Rehabilitation techniques for neurological injuries

A person's life can change radically if he or she has suffered neurological or spinal cord injuries, strokes, cerebral palsy or their sequelae, which often affect body mobility and limit independence.

In the face of these, it is necessary that patients have access to multidisciplinary therapy. multidisciplinary therapy that aims at neurorehabilitationThis is a process that seeks to restore, minimize or compensate the functional deficits caused by a lesion of the central nervous system. The multidisciplinary rehabilitation involves the participation of specialized professionals.

The evaluation of physiatrists and the intervention of kinesiologists, occupational therapists or speech therapists make it possible to determine the treatment indicated for each person, according to his or her injury, with specific exercises in addition to technologies such as functional electrostimulation (FES). 

 

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Neurorehabilitation options

When a patient suffers from central or peripheral nervous system involvement, there is a profound and progressive deterioration of the patient's deterioration of functionality that leads him, together with his family members, to search for a solution.

This has led to the emergence of a variety of techniques and procedures throughout history. techniques and procedures and procedures in the field of neurorehabilitation neurorehabilitation.

This is possible thanks to the evolutionfrom a static idea that an injury to the nervous system entailed loss of function and was not recoverable, to a new model based on neuroplasticity. to a new model based on neuroplasticity, which is the potential forwhich is the potential for reorganization of the cerebral cortex, leading to the activation of previously silent neuronal circuits to become functional and take over the lost activity.

The neurorehabilitation is where the multidisciplinary multidisciplinary approachIt includes drugs, physiotherapy techniques, occupational therapy, use of appropriate orthoses, neurocognitive therapy, among others, among the techniques that can be used in the treatment process.

The World Health Organization (WHO) (WHO) highlights some examples of rehabilitation options:

  • Speech and language training to improve a person's communication after brain injury.
  • Physical exercise training to improve muscle strength, voluntary movements and balance in people with stroke or Parkinson's disease.
  • Modify an elderly person's home environment to improve their safety and independence at home and reduce their risk of falls.
  • Prescribing medication to reduce spasticity in a child with cerebral palsy.
  • Psychological therapies for a person with emotional distress after spinal cord injury.

Technologies applied to neurorehabilitation

In addition to the multidisciplinary approach to neurorehabilitationThanks to information and communication technologies, innovations have emerged that have been incorporated as complementary tools to conventional therapy.

Some of the technologies, which we can see in detail in the following article, are: 

  • Robotic Rehabilitationwhich offers highly controlled, repetitive and intensive training.
  • Portable exoskeletons for gait rehabilitation.
  • Transcranial magnetic stimulation (TMS) and electrical brain stimulationnon-invasive techniques that allow modulating neuronal changes in a safe and painless way.
  • Virtual RealityVirtual Reality, a useful, up-to-date tool that can be used in motor rehabilitation.
  • Neural interfacesengineering solutions aimed at restoring the brain connections that allow the organism to coordinate itself again.
  • MonitoringThe technology, based on portable sensors such as accelerometers and inertial measurement units that, because they can be connected to different anatomical locations, allow monitoring of the type, quantity and quality of daily activities and therapy.

Functional electrostimulation

biofeedback

The functional electrostimulation (FES) is a therapeutic technique that uses electrical currents to stimulate nerves and muscles with the aim of restore or improve motor function in patients with various neurological and muscular conditions.

It is typically applied in situations where there is an alteration in the communication between the nervous system and the muscles, with the aim of improving sequelae related to muscle weakness, lack of coordination and loss of mobility.

TrainFES has developed the best technology for neuromuscular rehabilitation for those who suffer from some type of motor paralysis of central origin.

In addition to the multidisciplinary approach, the methodology of TrainFES methodology is equipped with advanced technology for the application of functional electrostimulationto generate functional movements, such as bipedalism, walking, improving reach, grasping or swallowing.

Scientific evidence

Various studies and scientific reviews show how functional electrostimulation functional electrostimulation is a complement rehabilitation therapies for people with some degree of motor paralysis.

Upper extremityThis study analyzed the effect of FES-based training with bimanual activation and biofeedback therapy, concluding that electrical stimulation works for the rehabilitation of the paretic upper extremity in people with stroke sequelae.

Reduces fallsAn investigation of the effect of applying FES to the quadriceps of the paretic limb during postural perturbations showed that it reduces the incidence of laboratory falls, improves reactive stability control, and reduces vertical limb collapse in people with chronic stroke.

Foot dropA paper reviewed the technological advances and clinical results obtained in the neuroprosthetic management of drop foot, stating that the development of transcutaneous, self-fitting drop foot systems to provide patient autonomy outside the clinic is a particularly promising direction of research.

Multiple uses of FESA review of the literature determined that functional electrostimulation can be a valuable home therapy, with good results in people with paralysis and musculoskeletal problems, cardiorespiratory and renal pathology, as well as being a viable form of exercise for the elderly.

Spinal cord injuryThe analysis of combined applications with rowing, cycling, power walking and other derivatives showed that, in general, functional electrostimulation can be used to improve breathing, circulation, hand strength, mobility and metabolism after spinal cord injury.

Improving activity after strokeFunctional electrostimulation appears to moderately improve activity compared to no intervention and to training alone, suggesting that it should be used in stroke rehabilitation to improve the ability to perform activities.

Early rehabilitation in ICUThe review of how functional electrostimulation contributes from the time the patient is in the Intensive Care Unit (ICU) determined that cycling was the exercise that increased cardiac output and produced sufficient muscular work intensity.

Pain reductionFunctional electrostimulation significantly reduced ischemic pain and improved quality of life -compared to walking without FES- in patients with intermittent claudication.

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