Neurorehabilitation

From Wikipedia, the free encyclopedia
Jump to: navigation, search

Neurorehabilitation is a complex medical process which aims to aid recovery from a nervous system injury, and to minimize and/or compensate for any functional alterations resulting from it.

Neurorehabilitation is a speciality of neuroscience, which deals with the study and application of complex medical processes aiming at recovery from nervous system injury and to compensate for functional alterations.

In case of a serious disability, such as caused by a severe spinal injury or brain damage, the patient and their families' abilities, life style, and projects, are suddenly shattered. In order to cope with this situation, the person and their family must establish and negotiate a "new way of living", both with their changed body and as a changed individual within their wider community.

Thus, neurorehabilitation works with the skills and attitudes of the disabled person and their family and friends. It promotes their skills to work at the highest level of independence possible for them. It also encourages them to rebuild self-esteem and a positive mood. Thus, they can adapt to the new situation and become empowered for successful and committed community reintegration. Neurorehabilitation should be:

  • Holistic It should cater for the physical, cognitive, psychological, social and cultural dimensions of the personality, stage of progress and lifestyle of both the patient and their family.
  • Patient-focused Customized health care strategies should be developed, focused on the patient (and family).
  • Inclusive Care-plans should be designed and implemented by multidisciplinary teams made up of highly qualified and motivated practitioners experienced in multidisciplinary teamwork.
  • Participatory The patient and their family's active cooperation is essential. The patient and family must be well-informed, and a trusting relationship with the multidisciplinary team must be built.
  • Sparing Treatment must aim at empowering the patient to maximise independence, and to reduce physical impairment and reliance on mobility aids.
  • Lifelong The patient's various needs throughout their life must be catered for, by ensuring continuity of care all the way through from injury onset to the highest possible level of recovery of function. This may include addressing medical complications of the injury or illness later in life.
  • Resolving Treatment has to include adequate human and material resources for efficiently resolving each patient's problems as they arise.
  • Community-focused. It is necessary to look for the solutions best adapted to the specific characteristics of the community and to further the creation of community resources favouring the best possible community reintegration of the disabled person.

What is Neurorehabilitation?[edit]

Neurorehabilitation is a collection processes that are case specific which focus on aiding a person's recovery, or help that individual to live a more normal, active, and independent life. The quality of life of a person can be greatly affected by a brain or spinal cord injury, or a medical condition which affects the mobility, cognitive functions, or other physical or psychological processes that have been affected by changes in the nervous system. The goal of neurorehabilitation is to combat those changes and improve quality of life by various therapies.

Conditions Commonly Treated by Neurorehabilitation[edit]

How Neurorehabilitation Works[edit]

By focusing on all aspects of a person's wellbeing, neurorehabilitation offers a series of therapies from the psychological to occupational, teaching or re-training patients on mobility skills, communication processes, and other aspects of that person's daily routine. Neurorehabilitation also provides focuses on nutrition, psychological, and creative parts of a person's recovery.

Many neurorehabilitation programs, whether offered by hospitals or at private, specialized clinics, have a wide variety of specialists in many different fields to provide the most well rounded treatment of patients. These treatments, over a period of time, and often over the lifetime of a person, allow that individual and that person's family to live the most normal, independent life possible.

While the field of neurorehabilitation is relatively new, many therapies are controversial, and while some are considered cutting edge technology, there may be little research to support whether or not helpful progress is the result. Neurorehabilitation is the culmination of many different fields to provide the best care and education for patients with injuries or diseases affecting their nervous system.

Types of Neurorehabilitation[edit]

The ultimate goal for neurorehabilitation patients is to improve their quality of life and allow them the most independent life possible for their condition. In order to do so, many areas of study and many therapies are needed to help the individual and that individual's family or community to adjust to their new ways of life.

The most important therapies are those that help people live their everyday lives. These include occupational therapy, psychological therapy, speech and language therapy, and therapies focused on daily function and community re-integration. A particular focus is given to improving mobility and strength, as this is key to a person's independence.

Physical and occupational therapies are important parts of neurorehabilitation. Physical therapy in helping patients recover includes: balance retraining, gait analysis and transfer training, neuromuscular retraining, orthotics consultations, and aqua therapy. Occupational therapy helps patients in activities of daily living. Some of these include: home management and safety training, cognitive retraining for memory, attention, processing, and executive functions. It may also include neuro-muscular strengthening and training, and visual perceptual skill development.

robot-assisted therapy is an established intervention for motor rehabilitation of severe to moderate impaired stroke patients As an example, according to the latest stroke rehabilitation guidelines published in the AHA scientific statement[1], robot assisted therapy should be used for UPPER EXTREMITY motor rehabilitation of severe to moderate stroke patients, in the inpatient, outpatient and chronic care settings Specifically the AHA made the following two statements:

   “Robot-Assisted  UPPER EXTREMITY  therapy, however, can improve motor function during the inpatient period after stroke.”[2]
  “Robot-assisted therapy has been shown to improve UPPER EXTREMITY motor function in outpatient and chronic care settings.”[3]

[1] American Heart Association Scientific Statement Published in

Stroke Miller et al. (2010); 41:2402-2448

[2] Robot training enhanced motor outcome in patients with stroke maintained over 3 years. Neurology. Volpe BT, Krebs HI, Hogan N, Edelsteinn L, Diels CM, Aisen ML. 1999;53:1874 –1876.

Does shorter rehabilitation limit potential recovery poststroke? Neurorehabilitation Neural Repair. Fasoli SE, Krebs HI, Ferraro M, Hogan N, Volpe BT. 2004;18:88 –94.

The effect of robot-assisted therapy and rehabilitative training on motor recovery following stroke. Arch Neurology Aisen ML, Krebs HI, Hogan N, McDowell F, Volpe BT.1997;54:443.

[3] Intensive sensorimotor arm training mediated by therapist or robot improves hemiparesis in patients with chronic stroke. Neurorehabil Neural Repair Volpe BT, Lynch D, Rykman-Berland A, Ferraro M, Galgano M, Hogan N, Krebs HI. Neurorehabil Neural Repair. 2008;22:305–310.

Technological Developments[edit]

Over the last decade with the aid of science and technology, we are more familiar with the human brain and its function than ever before. Now, scientists are using technology with neurorehabilitation to provide cutting edge improvements to therapies for patients with nervous system issues. In particular, the use of robotics in neurorehabilitation is becoming more and more common.

Virtual reality simulations and video games provide patients with an interactive way to explore and re-learn different aspects of their lives and environments while being observed within the safety of their therapists and physicians.

These devices and simulations along with other robotic technology offers patients who have just had strokes or other brain or spinal cord injuries the option of training and physical therapy much sooner than might otherwise be possible, thus shortening the recovery period.

As technology and our understanding of the brain progress, robotics will most likely have a more integrated impact in how neurorehabilitation adapts.

See also[edit]

External links[edit]

Notes[edit]

This article incorporates material from the Institut Guttmann, who consents publication licensed by the Free Documentation GNU/GFDL