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Web End = J Neurol (2017) 264:603615 DOI 10.1007/s00415-016-8307-9
http://crossmark.crossref.org/dialog/?doi=10.1007/s00415-016-8307-9&domain=pdf
Web End = NEUROLOGICAL UPDATE
Neurorehabilitation: applied neuroplasticity
Fary Khan1,2,3 Bhasker Amatya1,2 Mary P. Galea1,2 Roman Gonzenbach4
Jrg Kesselring4
Received: 3 October 2016 / Revised: 6 October 2016 / Accepted: 7 October 2016 / Published online: 24 October 2016 Springer-Verlag Berlin Heidelberg 2016
Abstract The prevalence of disability due to neurological conditions is escalating worldwide. Neurological disorders have signicant disability-burden with long-term functional and psychosocial issues, requiring specialized rehabilitation services for comprehensive management, especially treatments tapping into brain recovery neuro-plastic processes. Neurorehabilitation is interdisciplinary and cross-sectorial, requiring coordinated effort of diverse sectors, professions, patients and community to manage complex condition-related disability. This review provides evidence for a range of neurorehabilitation interventions for four common neurological conditions: multiple sclerosis (MS), stroke, traumatic brain injury and Parkinsons disease using the Grade of Recommendation, Assessment, Development and Evaluation tool for quality of evidence. Although, existing best-evidence for many interventions is still sparse, the overall ndings suggest strong evidence for physical therapy and psychological intervention for improved patient outcomes; and. moderate evidence for multidisciplinary rehabilitation for longer term gains at the levels of activity (disability) and participation in MS and
stroke population. The effect of other rehabilitation interventions is inconclusive, due to a paucity of methodologically robust studies. More research is needed to improve evidence-base for many promising rehabilitation interventions.
Keywords Neurological disorder Rehabilitation
Neuroplasticity Disability
Introduction
Neurological disorders, a diverse set of conditions resulting from injury or disease of the nervous system, affect up to 1 billion people worldwide and constitute 6.3 % of the global burden of disease [1]. The disease-burden of these conditions is projected to increase by 12 % to 103 million in 2030 from an estimated 92 million disability-adjusted life-years (DALYs) in 2005 [1]. Cerebrovascular disease (stroke) contributes more than half the burden in DALYs of neurological conditions overall [1]. Neurological disorders cause nearly 12 % of total deaths globally, with cerebrovascular diseases contributing almost 85 % of these deaths [1]. The mortality rates related to neurological conditions are signicantly higher in lower-middle income countries compared with high-income countries (16.8 vs.13.2 %) [1, 2].
Although musculoskeletal conditions (such as arthritis,
trauma) are prevalent and cause disability; neurological conditions have diverse symptoms, longer and...