[libribook.com] Traumatic Scar Tissue Management 1st Edition

Pathophysiological Consideration
When one brain hemisphere has been damaged, the intact hemisphere may
take over some of its functions. Compensation can also occur via
reorganization and formation of new connections between intact neurons.
The ‘rewiring’ of neuronal connection is stimulated by activity. For neurons
to form beneficial connections, they must be correctly stimulated.
Inappropriately stimulated, bored or unstimulated neurons will disengage or
find something else to do. Neuroplasticity can also result in an impairment
or harmful compensation; for example, some who are deaf may experience
tinnitus, thought to be the result of the rewiring of brain cells starved for
sound. Another illustration of this is neuroplastic pain – pain caused by or
increased as a result of changes within the NS. In addition to the higher
brain centers, neuroplastic changes can occur in the spinal cord and
periphery following injury and inflammation. Neuroplastic changes may
increase the magnitude of perceived sensation (pain) and may contribute to
pain translation (shift from acute pain to chronic/persistent pain) and
consequent increased sensitivity (Puretić & Demarin 2012).
Spinal Cord
The spinal cord propagates nerve impulses between the spinal nerves and the
brain, primarily functioning as a conduit for motor and sensory information, and
as a center for coordinating certain reflexes, which it can independently control.
Each of the 31 segments of the spinal cord comprises one pair of dorsal and
ventral horns:
• Ventral components: groups of efferent (out-going) motor neurons
• Dorsal components: groups of afferent (in-coming) sensory neurons (Zigmond
et al. 1999) (Fig. 4.2).
The spinal cord also contains interneurons which modulate bidirectional
information from the sensory and motor components.