Post-Stroke Rehabilitation: Importance of Neuroplasticity and Sensorimotor Integration Processes

Abstract

Stroke remains one of the leading causes of disability and social maladaptation of patients, residual signs of stroke of different severities being seen in 65% of patients [1,2]. Data from the National Stroke Register provide evidence that only about 20% of patients surviving stroke are able to return to their former work [3]. Correctly planned rehabilitation measures are very important for this group of patients, these being effective to some extent or other in 80% of stroke patients, with spontaneous complete recovery of impaired functions in 10%; rehabilitation is ineffective in only 10% of patients [4,5]. Recent years have seen significant progress in the rehabilitation of poststroke patients. The mechanisms of compensatory processes in the central nervous system (CNS) have been actively studied with the aim of creating new methods with improved rehabilitation efficacy [6]. Use of neuroimaging and neurophysiological methods provides for studies of the processes of reorganization and plastic changes in the CNS which are accompanied by clinical functional improvements.Neuroplasticity and Sensorimotor Integration. CNS recovery after injury is built on the phenomenon of neuroplasticity, which is the ability of various CNS components to undergo reorganization due to structural changes in brain matter [7], including qualitative and quantitative neuronal rearrangements [8], and because of functional systems of the CNS, changes in the glia, and the development of new interneuronal connections [9]. Brain areas which prior to injury were not involved or had smaller roles in a particular function acquire involvement, and this reorganization is directed to compensating for the injured areas or those with which the injured areas had functional connections [10,11]. Neuroplasticity processes in the CNS operate at different levels -molecular, cellular, synaptic, and tissue, with the involvement of large groups of neurons in cortical and subcortical structures. The pattern of activation in the brain of each patient at any given moment reflects the state of reorganization of motor neural networks [12]. Performance of tasks is associated with activation of neural networks directly proportional to the complexity of the task, due to recruitment of existing but inactive elements of the functional system [13,14]; after injury, there is activation of "non-standard" primary and secondary areas of both cerebral hemispheres, these being able to carry out the functions of the injured structures [15]. These processes can occur because of a degree of multifunctionality, including the polysensory functions of CNS neurons [11], which allow them to perceive afferent stimuli of different modalities, and also because of axon growth, formation of new synapses, and increases in the activity of new parts of neural networks [7,14].Investigation of stroke patients by positron emission tomography (PET) and functional MRI scans (fMRI) have Questions of the neurorehabilitation of strokes patients are addressed. The importance of the phenomenon of neur...

The effects of kinesthetic and visual motor imagery on interjoint coordination in the hemiplegic index finger: an experimental study using the index of temporal coordination

“…While it has been suggested that brain recovery occurring spontaneously may plateau at six months post-stroke (Nudo, 1999), these results indicate that motor imagery treatment may be effective sometime after this. The precise mechanisms underpinning neural plasticity and recovery of function are subject to continuing research and debate (Ekusheva & Damulin, 2015;Nudo, 2007) and we suggest that the development of guidelines on the best time to implement motor imagery will need to take place in tandem with this.…”

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“…В раннем постнатальном периоде индуктором апоптоза является ограничение притока афферентной информации, которая служит источником трофических стимулов как для развивающейся, так и для уже зрелой нервной системы. Это подтверждается тем фактом, чтоприток сенсорной информации является организатором процессов созревания и трофического обеспечения нервной системы [46,47,48]. То есть, непрерывный приток информации выступает в качестве главного условия существования и развития нервной системы.…”

Exploring the Caring Incorporating Yoga Program in Promoting Physical Recovery of Stroke Patients in Acute Phase

“…It has become a popular practice for health maintenance and illness recovery in the global community [27] and is the way of life and cultural heritage in Nepal [28]. Yoga has many physical exercises with highly positive signi cant effect on stroke rehabilitation [29,30], through enhancing neuroplasticity and neural pathways [31] that could enhance functional ability [32]. In addition, it also incorporates physical, mental and spiritual elements which have the power to integrate and balance among body, mind and spirit of an individual's health in various illnesses [33,34] that enhanced motivation, positive attitude, and activity participation [35,32] and high adherence to the program [36] which were lacking in conventional rehabilitation therapies [37].…”