Neuroplasticity and functional recovery in rehabilitation after stroke
Thais
Raquel Martins Filippo
1
,
Fabio Marcon Alfieri
1
,
Flavio Rodrigo Cichon
1
,
Marta Imamura
1
,
Linamara
Rizzo Battistella
ABSTRACT
The concept of rehabilitation in stroke is currently based on evidence of neuroplasticity, considered
to be responsible for recovery after a stroke. The scarcity of information in the literature, especially
concerning methods that specifically evaluate neuroplasticity, does not match its functional
importance. In general, the literature discusses the functional evaluations of limbs after a
stroke and a few studies focus on cerebral impairment.
Objective:
To review the literature and evaluate current rehabilitation programs for stroke and their potential to promote functional improvement and neuronal plasticity.
Method:
A literature review was conducted searching the PubMed database with articles published from 2000 to 2015. The descriptors used were: “Stroke/rehabilitation” OR “Stroke/therapy” AND “Neuronal Plasticity”.
Results:
From the 86 studies found, 36 were classified as Therapy/Narrow, with 17 articles being excluded either for not meeting the inclusion criteria or for not presenting a theme relevant to the study. After the selection by title and abstract, 19 articles were read entirely. Of those, six were excluded for not addressing the objective of the present study. In all, 13 articles were reviewed. The evaluation instruments in those 13 articles varied between functional magnetic resonance, transcranial magnetic stimulation, and single photon emission computed tomography (SPECT). The interventions used were specific for the upper limbs, except for one article about an intervention through hyperbaric oxygen therapy.
Conclusion:
Few studies evaluated the neuronal plasticity in rehabilitation after a stroke, and most articles presented improvements in function as well as in neuroplasticity. However, larger studies should investigate and correlate both aspects in the rehabilitation of stroke patients.
I agree with your assessment that there is nothing new, but I actually like these “systematic review” (see http://www.researchcore.org/faq/answers.php?recID=5) studies that research the existing literature, and try to assess where things are on an aspect of stroke.
ReplyDeleteHopefully, the reviewers are smart critical thinkers who understand what they are reading, since it is often over my head.
I mostly look for studies related to chronic stroke, upper limb deficits, and how to stimulate neuroplasticity, since this is what I think I need 3.5 years post stroke.
This paper has a good description of spasticity,
And the following sentence may provide some direction:
“Pilot studies using TMS, tDCS, or rTMS, have shown beneficial effects on motor abilities and motor learning. In addition, the combination of tDCS and peripheral stimulation (e.g., the stimulation of the peripheral nerve or peripheral sensory activities) seemed to increase the effects of each intervention by themselves.”