Science-Based Neurorehabilitation: Recommendations for Neurorehabilitation From Basic Science

Abstract

Neuroscience has fundamentally changed the understanding of learning and memory within recent years. Here, the authors discuss a number of specific areas where they believe new understanding of the CNS from basic science is having a fundamental impact on neurorehabilitation and is leading to new therapeutic approaches. These areas have constituted a basis for development of some basic principles for neurorehabilitation: Optimal rehabilitation should involve (a) active (patient) participation in the training, (b) training that does not only involve many repetitions, but also continues to challenge the skill of the training person, (c) motivation and reward, (d) intensive training and practice over a long time, (e) careful organization of the training in relation to other activities, and (f) incorporation of other potentially beneficial parameters such as sleep and diet. It should in this relation also be pointed out that albeit neurorehabilitation may be predicted to have the most optimal effect early in life and as soon after injury as possible, there is no reason to believe that beneficial effects of training may not be obtained late in life or several years after injury.

Exercise Training for Persons with Alzheimer's Disease and Caregivers: A Review of Dyadic Exercise Interventions

“…This is a very important point to consider in designing an exercise clinical trial for persons with dementia as well as in generalizing and applying the results in routine practice settings. Optimal rehabilitation training should involve the active participation of the patient as opposed to passive manipulation (Katalinic, Harvey, & Herbert, 2011; Nielsen, Willersley-Olsen, Christiansen, Lundbye-Jensen, & Lorentzen, 2015). The other key components of an optimal rehabilitation program include challenging the skill of the person training, motivating and rewarding, intensive training for as long a period of time that is feasible, and carefully organizing the training in the setting of other activities (Nielsen et al, 2015).…”

“…Optimal rehabilitation training should involve the active participation of the patient as opposed to passive manipulation (Katalinic, Harvey, & Herbert, 2011; Nielsen, Willersley-Olsen, Christiansen, Lundbye-Jensen, & Lorentzen, 2015). The other key components of an optimal rehabilitation program include challenging the skill of the person training, motivating and rewarding, intensive training for as long a period of time that is feasible, and carefully organizing the training in the setting of other activities (Nielsen et al, 2015). Importantly, the patients and caregivers need to understand that consistent training several times a week will be part of the rest of their lives if they want to maintain any potential benefits.…”

“…Therefore, trained caregivers could play a central role by continuing regular and challenging training with the persons with AD in the absence of a therapist. Periodic reinforcement with a therapist will be a component of the rehabilitation training regimen to adapt the level of difficulty of training with the goals of improving the performance of a given task and achieving new skills to promote brain plasticity (Burke & Barnes, 2006; Nielsen et al, 2015). Thus, we propose that the caregivers would also play a significant role in the training of persons with AD and the promotion of short- and long-term brain plasticity by increasing adherence to the exercise program.…”

Interacting Learning Processes during Skill Acquisition: Learning to control with gradually changing system dynamics

“…Consistent with many studies on skill acquisition from a wide range of disciplines, we found that gradually increasing the difficulty of a task is beneficial for acquiring a motor skill. Choosing an adequate initial task complexity and increasing the complexity in relation to the improvement during learning, is seen as important prerequisite for efficient motor learning and is, thus, commonly used as training principle in sports as well as in rehabilitation 16,45 . The theoretical relationship between task difficulty, skill level and learning was systematically described in the "challenge point" framework 46 .…”

Feasibility and Implementation of a Video-Based Yoga Program in a Special Education Setting Using a Collaborative Model

“…In the motor learning theory, this is essential to promote control of postural mechanisms involved in the yoga postures and movements. 13 The occupational therapist provided sensory cues and props that matched the yoga video in order to increase student engagement. The speech therapist promoted interaction among the students in the class by increasing awareness and turn taking as appropriate.…”