Published in: European Journal of Physiotherapy, 2015
Neuroplasticity in action post-stroke: Challenges for physiotherapists
Gunilla Frykberg & Rajul Vasa
Department of Neuroscience/Rehabilitation Medicine, Uppsala University, Sweden, and Rajul Vasa Foundation, Center for Brain and Spinal Injury Rehab, Mumbai, India
Knowledge regarding neuroplasticity post-stroke is increasingly expanding. In spite of this, only a few physiotherapy interventions have been able to demonstrate effectiveness in achieving recovery of lost sensorimotor control. The aims of this review article are to highlight and discuss challenges for physiotherapists working with patients post-stroke, to question some current assessment methods and treatment approaches, and to pose critical questions indicating a possible new direction for physiotherapists in stroke rehabilitation. Differentiation between recovery and compensation post-stroke is increasingly being emphasized. Implementation of this goal in the clinic is insufficient, with a lack of assessment tools with potential to discriminate between the concepts. Large-scale reviews are performed without considering whether functional gains are achieved through “more effective” compensatory strategies or through recovery. Cortical plasticity in neurorehabilitation research and voluntary control in contemporary treatment methods are in focus. Challenges for physiotherapists in stroke rehabilitation consist of rethinking, including looking upon the body under the influence of gravity, focusing on implicit factors that impact movement control and developing new assessment tools. The introduction of a new assessment and treatment concept aiming at expanding the boundaries of center of mass movements towards the paretic side is proposed. In conclusion, we need to assume our responsibilities and step forward as the experts in movement science that we have the potential to be.
Watch Dr. Rajul Vasa's interview recorded on the programme - 'Hearts to Hearts' on Zee News Marathi. Date: 14th Mar 2015
In February Pekka Paalanen went to visit his mother. In an instant the stay changed into a trip to the hospital for months.
Movie director Pekka Paalanen, 32, was visiting his mother who suffers from cancer in Porvoo. His head ached, but he thought it would pass by taking aspirin. Suddenly the air felt stuffy and he felt dizzy. As he fell, he realised he could not intercept with his hand, because it didn’t work.
Mother called for an ambulance and so started the trip toward Helsinki’s Meilahti’s hospital. Pekka had had a severe aneurysm with only a 50 pro cent chance of survival.
— Although mother tried to ask what’s the matter, my words didn’t make sense. After the ambulance I don’t remember much else, Pekka remembers.