Neuroplasticity in action post-stroke: Challenges for physiotherapists

Still doesn't seem to be addressing  how to get neuroplasticity to work for functionality that existed in the now dead areas.

You might want to read up on Rajul Vasa first.

Vasa concept - Is there a connection between increased degrees of freedom from flaccidity following stroke, and development of passive tissue contracture and spasticity?

Vasa concept

 

 

http://informahealthcare.com/doi/abs/10.3109/21679169.2015.1039575 

Gunilla E. Frykberg, and Rajul Vasa

¹Department of Neuroscience/Rehabilitation Medicine, Uppsala University, Sweden

²Rajul Vasa Foundation, Center for Brain and Spinal Injury Rehab,

Mumbai

, India

Correspondence: Gunilla Elmgren Frykberg, RPT, PhD, Department of Neuroscience/Rehabilitation Medicine, Uppsala University,

SE-751 85 Uppsala

, Sweden. Tel: + 46 18 611 28 75. E-mail: gunilla.elmgren.frykberg@neuro.uu.se

Knowledge regarding neuroplasticity post-stroke is increasingly expanding. In spite of this, only a few physiotherapy interventions have been able to demonstrate effectiveness in achieving recovery of lost sensorimotor control. The aims of this review article are to highlight and discuss challenges for physiotherapists working with patients post-stroke, to question some current assessment methods and treatment approaches, and to pose critical questions indicating a possible new direction for physiotherapists in stroke rehabilitation. Differentiation between recovery and compensation post-stroke is increasingly being emphasized. Implementation of this goal in the clinic is insufficient, with a lack of assessment tools with potential to discriminate between the concepts. Large-scale reviews are performed without considering whether functional gains are achieved through “more effective” compensatory strategies or through recovery. Cortical plasticity in neurorehabilitation research and voluntary control in contemporary treatment methods are in focus. Challenges for physiotherapists in stroke rehabilitation consist of rethinking, including looking upon the body under the influence of gravity, focusing on implicit factors that impact movement control and developing new assessment tools. The introduction of a new assessment and treatment concept aiming at expanding the boundaries of center of mass movements towards the paretic side is proposed. In conclusion, we need to assume our responsibilities and step forward as the experts in movement science that we have the potential to be.

Read More: http://informahealthcare.com/doi/abs/10.3109/21679169.2015.1039575