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Myung Jun Shin, M.D.
, Sang Hun Kim, M.D., Chang-Hyung Lee, M.D., Ph.D.1, Yong-Il Shin, M.D., Ph.D.1
, Sang Hun Kim, M.D., Chang-Hyung Lee, M.D., Ph.D.1, Yong-Il Shin, M.D., Ph.D.1
Abstract
The purpose of this review is to provide a comprehensive approach for optimal strategies of upper limb motor rehabilitation after stroke. Stroke is a common, serious, and disabling global health-care problem. Optimal organization of rehabilitation for stroke patients has been extensively documented. However, between 30% and 66% of individuals with stroke do not obtain satisfactory motor recovery of the affected upper limb with rehabilitative interventions. The recovery of the affected upper extremity depends on intensity, task progression, and repetition to neural plasticity, namely, the ability of central nervous system cells to modify their structure and function in response to external stimuli. Recently, constraint-induced movement therapy, motor imagery, action observation, or mirror therapy has emerged as interesting options as add-on interventions to standard physical therapies. In this review, we will discuss to establish a framework by which several promising interventions for neural plasticity.
Figures and Tables
Fig. 1
Strategies of neuromodulation for stroke recovery. ↑= Facilitation or activation. ↓= Inhibition or inactivation.
Table 1
Summary of the evidence for specific rehabilitation treatments by Langhorne P, Bernhardt J, and Kwakkel G., 2011, Lancet.
Guideline recommendation categories: recommended=recommended use for a substantial proportion of stroke patients; selected use=might be considered in selected patients or circumstances; not mentioned=no specific recommendation made; not recommended=not recommended for routine use (outside the context of a clinical trial).
Guideline grade of recommendation categories: (A)=based on robust information from randomised trials that is applicable to the target population; (B)=based on less robust information (from experimental studies); (C)=consensus or expert opinion.
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