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

 So ask your competent? doctor if in the succeeding 22 years we have gotten past 'concepts' to actually delivering EXACT REHAB PROTOCOLS! I can guarantee the answer is NO, incompetence for decades at a time and still no one gets fired for such cesspools of incompetence! 

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

J Neurol (2002) 249 : 518 – 528 © Steinkopff Verlag 2002

Hartwig Woldag 

Horst Hummelsheim

Dr. H. Woldag () · H. Hummelsheim Neurologisches Rehabilitationszentrum Leipzig University of Leipzig Muldentalweg 1 04828 Bennewitz bei Leipzig, Germany Tel.: +49-34 25/8 88-3 90 Fax: +49-3425/888-877 E-Mail: woldag@sachsenklinik.de

Abstract 

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 elec- trical 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.

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