A Scientific Basis for Neurologic Rehabilitation

THE WESTERN JOURNAL OF MEDICINE, 1993 · DOI: · Published: July 1, 1993

Neurology Neuroplasticity Rehabilitation

Simple Explanation

Medical rehabilitation aims to help patients maximize self-reliance and psychological acceptance of irreversible impairments. Functional recovery after nervous system injury was thought to be due to resolution of edema or behavioral adaptations. Recent research focuses on enhancing activity in spared neuronal pathways and promoting regeneration of injured pathways.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Traditional rehabilitation methods haven't shown clear superiority, but techniques based on animal studies show promise.
2
Axons in the brain and spinal cord can regenerate if given the right environment.
3
Molecules on oligodendrocytes inhibit axon regeneration, leading to experiments using antibodies to enhance regeneration.

Research Summary

Medical rehabilitation historically focused on symptom relief, but should now incorporate research on the nervous system's response to injury. Current research explores enhancing spared neuronal pathways and promoting regeneration of injured pathways for greater therapeutic benefit. Developments like fetal tissue transplants and neutralizing inhibitory molecules show promise for restoring neurologic function.

Practical Implications

Enhanced Rehabilitation Techniques

Rehabilitation programs should integrate techniques based on physiologic and pharmacologic studies to improve functional outcomes for patients with stroke and spinal cord injuries.

Regeneration-Focused Therapies

Future research should focus on neutralizing factors that inhibit axon regeneration to promote the reconstitution of normal neurologic function.

Investment in Research

Expanding the research mission of rehabilitation medicine to include morphologic and physiologic plasticity can rejuvenate the field and attract innovative research.

Study Limitations

1
Axonal regeneration has not yet resulted in the recovery of lost functions.
2
The quantity of regenerating axons is currently a small fraction of those injured.
3
There is no evidence that transplanted fetal cells make synaptic connections with host neurons.

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