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The neuroplasticity-based model (NBM): an updated neurorehabilitation model that emphasizes evidence-informed
David Morris1, Sarah Dos Anjos2, Mary H Bowman2
1Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Purpose:
Since its inception, neurorehabilitation principles guiding patient/client assessment and management have evolved alongside scientific discoveries. Historically, three models have shaped neurorehabilitation assessment and intervention: muscle-reeducation, neurotherapeutic facilitation, and contemporary task-oriented approaches, grounded in reflex, hierarchical, and systems theories of motor control and recovery. In recent decades, neuroplasticity research has challenged established principles of neurorehabilitation, supporting a shift toward an updated model. The purpose of this paper is to describe the implications of neuroplasticity research for neurorehabilitation and propose a new model that integrates emerging theories of adaptive neuroplasticity promotion in rehabilitation.
Methods:
This special interest paper explores the current understanding of neuroplasticity and the implications of these findings for management of neurologic movement dysfunction. Based on the current literature, we propose and describe a fourth neurorehabilitation model, the Neuroplasticity-Based Model (NBM), that may better guide clinical assessment and management.
Results:
The NBM's five therapeutic aims include optimal intervention delivery, experiences designed to focus attention, intentional experiences to induce physiological stress, health promotion strategies, and behavioral change support. These aims are tailored to individual factors to create client-centered interventions that promote adaptive neuroplasticity.
Conclusion:
The NBM offers a comprehensive framework for integrating emerging neuroplasticity discoveries into neurorehabilitation practice.
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