Takeuchi Naoyuki, Izumi Shin-Ichi
Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, Japan.
Stroke Res Treat. 2013;2013:128641. doi: 10.1155/2013/128641. Epub 2013 Apr 30.
Motor recovery after stroke is related to neural plasticity, which involves developing new neuronal interconnections, acquiring new functions, and compensating for impairment. However, neural plasticity is impaired in the stroke-affected hemisphere. Therefore, it is important that motor recovery therapies facilitate neural plasticity to compensate for functional loss. Stroke rehabilitation programs should include meaningful, repetitive, intensive, and task-specific movement training in an enriched environment to promote neural plasticity and motor recovery. Various novel stroke rehabilitation techniques for motor recovery have been developed based on basic science and clinical studies of neural plasticity. However, the effectiveness of rehabilitative interventions among patients with stroke varies widely because the mechanisms underlying motor recovery are heterogeneous. Neurophysiological and neuroimaging studies have been developed to evaluate the heterogeneity of mechanisms underlying motor recovery for effective rehabilitation interventions after stroke. Here, we review novel stroke rehabilitation techniques associated with neural plasticity and discuss individualized strategies to identify appropriate therapeutic goals, prevent maladaptive plasticity, and maximize functional gain in patients with stroke.
中风后的运动恢复与神经可塑性有关，神经可塑性涉及建立新的神经元连接、获得新功能以及补偿损伤。然而，中风影响的半球神经可塑性受损。因此，运动恢复疗法促进神经可塑性以补偿功能丧失很重要。中风康复计划应包括在丰富环境中进行有意义、重复、强化且特定任务的运动训练，以促进神经可塑性和运动恢复。基于神经可塑性的基础科学和临床研究，已开发出各种用于运动恢复的新型中风康复技术。然而，中风患者康复干预的有效性差异很大，因为运动恢复的潜在机制是异质性的。已开展神经生理学和神经影像学研究，以评估中风后有效康复干预中运动恢复潜在机制的异质性。在此，我们综述与神经可塑性相关的新型中风康复技术，并讨论个性化策略，以确定合适的治疗目标、预防适应不良的可塑性并使中风患者的功能增益最大化。
