A Review of Neuroplasticity: Some Implications for Physiotherapy in the Treatment of Lesions of the Brain

Stephenson, Richard

doi:10.1016/s0031-9406(10)60008-9

Cited by 25 publications

(14 citation statements)

References 30 publications

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“…Improvement after a cerebral insult occurs because of two processes: 'intrinsic' or sponta neous neurological remission and 'extrinsic' or functional improvement which is depen dent on motor learning and neuroplasticity [4,10]. Since posture is fundamental to stability as well as movement, attention to midline orientation is one of the principles of rehabili tation from the earliest stages [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…Stability and intact equilibrium responses are essential for unassisted walking, even if there is residual weakness in one leg [3]. Current theories of neuroplasticity also point to the importance of retraining the 'midline' orientation [4] rath er than 'teaching' the intact side to compen sate for the paralyzed limbs. This suggests that early observations on equilibrium might pro vide both a prognostic and a diagnostic guide to the stroke patient's potential recovery of mobility.…”

Section: Introductionmentioning

confidence: 99%

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Sitting Equilibrium 2 Weeks after a Stroke Can Predict the Walking Ability after 6 Months

et al. 1996

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The prediction of mobility soon after a stroke should allow proper selection for rehabilitation and suggest the long-term prognosis of gait ability. Stable gait is related to midline body orientation and equilibrium mechanisms. We proposed that the sitting balance during the 1st, 2nd, or 3rd weeks after a hemiplegia could be a prognostic indicator for gait at 6 and 12 months. Sitting equilibrium measured in hospital was correlated with gait at the time of discharge and after 6 and 12 months, assessed by standing up, walking, and climbing stairs. The power in the affected limbs in hospital was also correlated with gait at those times. In the 134 patients followed up at 6 months, the correlation of equilibrium with gait at 6 months was r = 0.675 (p < 0.0001), and that of arm power with gait was r = 0.551 (p < 0.0001). Correlations with gait at 12 months were smaller and less meaningful. Assessment of sitting balance, even before the patient can stand, forms an important part of early management of the stroke patient.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sitting Equilibrium 2 Weeks after a Stroke Can Predict the Walking Ability after 6 Months

et al. 1996

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“…The brain is a learning organ, capable of restoring lost neural paths during the rehabilitation process. Using this capability, known as neuroplasticity [ 7 ], it is possible to reduce rehabilitation periods and improve the recovery results. To that end, it is necessary to provide some sort of neurological feedback to the patient during the rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Decoding the Attentional Demands of Gait through EEG Gamma Band Features

et al. 2016

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Rehabilitation techniques are evolving focused on improving their performance in terms of duration and level of recovery. Current studies encourage the patient’s involvement in their rehabilitation. Brain-Computer Interfaces are capable of decoding the cognitive state of users to provide feedback to an external device. On this paper, cortical information obtained from the scalp is acquired with the goal of studying the cognitive mechanisms related to the users’ attention to the gait. Data from 10 healthy users and 3 incomplete Spinal Cord Injury patients are acquired during treadmill walking. During gait, users are asked to perform 4 attentional tasks. Data obtained are treated to reduce movement artifacts. Features from δ(1 − 4Hz), θ(4 − 8Hz), α(8 − 12Hz), β(12 − 30Hz), γlow(30 − 50Hz), γhigh(50 − 90Hz) frequency bands are extracted and analyzed to find which ones provide more information related to attention. The selected bands are tested with 5 classifiers to distinguish between tasks. Classification results are also compared with chance levels to evaluate performance. Results show success rates of ∼67% for healthy users and ∼59% for patients. These values are obtained using features from γ band suggesting that the attention mechanisms are related to selective attention mechanisms, meaning that, while the attention on gait decreases the level of attention on the environment and external visual information increases. Linear Discriminant Analysis, K-Nearest Neighbors and Support Vector Machine classifiers provide the best results for all users. Results from patients are slightly lower, but significantly different, than those obtained from healthy users supporting the idea that the patients pay more attention to gait during non-attentional tasks due to the inherent difficulties they have during normal gait. This study provides evidence of the existence of classifiable cortical information related to the attention level on the gait. This fact could allow the development of a real-time system that obtains the attention level during lower limb rehabilitation. This information could be used as feedback to adapt the rehabilitation strategy.

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“…This aims to re‐educate movement in neurologically damaged patients by facilitating normal patterns of movement, thereby allowing experience of that movement which stimulates the central nervous system (CNS) to re‐establish control over the affected limbs. The physiological means by which this is achieved is referred to as neuroplasticity (Bach‐y‐Rita 1981, Wainberg 1988, Stephenson 1993). One of the key tenets of plasticity theory (and so the Bobath approach), is that plastic changes can take place in the CNS both through abnormal and normal patterns.…”

Section: Discussionmentioning

confidence: 99%

Observing washing and dressing of stroke patients: nursing intervention compared with occupational therapists. What is the difference?

Booth

Davidson

Winstanley

et al. 2001

Journal of Advanced Nursing

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This study sought to compare the interventions of qualified nurses with those of occupational therapists during morning care with the same population of stroke patients. Nonparticipant structured observation was used to identify the activities and interventions carried out by each of the two groups in a naturalistic care setting. Approval for the study was granted by the local ethics committee. In order to allow comparison between pairs, staff-patient interactions during morning care (n=10) were observed by a single researcher, firstly, with an occupational therapist and within 3 days of this, with a nurse. Twenty observation sessions were recorded in total during which time the activities, contacts and interactions were coded and recorded at 20-second intervals on a standard proforma. Analysis was undertaken using the Statistical Package for Social Sciences (SPSS) for windows. The results showed that occupational therapists used 'prompting and instructing' commands more than nurses and used facilitation techniques significantly more (P=0.0283). 'Supervision' interactions were preferred by nurses with 42.1% of their time spent performing this activity compared with 25.1% for occupational therapists. These results are limited to the group under observation. It is suggested that the reasons for the observed differences in intervention styles used by occupational therapists and nurses may be attributed to the approach taken to the assessment and treatment of stroke patients. This difference might be attributed to a lack of preparation for specialist neurological/neurovascular practices of nurses working in the field of stroke rehabilitation.

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A Review of Neuroplasticity: Some Implications for Physiotherapy in the Treatment of Lesions of the Brain

Cited by 25 publications

References 30 publications

Sitting Equilibrium 2 Weeks after a Stroke Can Predict the Walking Ability after 6 Months

Sitting Equilibrium 2 Weeks after a Stroke Can Predict the Walking Ability after 6 Months

Decoding the Attentional Demands of Gait through EEG Gamma Band Features

Observing washing and dressing of stroke patients: nursing intervention compared with occupational therapists. What is the difference?

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