate practice that the skill becomes 'over learned' with minimal performance variance in which they can broaden their attentional focus to other performance factors. 
    Influenced by:
    Individual differences, Skill Complexity and Pressure
    ]]>     2019-04-11 00:04:24 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/350588615     Two Stage Model (Gentile, 1972, 2000) chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/350599428 Initial Stage: understanding and acquiring basic movement with the ability to distinguish non-regulatory conditions and  regulatory conditions.
    Later Stage: increasing the consistency and adaption of the skill by practising:
    • Fixation: Closed skills in stable and predictable environments to improve consistency 
    • Diversification: Open skills that require the athlete to react and adapt to changing conditions in the environment outside of the athletes control (e.g. loud crowd)
    Spittle, M. (2013) Motor learning and skill acquisition: Applications for physical education and sport. South Yarra, Australia: Palgrave Macmillan.
    ]]>     2019-04-11 00:56:13 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/350599428     Dynamic Systems and Stages of Learning (Bernstein, 1967) chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/350599833 Skill learning is based on solving degrees of freedom problem that is gradually releasing movement from ridged to relaxed and fluid.
    Freezing the Degrees of Freedom: reduction of independently moving body parts required for movement (i.e. athlete is tense and rigid at first using more muscles than required), thus control and coordination is hindered. For example, when teaching a child to skip they will typically engage in full circumduction of the arms to rotate the rope.
    Releasing:  the more the movement is practiced the learner will begin to release more degrees of freedom (i.e. relaxing the muscles not required for that movement). For example, as the child gets better they will release the wrist joints to do the rotation thus the arms will remain by their sides.
    Exploiting: exploring and experimenting with the movement's passive and reactive forces in the body /environment to achieve the most energy efficient movement. Example, jumping with two feet on a ratio of 1:1 (1 skip: 1 jump) is more energy efficient then jumping 1:2 ratio at the same pace.

    Spittle, M. (2013) Motor learning and skill acquisition: Applications for physical education and sport. South Yarra, Australia: Palgrave Macmillan.

    ]]>     2019-04-11 00:57:41 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/350599833     Neuroplasticity and Rehabilitation (Hallet, 2005) chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351518883 2019-04-14 23:11:22 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351518883 Neuroplastic Process chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351519001
  • Remodelling occurs in individual cells; groups of neurons and functions adapt to change behaviour 
  • Persistent early change more likely to be permanent
  • long-term potentiation (increases synaptic strength) and long-term depression (decreases synaptic strength)
  • remodelling of Neuron's dendritic spines and connectivity
    • ]]>     2019-04-14 23:12:38 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351519001     Principles of Rehabilitation and Neuroplasticity chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351519723
  • Competition for representation in the brain. movements used more often have a stronger/large area of the motor cortex devoted to their function than lesser used areas.
  • Thepremotor Cortex can substitute the Primary Motor Cortex
  • Contralesional Hemisphere can replace the Thepremotor Cortex and the Primary Motor Cortex as a last resort.
  • Neuroplasticity can be facilitated:
    • Focused Physical Therapy/ Constraint-Induced Therapy 
    • Combination of drug therapy (amphetamine) and physical therapy.
    • use of local anaesthesia of proximal muscles to help lower muscles strengthen their representation
    • ]]>     2019-04-14 23:20:05 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351519723     Example of Local Anaesthesia chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351520380 2019-04-14 23:27:38 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351520380 Pain, Rehabilitation and Neuroplasticity chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351528264
  • Experimental/chronic pain often results in unfavourable neuroplastic changes leading to decreased performance
  • Motor rehab focused at re-establishing normal motor strategies 
  • Neuroplastic changes underlie functional recovery
  • Musculoskeletal pain management involves isolation training: activating of delayed/inhibited muscle with repeatedly with voluntary contractions. Skilled/precise actions facilitate cortical neuroplastic change
  • Acute pain suppresses rapid increase in cortical excitability hindering performance improvements
  • Experiemental pain interferes with nueroplastic change underlying simple instrumental learning (condition and response)
  • Pain is associated with: increased stress, reduced cognitive performance, reduced sleep and attention/focus deficits.
  • Novel motor skill training implemented with initial pain symptoms reduced risk of unfavourable neuroplastic changes as a result of pain
  • gradually making novel motor skill training more complex throughout rehabilitation may encourage cognitive effort enhancing cortical changes
  • Maximising cortical nueroplastic changes facilitate greater potential for rehab success. 
    • Low task repetition to avoid fatigue and pain to optimise musculoskeletal pain
    • ]]>     2019-04-15 00:42:30 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351528264     Personal Thoughts chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351529708
  • Pain may also cause fear, worry, reduced self-competence and self-confidence.
  • As humans either engage in avoidance or engagement behaviours. Pain will typically promotes avoidance of anything that causes something to hurt. Thus, an injured limb would typically promote the individual to restrict or completely stop movement altogether. This would most likely lead to unfavourable neuroplastic changes as the restricted limb would begin to weaken its neural connection and lose its representation in the primary motor cortex whilst the uninjured limb would potentially strengthen its connection and representation (suggested in 'Use It or Lose It - Stroke Example'). This could be problematic if the injury is long term without movement.
  • As the athlete begins to engage in skill acquisition post rehabilitation they could experience the degrees of freedom problem presented in the dynamic systems stages of learning. In which the cognitive components of fear of re-injury, worry, reduced competence and confidence (dependent on how traumatic the original event of the injury) may cause the individual to restrict movement in an attempt to protect the previously injured site; Thus, potentially restarting the process of developing new 'mistake' neural pathways before the learning moves through the stages of releasing and eventually exploiting again. However, they not only may they not return to their post injury skill level they could strengthen a neural pathway out of avoidance of the injury leading to incorrect technique, possibly affecting the kinetic chain increasing the risk of a different injury.
  • With regards to 'The Brain That Changes Itself: Chapter 7 Pain, Pg 128' there is Reason to believe that this neuropathic pain could extend into the field of sporting injuries and rehabilitation process for skill acquisition post rehabilitation. Which is why it is important to understand neuroplasticity's underlying involvement with skill acquisition. As chronic pain could potentially be neuropathic which in turn could lead to longer rehabilitative training and reinforcement of physical compensation (accounting for the movements that prompt pain) whilst re-acquiring a skill. Possibly increasing the risk of other injuries due to potentially detrimental changes in the kinetic chain of movement
  • Starting early with novel tasks at low repetition to avoid fatigue and pain before gradually increasing skill complexity as suggested in Boudrea, Farina and Falla (2010) may potentially reduce the chance an athlete will experience the degrees of freedom problem again.
  •  Cognitive Distortions (e.g. negative self talk of their incapability leading to further psychological issues) after severe injuries may need the use of Cognitive Restructuring to aid neuroplastic changes. As negative affect as the potential to slow down the bodies ability heal itself (e.g. injured athlete may become depressed not being able to perform optimally which may lead to reduced appetite that may lead to a decrease in required essential nutrients to heal).
    • ]]>     2019-04-15 00:54:00 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351529708     Use It or Lose It - Stroke Example chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351549661
  • Skill learning is practice dependent of synaptic structural/functional reorganisation of Motor Cortex.
  • Experience Expectant Plasticity – experience of brain development during early sensitive periods. 
  • Competitive environment - effectively activated neural connections are maintained/strengthened and less activated are eliminated (Long-term potentiation vs Long-term depression as mentioned in 'Neuroplastic Process'; competition for brain representation mentioned in 'Principles of Rehabilitation and Neuroplasticity')
  • Rehabilitative Treatments initiate within one week increases the chances that the affected area keeps its representation in the motor cortex compared to when rehabilitation is delayed for 30 days after injury.
  • When initiated earlier rehabilitative treatments are typically shorter resulting in greater functional improvements compared to delayed treatments. Constraint Induced treatments increased performance of fine motor skills if started 3-9months post injury.
  • Forced Constraint Induced Therapy for two weeks is potentially be detrimental if done to early immediately following injury; However, is not detrimental if delayed by 7 days.
  • Vouluntary exercise can improve cognitive performance after 0-6 days post injury; However, can lead to impaired cognitive performance if exercise is conducted within this period.
  • Skill training of uninjured limb increases dendrite growth in Contraslesional Cortext which is detrimental to injured limb.
    • ]]>     2019-04-15 03:22:20 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351549661     The Brain That Changes Itself: Chapter 7 Pain, Pg 128 chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351551939
  • Injuries can not only damage body tissues but also nerves which can then continually signal the brain that there still is something wrong with the injured part. Known as Neuropathic Pain.
  • Typically seen/reported in amputees but can also be seen in cases of labour pains or large ulcers. 
    • ]]>     2019-04-15 03:38:06 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351551939     Personal Thought chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351553160
  • Although this article focuses on Stroke victims and the importance of early intervention to facilitate neuroplasticity to aid motor skill acquisition post injury. I feel it could be implemented into severe cases of Traumatic Brain Injuries occurring from sports (e.g. severe concussions from football tackles or in Boxing or head injuries obtained from other sporting incidents such as a cricket ball hitting a player or a diver hitting their head on the platform before entering the water where they'd be deprived of oxygen)
    • ]]>     2019-04-15 03:48:13 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351553160     Personal Thought for Future Study chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351554095 Raises the question if early intervention of combined motor skill acquisition, facilitation of neuroplasticity with psychological monitoring/intervention would be beneficial post contact sports career for the players mental health.
    For example, instead of the athlete only undergoing a '48hr concussion watch' period also taking time off playing/training contact for a longer period of time (maybe 2 weeks) and focusing on rehabilitative training that involves no contact risking further head trauma.

    Movie: Concussion
    • Based on a true story, neuropathologist Dr. Bennet Omalu, discovered link between Repeated head blows in contact sports and cognitive/emotional impairments
    • Developed the term Chronic Traumatic Encephalopathy (CTE)
    • Touches on lifespan development that under 18’s shouldn’t play contact sports
    • Memory-related diseases more prevalent in NFL players than the rest of the population.

    ]]>     2019-04-15 03:56:05 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351554095     chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351565510 2019-04-15 05:31:11 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351565510 The Brain That Changes Itself Chapter 7 Pain, Pg 133-135 chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351569446
  • Neurologist Vilayanur Ramachandran explores the potential of neuroplasticity and body image distortions.
  • pain/body image is created by the individuals brain and then projected onto the body
    • ]]>     2019-04-15 06:04:31 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351569446     The Brain That Changes Itself Chapter 6 Brain Lock Unlocked, Pg 117 chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351569938
  • worrying, post-traumatic stress disorders, phobias/fear, panic attacks and obsessive compulsive disorder.
  • Compulsive worrying can gradually alter the brain structure. Obsessively thinking something bad will happen.
  • Jeffery Schwartz developed plasticity based treatment to help those with OCD and those with everyday worries:
    • Acknowledge the issue through relabelling
    • Acknowledge that the anxiety/fear will not subside immediately and it will take time
    • Distinguish between worrisome thoughts/urges intruding conscious thought (form) and the reality of the issues (content). It is best to focus on form than the content
    • ]]>     2019-04-15 06:09:32 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351569938     chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351572327 2019-04-15 06:33:48 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351572327 Personal Thoughts chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351573203
  • When an injured athlete returns to sport they may have body image issues if they were absent from training for a multitude of reasons (e.g. multiple surgeries or experiencing negative affect). Thus changing how the athlete physically feels within themselves and their self-perception of how they look (e.g. might have lost all over muscle tone due to inactivity or inability to continue an intense training regime)
  • This could elicit compulsive worrying about what their peers will think of them in terms of their current skill abilities and how the athlete perceives others will see them physically. As there is typically a stigma around what makes an athlete. This is added pressure whilst trying to reacquire skills as they will be possibly combating the physical/neuropathic pain of the injury, the degrees of freedom problem and any reduced neurological representation of the movement having not undertaken that skill. 
  • Athletes could be worried about re-injury as well as trying to understand how to re-acquire the skill especially if there has been any reconstructive surgery that may have resulted in reduced movement through having to surgically pin or plate the injury.
  • All of these would not only increase cognitive load reducing attentional focus (narrowing field of vision thus potentially missing environmental needed to acquire the skill but could eventually alter the brain structure engaging the neuroplastic process of strengthening the compulsive worrying. This could lead to the athlete becoming compulsive worrier inhibiting their ability to move through the the '3 Stages of Motor Learning' to achieve autonomous movement. 
    • ]]>     2019-04-15 06:39:42 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351573203     Personal Thought for Expansion of Neurplasticity of Compulsive Worrying chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351576277 Does personality characteristics/traits influence the degree of neuroplasticity in regards an individuals resilience to becoming a compulsive worrier]]> 2019-04-15 07:04:58 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351576277 Cognitive Load chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351578743
  • Total amount of mental effort being used in working memory 
  • Intrinsic Cognitive Load - Topic specific (e.g. in sport this refers to actions controlled by the athlete)
  • Extraneous Cognitive Load - Presented information (e.g. in sport environmental cues such as a particularly part of music in a dance routine signalling for a specifically corresponding move.
  • High cognitive load has the potential to hinder balance, attention and focus


    • ]]>     2019-04-15 07:24:29 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351578743     Personal Thought chorsley2 https://padlet.com/chorsley2/vnikgy84elyb/wish/351580148
  • To minimise the impact of cognitive overload during skill acquisition post rehabilitation breaking down the re-learning of skills using the 'Two Stage Model' might be beneficial by:
    •  Fixation - practicing in a controlled environment eliminating the impact of negative peer opinions, creating/facilitating a supportive environment, reducing chances for the athlete to compare themselves to other athletes instead of comparing themselves to their progress made in their rehabilitation.
    • Diversification - once the athlete as acquired the skill gradually introducing tasks to cognitively load the athlete. For example, after an ankle injury to gradually load a soccer player after relearning to kick a ball into a goal from a variety of angles without a goalie introduce some team members to act as a noisy crowd.
    • ]]>     2019-04-15 07:34:58 UTC https://padlet.com/chorsley2/vnikgy84elyb/wish/351580148