Evidence-based physiotherapeutic concepts for improving arm and hand function in stroke patients: A review

In recent years, our understanding of motor learning, neuroplasticity and functional recovery after the occurrence of brain lesion has grown significantly. New findings in basic neuroscience provided stimuli for research in motor rehabilitation. Repeated motor practice and motor activity in a real w...

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Bibliographic Details
Published in:Journal of neurology 2002-05, Vol.249 (5), p.518-528
Main Authors: WOLDAG, Hartwig, HUMMELSHEIM, Horst
Format: Article
Language:English
Subjects:
Activities of daily living
Arm - innervation
Arm - physiopathology
Biological and medical sciences
Electric Stimulation Therapy - methods
Electromyography
Exercise
Exercise Therapy - methods
Feedback - physiology
Fingers & toes
Hand - innervation
Hand - physiopathology
Humans
Imagery (Psychotherapy)
Medical sciences
Movement - physiology
Muscle Contraction - physiology
Neurology
Neuromuscular electrical stimulation
Occupational therapy
Paresis
Physical therapy
Rehabilitation
Stroke
Stroke - physiopathology
Stroke Rehabilitation
Transcranial magnetic stimulation
Vascular diseases and vascular malformations of the nervous system
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Summary:In recent years, our understanding of motor learning, neuroplasticity and functional recovery after the occurrence of brain lesion has grown significantly. New findings in basic neuroscience provided stimuli for research in motor rehabilitation. Repeated motor practice and motor activity in a real world environment have been identified in several prospective studies as favorable for motor recovery in stroke patients. EMG initiated electrical muscle stimulation -- but not electrical muscle stimulation alone -- improves motor function of the centrally paretic arm and hand. Although a considerable number of physiotherapeutic "schools" has been established, a conclusive proof of their benefit and a physiological model of their effect on neuronal structures and processes are still missing. Nevertheless, evidence-based strategies for motor rehabilitation are more and more available, particularly for patients suffering from central paresis.
ISSN:0340-5354
1432-1459
DOI:10.1007/s004150200058