Principles of rehabilitation of patients with neurologic disorders

Samir R Belagaje MD FAAN (

Dr. Belagaje of Emory University School of Medicine has no relevant financial relationships to disclose.

)
James G Greene MD PhD, editor. (Dr. Greene of Emory University School of Medicine has no relevant financial relationships to disclose.)
Originally released March 21, 2017; updated March 13, 2019; expires March 13, 2022

Overview

In this article, the author focuses on rehabilitation of patients with acquired brain injury from both traumatic and nontraumatic causes. Rehabilitative strategies include both restorative therapies that serve to regain function and compensatory strategies that allow for compensation of lost function. Rehabilitation can occur in both inpatient and outpatient settings and involves multiple providers, including physical therapists, occupational therapists, and speech-language pathologists. New interventions, including pharmacological approaches, highlight a growing role for neurologists and physiatrists. This review will focus on the functional impairments that arise from acquired brain injury and the role of rehabilitative strategies to enhance neurologic recovery and improved functional outcomes.

Key points

 

• Acquired brain injury is a leading cause of disability in the United States.

 

• Human brain recovers from brain injury in 3 main ways: adaptation, regeneration, and neuroplasticity.

 

• Neuroplasticity refers to reorganization of neural connections to allow for functional recovery after acquired brain injury.

 

• Rehabilitation is often provided in a team-based approach and involves various disciplines, such as physical therapy, occupational therapy, and speech and language therapy.

 

• Early rehabilitation is important for neuroplasticity and improved neurologic recovery, and task-specific therapies are the most effective.

 

• Medications and devices have been proposed as adjunctive treatments to traditional rehabilitation strategies to help with recovery of several neurologic deficits, including paresis, aphasia, and spasticity.

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