by Kristijan Todoroski

Created on: January 22, 2012

History of stroke neuro-rehabilitation

Knowledge of stroke and the process of recovery after stroke has developed enormously in the late 20th century and early 21st century. It was not until the year 1620 that Johan Wepfer, by studying the brain of a pig, came up with the theory that stroke was caused by an interruption of the flow of blood to the brain.[6] This was an important breakthrough, but once the cause of strokes was known, the question became how to treat patients with stroke.

For most of the last century, people were actually discouraged from being active after a stroke. Around the 1950s, this attitude changed, and health professionals began prescription of therapeutic exercises for stroke patient with good results. Still, a good outcome was considered to be achieving a level of independence in which patients are able to transfer from the bed to the wheelchair without assistance. This was still a fairly bleak outlook, but the situation was improving.

In the early 1950s, Twitchell began studying the pattern of recovery in stroke patients. He reported on 121 patients he had observed. He found that by four weeks, if there is some recovery of hand function, there is a 70% chance of making a full or good recovery. He reported that most recovery happens in the first three months, and only minor recovery occurs after six months.[7] More recent research has demonstrated that significant improvement can be made years after the stroke.

Around the same time, Brunnstrom also described the process of recovery, and divided the process into seven stages. As knowledge of the science of brain recovery improves, methods of intervening have evolved. There will be a continued fundamental shift in the processes used to facilitate stroke recovery.

[edit]Current perspectives and therapeutic avenues

[edit]Motor re-learning

"Neurocognitive Rehabilitation by Carlo Perfetti concept", widespread in many countries, is an original motor re-learning theories application.[8]

[edit]Constraint-induced movement therapy

The idea for constraint-induced therapy is actually at least 100 years old. Significant research was carried out by Robert Oden. He was able to simulate a stroke in a monkey's brain, causing hemiplegia. He then bound up the monkey's good arm, and forced the monkey to use his bad arm, and observed what happened. After two weeks of this therapy, the monkeys were able to use their once hemiplegic arms again. This is due to neuroplasticity. He did

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