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[神经康复的技术进展]

[Technological advances in neurorehabilitation].

作者信息

Gutiérrez-Martínez Josefina, Núñez-Gaona Marco Antonio, Carrillo-Mora Paul

机构信息

Subdirección de Investigación Tecnológica. Instituto Nacional de Rehabilitación.

出版信息

Rev Invest Clin. 2014 Jul;66 Suppl 1:S8-23.

Abstract

Neurological rehabilitation arose as formal method in the 60's, for the therapeutic treatment of patients with stroke or spinal cord injury, which develop severe sequelae that affect their motor and sensory abilities. Although the Central Nervous System has plasticity mechanisms for spontaneous recovery, a high percentage of patients should receive specialized therapies to regain motor function, such as Constraint Induced Movement Therapy or Upright physical Therapy. The neurorehabilitation has undergone drastic changes over the last two decades due to the incorporation of computer and robotic electronic devices, designed to produce positive changes in cortical excitability of the cerebral hemisphere damaged and so to improve neuroplasticity. Among equipment, we can mention those for electrotherapy devices, apparatus for transcranial magnetic stimulation, the robotic lower limb orthoses, robot for upper limb training, systems for functional electrical stimulation, neuroprosthesis and brain computer interfaces. These devices have caused controversy because of its application and benefits reported in the literature. The aim of Neurorehabilitation technologies is to take advantage of the functional neuromuscular structures preserved, and they compensate or re-learn the functions that previously made the damaged areas. The purpose of this article is to mention some clinical applications and benefits that these technologies offer to patients with neuronal injury.

摘要

神经康复作为一种正式的治疗方法兴起于20世纪60年代,用于治疗中风或脊髓损伤患者,这些患者会出现严重后遗症,影响其运动和感觉能力。尽管中枢神经系统具有自发恢复的可塑性机制,但仍有很大比例的患者需要接受专门治疗以恢复运动功能,如强制性运动疗法或直立位物理疗法。在过去二十年中,由于计算机和机器人电子设备的引入,神经康复发生了巨大变化,这些设备旨在对受损脑半球的皮质兴奋性产生积极影响,从而改善神经可塑性。在设备方面,我们可以提及电疗设备、经颅磁刺激仪器、机器人下肢矫形器、上肢训练机器人、功能性电刺激系统、神经假体和脑机接口。由于其在文献中报道的应用和益处,这些设备引发了争议。神经康复技术的目的是利用保留的功能性神经肌肉结构,并补偿或重新学习先前由受损区域执行的功能。本文的目的是提及这些技术为神经元损伤患者提供的一些临床应用和益处。

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