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Oxford Textbook of Neurorehabilitation最新文献

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Neuropalliative rehabilitationManaging neurological disability in the context of a deteriorating illness 神经姑息康复在疾病恶化的情况下管理神经功能障碍
Oxford Textbook of Neurorehabilitation Pub Date : 2020-05-01 DOI: 10.1093/med/9780198824954.003.0029
G. Eva, Joseph Bayly, E. Playford
{"title":"Neuropalliative rehabilitationManaging neurological disability in the context of a deteriorating illness","authors":"G. Eva, Joseph Bayly, E. Playford","doi":"10.1093/med/9780198824954.003.0029","DOIUrl":"https://doi.org/10.1093/med/9780198824954.003.0029","url":null,"abstract":"Although the concepts of ‘rehabilitation’ and ‘palliative care’ may seem paradoxical, the two approaches have a great deal in common. Rehabilitation for people with deteriorating, life-limiting neurological conditions can be organized into four distinct but overlapping categories: preventative, restorative, supportive, and palliative. Patients with neurological conditions can report palliative care needs from diagnosis; neuropalliative rehabilitation needs to be available within the context of whatever services are most appropriate for the patient’s circumstances at the time, requiring excellent coordination of care between neurology, palliative care, and rehabilitation services. Neuropalliative rehabilitation follows the same process that would be used in other conditions, but is underpinned by specific palliative care skills which include the ability to work flexibly with rapidly changing conditions, as well as understanding and being able to manage the tension between the patient’s active engagement in life and acknowledging loss and death.","PeriodicalId":362190,"journal":{"name":"Oxford Textbook of Neurorehabilitation","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125605781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The applicability of motor learning to neurorehabilitation 运动学习在神经康复中的应用
Oxford Textbook of Neurorehabilitation Pub Date : 2020-05-01 DOI: 10.1093/med/9780199673711.003.0007
J. Krakauer
{"title":"The applicability of motor learning to neurorehabilitation","authors":"J. Krakauer","doi":"10.1093/med/9780199673711.003.0007","DOIUrl":"https://doi.org/10.1093/med/9780199673711.003.0007","url":null,"abstract":"Rehabilitation is a form of directed training and is therefore predicated on the idea that patients respond to such training by learning. However, true recovery (restitution) with behavioural training is not synonymous with learning. Animal models suggest that there is a unique milieu of heightened plasticity post-stroke that is responsible for reduction in impairment both through spontaneous biological recovery and increased responsiveness to training. In the chronic phase of stroke, plasticity returns to normal levels with the goal mainly being task-specific compensation via normal motor learning mechanisms. In humans, there is a time-limited period of spontaneous recovery but it has yet to be shown whether patients after stroke have increased responsiveness to training over this same interval. Thus, new forms of behavioural intervention for patients may have distinct effects depending on whether they are initiated in the sensitive period after stroke (training interacting with repair) or in the chronic phase (compensation via motor learning). It is to be hoped that new pharmacological and non-invasive brain stimulation approaches will allow the post-stroke sensitive period to be augmented, extended, and re-opened. There may also be a subset of patients with chronic stroke that respond to much higher doses and intensities of motor training.","PeriodicalId":362190,"journal":{"name":"Oxford Textbook of Neurorehabilitation","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115292725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 28
Rehabilitation of gait and balance after CNS damage 中枢神经系统损伤后步态和平衡的康复
Oxford Textbook of Neurorehabilitation Pub Date : 2020-05-01 DOI: 10.1093/med/9780199673711.003.0018
J. Duysens, G. Verheyden, F. Massaad, P. Meyns, B. Smits-Engelsman, I. Jonkers
{"title":"Rehabilitation of gait and balance after CNS damage","authors":"J. Duysens, G. Verheyden, F. Massaad, P. Meyns, B. Smits-Engelsman, I. Jonkers","doi":"10.1093/med/9780199673711.003.0018","DOIUrl":"https://doi.org/10.1093/med/9780199673711.003.0018","url":null,"abstract":"This chapter discusses the importance of basic and clinical science for the rehabilitation of patients with stroke or SCI (spinal cord injury). Examples are given from novel approaches in rehabilitation. Insights can be obtained by investigating normal locomotor or postural activity but it is argued that the use of more challenging locomotor tasks can provide much needed additional information. To update rehabilitation tools it is also essential to keep track of new technological developments and new assessment tools. Careful assessments, based on advanced 3D recordings of posture and gait, can assist in making proper decisions about planned interventions, aimed at alleviating some clinical symptoms such as spasticity. With respect to training, the focus here is on general principles of sensorimotor rehabilitation of gait and posture. Learning is context dependent. The consequence is that current rehabilitation approaches need to emphasize that training should be ‘task-oriented training’, and should involve the whole body.","PeriodicalId":362190,"journal":{"name":"Oxford Textbook of Neurorehabilitation","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122083693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Functional recovery in CNS disease 中枢神经系统疾病的功能恢复
Oxford Textbook of Neurorehabilitation Pub Date : 2020-05-01 DOI: 10.1093/med/9780198824954.003.0011
S. Franz, A. Hug, N. Weidner
{"title":"Functional recovery in CNS disease","authors":"S. Franz, A. Hug, N. Weidner","doi":"10.1093/med/9780198824954.003.0011","DOIUrl":"https://doi.org/10.1093/med/9780198824954.003.0011","url":null,"abstract":"Animal models of central nervous system (CNS) diseases such as ischaemic stroke and spinal cord injury (SCI) are well suited for the analysis of tissue damage and functional impairment. Caveats with respect to preclinically observed spontaneous or elicited functional recovery, and the extrapolation into the clinical setting, are related to the animal species, respective disease models, the administration of the therapy under investigation, and the applied outcome measures in comparison to the clinical situation. SCI and ischaemic stroke share characteristics but differ in terms of therapeutic approaches. In ischaemic stroke innovative therapy concepts aim to protect CNS tissue at risk of degeneration, whereas in SCI efforts are made to regenerate damaged spinal cord tissue and to reinstall neuronal connectivity. This chapter examines components of animal models, the integration of clinical standard therapy concepts, the precise translation of experimental therapy administration, and the transferability of chosen structural and functional readouts in preclinical disease models of stroke and SCI.","PeriodicalId":362190,"journal":{"name":"Oxford Textbook of Neurorehabilitation","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128359742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vocational rehabilitation 职业康复
Oxford Textbook of Neurorehabilitation Pub Date : 2020-05-01 DOI: 10.1093/med/9780198824954.003.0027
A. Tyerman
{"title":"Vocational rehabilitation","authors":"A. Tyerman","doi":"10.1093/med/9780198824954.003.0027","DOIUrl":"https://doi.org/10.1093/med/9780198824954.003.0027","url":null,"abstract":"Work is a fundamental human right and a key element in quality of life, yet only a minority of people with a neurological condition return to, remain in, or attain work. A range of factors are associated with work for people with specific neurological conditions. Vocational rehabilitation (VR) to address key vocational needs are outlined (i.e. vocational assessment, return to work, preparation for alternative work, transition from education to employment, and long-term job retention), illustrated by examples.\u0000 Specialist VR programmes typically report positive outcomes. However, there is a need for more controlled studies to evaluate the effectiveness of VR in addition to core neurorehabilitation and the added value of specialist as opposed to generic VR provision.\u0000 There is also a pressing need for neurorehabilitation and VR services to prioritize unmet vocational needs, generate practice-based evidence, and provide evidence of cost-effectiveness.","PeriodicalId":362190,"journal":{"name":"Oxford Textbook of Neurorehabilitation","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122188857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Animal models of damage, repair, and plasticity in the brain 大脑损伤、修复和可塑性的动物模型
Oxford Textbook of Neurorehabilitation Pub Date : 2020-05-01 DOI: 10.1093/med/9780198824954.003.0012
A. Luft
{"title":"Animal models of damage, repair, and plasticity in the brain","authors":"A. Luft","doi":"10.1093/med/9780198824954.003.0012","DOIUrl":"https://doi.org/10.1093/med/9780198824954.003.0012","url":null,"abstract":"Recovery after a stroke is a multidimensional process depending on the individual deficit. Within each functional domain, spontaneous recovery occurs to a variable degree and can be improved by specific neurorehabilitative interventions. Basic knowledge about to the mechanisms of spontaneous and training-induced recovery is growing but translation to effective therapies has only been demonstrated in a few cases. Mechanistic knowledge is necessary to find new treatments that can fully exploit the brain’s capacity for recovery. Animal models can be an experimental platform to investigate these mechanisms. But it has to be realized that they oversimplify the human condition. The complexity of the interaction of motor, cognitive, social, emotional, and other factors contributing to recovery in humans cannot be modelled in animals. The opportunities and caveats of animal models are discussed.","PeriodicalId":362190,"journal":{"name":"Oxford Textbook of Neurorehabilitation","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121832542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting activities after stroke 预测中风后的活动
Oxford Textbook of Neurorehabilitation Pub Date : 2020-05-01 DOI: 10.1093/med/9780198824954.003.0004
G. Kwakkel, B. Kollen
{"title":"Predicting activities after stroke","authors":"G. Kwakkel, B. Kollen","doi":"10.1093/med/9780198824954.003.0004","DOIUrl":"https://doi.org/10.1093/med/9780198824954.003.0004","url":null,"abstract":"Knowledge about the functional prognosis of stroke patients admitted to a stroke unit has increased substantially over the past years. Prospective cohort studies suggest that the return of some finger extension and voluntary activity in the shoulder abductors within days post-stroke onset predicts a favourable recovery of the upper extremity function at 6 months. The Barthel index and the ability to sit unsupported are the main predictors for recovery of gait and activities of daily living (ADL) independency. Almost all developed prediction models identify patients with a favourable prognosis but are less suitable to predict accurately individuals who will not regain dexterity, mobility, and ADL independence following stroke. In individuals with an unfavourable prognosis, this entails measuring clinical determinants frequently and longitudinally during the post-stroke course. Moreover, future research should focus on cross-validating prediction models, which should also incorporate presently excluded stroke subtypes, such as brain stem strokes, intraparenchymal, and subarachnoid haemorrhages.","PeriodicalId":362190,"journal":{"name":"Oxford Textbook of Neurorehabilitation","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124019296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
The influence of age on neurorehabilitation 年龄对神经康复的影响
Oxford Textbook of Neurorehabilitation Pub Date : 2016-05-26 DOI: 10.1093/med/9780199673711.003.0006_update_001
M. Wirz, Louise Rutz-LaPitz
{"title":"The influence of age on neurorehabilitation","authors":"M. Wirz, Louise Rutz-LaPitz","doi":"10.1093/med/9780199673711.003.0006_update_001","DOIUrl":"https://doi.org/10.1093/med/9780199673711.003.0006_update_001","url":null,"abstract":"This chapter addresses issues related to neurorehabilitation of elderly patients. As society is growing older, the age of patients referred to rehabilitation is also increasing. This is evident in patients with spinal cord injury, which was classically a condition affecting young individuals. The stroke population is typically older. However, the age at the occurrence of stroke is also increasing. There is no clear criterion when a patient is considered old. Defining age exclusively by means of years of one’s life is insufficient. Nowadays, seniors can be healthy, active, and fit. In principle, there is no specific rehabilitation strategy for the aged. However, there are a number of age-related conditions that have to be accounted for during rehabilitation. It is the challenge of the rehabilitation team to uncover and reinforce resources while considering age-related impairments and limitations to return the person to their home, possibly for further rehabilitation, as soon as possible.","PeriodicalId":362190,"journal":{"name":"Oxford Textbook of Neurorehabilitation","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133073837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Spinal neuronal dysfunction after deprivation of supraspinal input 剥夺脊髓上输入后的脊髓神经元功能障碍
Oxford Textbook of Neurorehabilitation Pub Date : 2015-04-26 DOI: 10.1093/med/9780199673711.003.0008
M. Hubli, V. Dietz
{"title":"Spinal neuronal dysfunction after deprivation of supraspinal input","authors":"M. Hubli, V. Dietz","doi":"10.1093/med/9780199673711.003.0008","DOIUrl":"https://doi.org/10.1093/med/9780199673711.003.0008","url":null,"abstract":"A central nervous system lesion can lead to remote structural and functional changes which may limit functional recovery. For example, after a spinal cord injury (SCI) structural and functional alterations of spinal neuronal networks take place: in the first weeks after an SCI, neither locomotor nor spinal reflex (SR) activity can be evoked. Once spinal shock has resolved, an early SR component can be re-evoked and locomotor electromyography (EMG) activity re-appears when appropriate proprioceptive input is provided. In a more chronic stage of SCI alterations in SR components are accompanied by a decline of EMG amplitude in the leg muscles during assisted locomotion. According to rodent experiments it is assumed that the deprivation of supraspinal input and the lack of meaningful proprioceptive input to spinal neuronal networks account for such alterations. A critical combination of sensory cues through physiological training strategies might prevent the development of an undirected neural plasticity.","PeriodicalId":362190,"journal":{"name":"Oxford Textbook of Neurorehabilitation","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131943142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The International Classification of Functioning, Disability, and Health 国际功能、残疾和健康分类
Oxford Textbook of Neurorehabilitation Pub Date : 2015-02-26 DOI: 10.1093/med/9780199673711.003.0001
E. Playford
{"title":"The International Classification of Functioning, Disability, and Health","authors":"E. Playford","doi":"10.1093/med/9780199673711.003.0001","DOIUrl":"https://doi.org/10.1093/med/9780199673711.003.0001","url":null,"abstract":"The International Classification of Functioning, Disability and Health (ICF) provides a framework for the description of health and health-related states and offers a biopsychosocial model of disability. The ICF was introduced by the World Health Organization in 1999 as a response to the conceptual and practical difficulties posed by its predecessor, the International Classification of Functioning, Disability and Health. The ICF lists body functions and structure, and activity and participation. The relationship between impairment, activity, and participation is not linear, and can be further moderated by contextual influences, including personal and environmental factors. There are a wide range of potential applications of the ICF. It has been adopted most widely within rehabilitation services to describe individual functioning, but can also be used at a service and national policy level to describe, monitor, and evaluate different activities. This chapter outlines the use of the ICF, considers its strengths, and highlights its function in a range of settings.","PeriodicalId":362190,"journal":{"name":"Oxford Textbook of Neurorehabilitation","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128337318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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