A Novel Neurorehabilitation Approach for Neural Plasticity Overstimulation and Reorganization in Patients with Neurological Disorders

 

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Abstract

Neurological disorders are those that are associated with impairments in the nervous system. These impairments affect the patient’s activities of daily living. Recently, many advanced modalities have been used in the rehabilitation field to treat various neurological impairments. However, many of these modalities are available only in clinics, and some are expensive. Most patients with neurological disorders have difficulty reaching clinics. This review was designed to establish a new neurorehabilitation approach based on the scientific way to improve patients’ functional recovery following neurological disorders in clinics or at home. The human brain is a network, an intricate, integrated system that coordinates operations among billions of units. In fact, grey matter contains most of the neuronal cell bodies. It includes the brain and the spinal cord areas involved in muscle control, sensory perception, memory, emotions, decision-making, and self-control. Consequently, patients’ functional ability results from complex interactions among various brain and spinal cord areas and neuromuscular systems. While white matter fibers connect numerous brain areas, stimulating or improving non-motor symptoms, such as motivation, cognitive, and sensory symptoms besides motor symptoms may enhance functional recovery in patients with neurological disorders. The basic principles of the current treatment approach are established based on brain connectivity. Using motor, sensory, motivation, and cognitive (MSMC) interventions during rehabilitation may promote neural plasticity and maximize functional recovery in patients with neurological disorders. Experimental studies are strongly needed to verify our theories and hypothesis.

Zusammenfassung

Die Beeinträchtigungen des Nervensystems bei neurologischen Störungen führen bei den Betroffenen zu Einschränkungen bei den Aktivitäten des täglichen Lebens. In jüngster Zeit werden im Bereich der Rehabilitation zahlreiche hochmoderne Verfahren zur Therapie unterschiedlichster neurologischer Beeinträchtigungen eingesetzt. Allerdings werden diese teilweise kostspieligen Verfahren häufig nur in Kliniken angeboten. Für die meisten Patienten mit neurologischen Störungen ist es schwierig, eine solche Klinik zu erreichen. Ziel der vorliegenden Übersichtsarbeit war es, einen neuen wissenschaftlichen Ansatz in der Neurorehabilitation zu entwickeln, der die funktionelle Erholung von Patienten nach neurologischen Störungen verbessert und sowohl in der Klinik als auch im häuslichen Umfeld angewandt werden kann. Das menschliche Gehirn ist ein Netzwerk, ein komplexes, integriertes System, das das Zusammenspiel von Milliarden von Einheiten koordiniert. In der grauen Substanz befinden sich die meisten Nervenzellkörper. Sie enthält die Bereiche des Gehirns und des Rückenmarks, die an der Muskelkontrolle, der Sinneswahrnehmung, dem Gedächtnis, den Emotionen, der Entscheidungsfindung und der Selbstkontrolle beteiligt sind. Die funktionellen Fähigkeiten eines Patienten ergeben sich aus den komplexen Interaktionen zwischen verschiedenen Hirn- und Rückenmarksbereichen und neuromuskulären Systemen. Zwar erfolgt die Verbindung vieler Hirnareale über die Fasern der weißen Substanz, doch könnte die funktionelle Erholung bei Patienten mit neurologischen Störungen auch durch Stimulation nicht motorischer Fähigkeiten bzw. die Verbesserung nicht motorischer Symptome, wie etwa motivationale, kognitive und sensorische Symptome neben motorischen Symptomen, begünstigt werden. Der aktuelle Behandlungsansatz basiert auf dem Grundprinzip der Vernetzung des Gehirns. Der Einsatz motorischer, sensorischer, motivationaler und kognitiver (MSMC) Interventionen im Rahmen der Rehabilitation kann die Neuroplastizität fördern und die funktionelle Erholung bei Patienten mit neurologischen Störungen maximieren. Zur Bestätigung unserer Theorien und Hypothesen sind experimentelle Studien dringend erforderlich.

Publication History

Received: 04 December 2021

Accepted: 24 December 2022

Article published online:
16 February 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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