A Clinical Application of Easing Pain via Neuroplasticity
Presented by Adriaan Louw
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Neuroscience and brain imaging advances have shown that decreased movement of body parts leads to functional and structural changes in the brain. These neuronal representations of body parts are dynamically maintained, and changes in shape and size of body maps correlate to increased pain and disability. Neglect, increased fear-avoidance, and decreased use of body parts increases pain and disability, along with sensitization of the nervous system. This can result in extreme sensitivity to physical treatments such as hands-on therapy, exercise, etc. Neuroplasticity also provides hope. Body maps can be retrained within minutes. One strategy used in normalizing cortical maps is graded motor imagery (GMI), including normalizing laterality, motor imagery, mirror therapy, sensory discrimination, sensory integration, and more. The growing evidence shows the GMI program as a whole, or parts of it, can be used clinically to help desensitize a hypersensitive nervous system. This 90-minute session will showcase how brief GMI interventions can be readily applied in real-life clinics to accelerate the recovery of people struggling with pain.
Meet your instructor
Adriaan Louw
Adriaan earned his undergraduate degree, master’s degree, and PhD in physiotherapy from Stellenbosch University in Cape Town, South Africa. He is an adjunct faculty member at St. Ambrose University and the University of Nevada, Las Vegas, teaching pain science. Adriaan has taught throughout the US and internationally for 25…
Chapters & learning objectives
1. The Clinical Dilemma: Too Hot to Handle
A common feature in people suffering with pain is a heightened and sensitive nervous system; often rendering patients extremely sensitive to physical treatments, such as hands-on therapy, exercise, etc. This poses a significant challenge for health care providers. This chapter will showcase a series of clinical cases where patients afflicted with hypersensitivity are treated via a neuroplasticity treatment referred to as graded motor imagery (GMI).
2. A Working Knowledge of Neuroplasticity
The human brain is plastic: ever-changing and adapting to its environment. This chapter will provide clinicians with a working knowledge of neuroplasticity and showcase what happens to the brain in the event of pain, fear of pain, decreased movement, and immobilization; all of which have a profound impact on the pain people experience.
3. Assessing Altered Neuroplasticity in the Clinic
Neuroplastic and immune changes occur very fast after injury, and it is argued that many patients treated by health care providers have aspects of altered neuroplasticity processes in their clinical presentation. This chapter will showcase how working clinicians can use a series of clinical tests to assess sensitization of the nervous system, as well as neuroplastic changes associated with their pain experience.
4. Desensitizing a Hypersensitive Nervous System: Part One
The neuroplastic properties of the brain allow for treatment since they're... plastic. A series of “brain exercises” referred to as graded motor imagery (GMI) are used to help restore and normalize altered brain maps to ease pain. In this chapter, clinicians will be introduced to graded motor imagery, evidence of its effectiveness, and the building of a treatment plan. Treatment includes pain neuroscience education and restoring left/right discrimination (laterality).
5. Desensitizing a Hypersensitive Nervous System: Part Two
Chapter five of this course builds on chapter four's discussion of graded motor imagery (GMI). In this chapter, treatment such as motor imagery, sensory discrimination, and mirror therapy will be discussed and showcased in an easy-to-apply clinical format.