Sastre-Garriga J, Galán-Cartañá I, Montalbán X, Thompson A
Institute of Neurology, University College London, London, UK.
Neurologia. 2005 Jun;20(5):245-54.
Neurorehabilitation is predominantly an educational, dynamic process based on the adaptation of the individual and his environment to the actual neurological impairment and focuses on decreasing the impact of disabling neurological conditions on the individual in order to achieve optimum quality of life. It has been suggested by some that neurorehabilitation is the only approach available to us which can improve the limitations in activity and restrictions in social participation of people with multiple sclerosis. The neurorehabilitation approach is a holistic one and is a fundamental part of neurological care; it should not be forgotten by neurologists, especially when dealing with people with chronic disabling conditions such as multiple sclerosis. Together with the social model of disability, the concept of restorative neurology, as a scientific and therapeutic attempt to minimize those impairments directly responsible for the disability presented by the person, is recently gaining ground among neuroscientists and clinicians. In this review the conceptual basis for neurorehabilitation will be presented together with a review of the literature concerning the biological aspects of neurorehabilitative therapy (neuroplasticity) and the clinical trials evaluating the effectiveness of neurorehabilitation in people with multiple sclerosis. Finally, we will consider the practical aspects of neurorehabilitation.
神经康复主要是一个基于个体及其环境适应实际神经损伤的教育性、动态过程,其重点在于减少致残性神经疾病对个体的影响,以实现最佳生活质量。一些人认为,神经康复是我们可用的唯一方法,能够改善多发性硬化症患者的活动受限和社会参与受限状况。神经康复方法是一种整体方法,是神经护理的基本组成部分;神经科医生不应忘记这一点,尤其是在治疗像多发性硬化症这样的慢性致残疾病患者时。与残疾的社会模式一起,恢复性神经学的概念,作为一种科学和治疗尝试,旨在尽量减少直接导致患者残疾的那些损伤,最近在神经科学家和临床医生中越来越受到认可。在这篇综述中,将介绍神经康复的概念基础,并回顾有关神经康复治疗生物学方面(神经可塑性)的文献以及评估神经康复对多发性硬化症患者有效性的临床试验。最后,我们将考虑神经康复的实际方面。