Pathophysiology of stroke rehabilitation

• Verfasst von: Kreisel, Stefan H. [VerfasserIn]
• Verfasst von: Hennerici, Michael G. [VerfasserIn]
• Verfasst von: Bäzner, Hansjörg [VerfasserIn]
• Titel: Pathophysiology of stroke rehabilitation
• Titelzusatz: the natural course of clinical recovery, use-dependent plasticity and rehabilitative outcome
• Verf.angabe: Stefan H. Kreisel, Michael G. Hennerici, Hansjörg Bäzner
• Jahr: 2007
• Umfang: 13 S.
• Fussnoten: Published online: December 29, 2006 ; Gesehen am 04.05.2022
• Titel Quelle: Enthalten in: Cerebrovascular diseases
• Ort Quelle: Basel : Karger, 1991
• Jahr Quelle: 2007
• Band/Heft Quelle: 23(2007), 4, Seite 243-255
• ISSN Quelle: 1421-9786
• DOI: doi:10.1159/000098323
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Brain
• Sach-SW: Brain Ischemia
• Sach-SW: Humans
• Sach-SW: Motor Activity
• Sach-SW: Neuronal Plasticity
• Sach-SW: Recovery of Function
• Sach-SW: Stroke
• Sach-SW: Stroke Rehabilitation
• Sach-SW: Time Factors
• Sach-SW: Treatment Outcome
• K10plus-PPN: 1800870450

Abstract

Even though the disruption of motor activity and function caused by stroke is at times severe, recovery is often highly dynamic. Recuperation reflects the ability of the neuronal network to adapt. Next to an unmasking of latent network representations, other adaptive processes, such as excitatory metabolic stress, an imbalance in activating and inhibiting transmission, leading to salient hyperexcitability, or the consolidation of novel connections, prime the plastic capabilities of the system. Rehabilitative interventions may modulate mechanisms of neurofunctional plasticity and influence the natural course after stroke, both positively, but potentially also acting detrimentally. Though routine rehabilitative procedures are an integral part of stroke care, evidence as to their effectiveness remains equivocal. The present review describes the natural course of motor recovery, focusing on ischemic stroke, and discusses use- and training-dependent adaptive effects. It complements a prior article which highlighted the pathophysiology of plasticity. Though the interaction between rehabilitation and plasticity remains elusive, an attempt is made to clarify how and to what extent rehabilitative therapy shapes motor recovery.