神経リハビリテーションの現状と展望
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概要
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Neurological diseases are one of the most common causes for rehabilitation intervention such as physical therapy, occupational therapy, and speech therapy. Among them, stroke dominates the number of the patients and leading cause of adult disability in Japan. Until recently, there were no established training strategies to recover motor function for such patients. However, the findings from basic neuroscience brought the drastic change of this picture. The most critical and fundamental finding was" neural plasticity". The changes of organization in damaged primary cortex after movement training were demonstrated by using squirrel monkey. In addition, the methods to evaluate brain function such as fMRI, SPECT, PET, fNIRS, EEG, and MEG are developed. Studies in both animal model and patients after brain damage proved the principle that movement training in rehabilitation can modulate cortical plasticity. These results strongly suggest directions in the development of novel strategies to enhance training effects on motor recovery. The rehabilitation aimed to recover movement by inducing cortical plasticity is called as "neurorehabilitation". The most essential problem of neurorehabilitation is how to create to specific learning situations to promote mechanisms of neural plasticity in recovery from brain damage. In this review, we describe the concept of neurorehabilitation, the basic science principles on which they are based, and the current status and future view of clinical applications.
- 2012-03-31
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