http://nnr.sagepub.com/content/28/1/3.full?etoc
Over the past 8 years that I have served as the editor of Neurorehabilitation and Neural Repair,
many well-designed, conceptually driven, randomized clinical trials
have been published in this journal, as well as in others.
This positive turn reveals a growing interest in the
scientific bases of neurorehabilitation that was barely apparent as
recently
as 15 years ago.
Consider this. In 1999, Gert Kwakkel and colleagues published a randomized clinical trial in the New England Journal of Medicine,
a journal not prone to publishing rehab studies at the time. They
reported that therapy focused on the upper extremity improved
dexterity but not walking and that therapy focused on
the leg improved walking outcomes, but not arm functioning; both
strategies
were better than no therapy in patients who started
treatment within 14 days of stroke. That focused, intensive enough
therapy
can improve outcomes at almost any time after stroke
has been shown many times since then. Indeed, it is now unlikely that
an experimental intervention would be tested against a
control group that did not receive an equally intensive training
paradigm.
Energy abounds around the world in neurologic rehabilitation, evidenced by a citation factor of 4.8 for Neuro-rehabilitation and Neural Repair
over the past 5 years. What has changed since 1999?? It is the rising
tide of scientific insights and promising strategies.
Treatments being tested include action-observation and
imagery, virtual reality applications, transcranial magnetic
stimulation
and direct current neurostimulation to modulate
learning, electromechanical assists for arm and leg practice,
brain-computer
interfaces to control the environment, and
exoskeletons to assist movement. Mobile health and tele-rehabilitation
strategies
to monitor practice, give feedback, and for more
clinically meaningful outcome measurements may compliment these. A new
era
of pharmacologic interventions to enhance learning,
neural repair by cellular and axon/dendrite growth promoters and
neuromodulators,
genetic insights, imbedded electrodes to activate
brain or spinal networks, and adaptive robotic training are among those
that will come into testing over the next 5 to 10
years.
It is my pleasure to congratulate Randolf Nudo, PhD, Professor of Molecular and Integrative Physiology at the University of
Kansas, as the new editor of Neurorehabiliation and Neural Repair.
He has been a major contributor to modeling physiologic and structural
neural adaptations in relation to rehabilitation
interventions. He and his editorial staff will have
the opportunity to influence the clinical and basic science innovations,
through their interaction with researchers, that will
make the next 10 years exciting for clinicians and hopeful for our
patients.
Left to right: Gert Kwakkel, Tom Carmichael, Mickey Selzer (editor, 2000-2005), Bruce Dobkin (editor, 2006-13), Randy Nudo
(incoming editor).
Thanks to Gert Kwakkel, my European managing
editor, Tom Carmichael, my managing editor for the neurobiology of
repair, the
associate editors and editorial board, the
indefatigable authors and peer reviewers, the American Society of
NeuroRehabiliation,
the World Federation of NeuroRehabilitation, and the
staff at SAGE Publications for all their help. All of us will be there
to help Randy Nudo nurture the journal into the future
of neurologic rehabilitation.
Bruce H. Dobkin, MD
Outgoing Editor-in-Chief
Outgoing Editor-in-Chief
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