Neural plastic changes in the brain are part of normal learning and development and also occur in response to brain injury. Experience and training are critical ingredients to this change (Carey, 2012).
Restorative approaches to rehabilitation after stroke may be likened to the science and art of bonsai (Carey, 2012). The mature plant (stroke survivor) has innate and organic potential for growth and change (recovery). It requires the right environment of soil, water and sunshine (likened to an enriched environment and family) together with the skill of the bonsai master (therapist) to achieve the desired outcome. The bonsai master (therapist) works with the plant (person) to help guide and shape its growth in the desired direction while being responsive to the natural strengths of the plant (individual). Grafting (adjunctive or assistive therapies) may be required at times to achieve new connections and growth.
Reference: Carey, L.M. (Ed.). (2012) .Stroke Rehabilitation: Insights from Neuroscience and Imaging. New York: Oxford University Press.