Winstein Carolee J, Kay Dorsa Beroukhim
Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, Los Angeles, CA, USA; Department of Neurology, Keck School of Medicine, Los Angeles, CA, USA; Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA.
Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, Los Angeles, CA, USA; Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA.
Prog Brain Res. 2015;218:331-60. doi: 10.1016/bs.pbr.2015.01.004. Epub 2015 Mar 19.
The revolution in neuroscience provided strong evidence for learning-dependent neuroplasticity and presaged the role of motor learning as essential for restorative therapies after stroke and other disabling neurological conditions. The scientific basis of motor learning has continued to evolve from a dominance of cognitive or information processing perspectives to a blend with neural science and contemporary social-cognitive-psychological science, which includes the neural and psychological underpinnings of motivation. This transformation and integration across traditionally separate domains is timely now that clinician scientists are developing novel, evidence-based therapies to maximize motor recovery in the place of suboptimal solutions. We will review recent evidence pertaining to therapeutic approaches that spring from an integrated framework of learning-dependent neuroplasticity along with the growing awareness of protocols that directly address the patient's fundamental psychological needs. Of importance, there is mounting evidence that when the individual's needs are considered in the context of instructions or expectations, the learning/rehabilitation process is accelerated.
神经科学领域的革命为依赖学习的神经可塑性提供了有力证据，并预示了运动学习在中风及其他致残性神经系统疾病后的恢复性治疗中的重要作用。运动学习的科学基础已从认知或信息处理视角占主导地位，持续发展为与神经科学以及当代社会认知心理科学相融合，其中包括动机的神经和心理基础。鉴于临床科学家正在开发新的循证疗法，以取代效果欠佳的解决方案，从而最大限度地促进运动恢复，这种跨越传统上相互独立领域的转变与整合正逢其时。我们将回顾近期的证据，这些证据涉及源于依赖学习的神经可塑性综合框架的治疗方法，以及对直接满足患者基本心理需求的方案的日益认识。重要的是，越来越多的证据表明，当在指导或期望的背景下考虑个体需求时，学习/康复过程会加速。
