The Clinical Science of Neurologic Rehabilitation (Contemporary Neurology Series, 66)

The Second Edition of this single-authored volume integrates multiple disciplines of basic and clinical research to help clinicians further develop the best possible care for the rehabilitation of patients with neurologic diseases. From the readable descriptions of the structures and functions of pathways for movement and cognition, the reader comes to understand the potential for training induced, pharmacologic, and near-future biologic interventions to enhance recovery. Dr. Dobkin shows how functional neuroimaging serves as a marker for whether physical, cognitive, and neuromodulating therapies work and how they sculpt the plasticity of the brain. Themes, such as how the manipulation of sensory experience can serve as a formidable tool for rehabilitation, run throughout the text, built from the level of the synapse to behaviors such as grasping, walking, and thinking. From illustrating how we may one day repair the brain and spinal cord to how to retrain spared and new pathways, Dr. Dobkin draws insights from a broad swath of fundamental research to give clinicians tools they can translate into bedside practices.The book treats the medical complications and therapeutic approaches to neurologic diseases as an interconnected matrix. The management of common medical issues, impairments, and disabilities are described across diseases. Special problems posed by patients with stroke, myelopathies, brain injury, multiple sclerosis, degenerative diseases, and motor unit disorders receive individual comment. Short-term and delayed pulse interventions for patients, along with clinical trials, are dissected and put into perspective.The First Edition of this book was titled Neurologic Rehabilitation. The title has been changed to reflect Dr. Dobkin's sense that fundamental research now drives the field of neurologic rehabilitation even more than it could in 1996 when the First Edition was published. The Second Edition features entirely new chapters on functional neuroimaging of recovery; neurostimulators and neuroprosteses; integration into the book of many new clinical and neuroscientific observations relevant to the clinician; and extensive updating and expansion of all chapters.Readers, whether clinicians serving the rehabilitation team, or students or researchers in neuroscience, neurology, physical medicine, allied health, or bioengineering, will acquire new insights and tools for creative pursuits that aim to lessen the disabilities of patients. CONTENTS......Page 11 Part I. Neuroscientific Foundations for Rehabilitation......Page 19 1. ORGANIZATIONAL PLASTICITY IN SENSORIMOTOR AND COGNITIVE NETWORKS......Page 21 SENSORIMOTOR NETWORKS......Page 22 STUDIES OF REPRESENTATIONAL PLASTICITY......Page 57 BASIC MECHANISMS OF SYNAPTIC PLASTICITY......Page 62 COGNITIVE NETWORKS......Page 70 SUMMARY......Page 82 2. BIOLOGIC ADAPTATIONS AND NEURAL REPAIR......Page 94 TERMS FOR IMPROVEMENT AFTER INJURY......Page 97 INTRINSIC BIOLOGIC ADAPTATIONS......Page 99 POTENTIAL MANIPULATIONS FOR NEURAL REPAIR......Page 117 MUSCLE PLASTICITY......Page 131 EXPERIMENTAL INTERVENTIONS FOR REPAIR OF SPINAL CORD INJURY......Page 136 RELEVANCE OF ANIMAL MODELS OF REPAIR TO CLINICAL TRIALS......Page 147 SUMMARY......Page 152 3. FUNCTIONAL NEUROIMAGING OF RECOVERY......Page 165 NEUROIMAGING TECHNIQUES......Page 166 LIMITATIONS OF FUNCTIONAL NEUROIMAGING STUDIES......Page 178 METABOLIC IMAGING AT REST AFTER INJURY......Page 181 ACTIVATION STUDIES: FUNCTIONAL REORGANIZATION AFTER INJURY......Page 185 TRAINING-INDUCED REORGANIZATION......Page 194 NEUROPHARMACOLOGIC MODULATION......Page 202 SUMMARY......Page 203 4. NEUROSTIMULATORS AND NEUROPROSTHESES......Page 211 PERIPHERAL NERVOUS SYSTEM DEVICES......Page 212 CENTRAL NERVOUS SYSTEM DEVICES......Page 216 ROBOTIC AIDS......Page 221 SUMMARY......Page 224 Part II. Common Practices Across Disorders......Page 229 THE TEAM APPROACH......Page 231 PHYSICIANS......Page 233 NURSES......Page 236 PHYSICAL THERAPISTS......Page 237 OCCUPATIONAL THERAPISTS......Page 249 SPEECH AND LANGUAGE THERAPISTS......Page 253 NEUROPSYCHOLOGISTS......Page 260 RECREATIONAL THERAPISTS......Page 261 SUMMARY......Page 262 NORMAL GAIT......Page 268 NEUROLOGIC GAIT DEVIATIONS......Page 270 QUANTITATIVE GAIT ANALYSIS......Page 276 APPROACHES TO RETRAINING AMBULATION......Page 280 SUMMARY......Page 286 7. ASSESSMENT AND OUTCOME MEASURES FOR CLINICAL TRIALS......Page 289 PRINCIPLES OF MEASUREMENT......Page 290 MEASURES OF IMPAIRMENT......Page 293 BEHAVIORAL MEASURES......Page 306 MEASURES OF DISABILITY......Page 307 MEASURES OF HEALTH-RELATED QUALITY OF LIFE......Page 316 MEASURES OF HANDICAP......Page 320 STUDY DESIGNS FOR REHABILITATION RESEARCH......Page 321 SUMMARY......Page 332 DEEP VEIN THROMBOSIS......Page 341 ORTHOSTATIC HYPOTENSION......Page 342 THE NEUROGENIC BLADDER......Page 343 BOWEL DYSFUNCTION......Page 347 NUTRITION AND DYSPHAGIA......Page 348 PRESSURE SORES......Page 352 PAIN......Page 354 SPASTICITY......Page 366 CONTRACTURES......Page 375 MOOD DISORDERS......Page 376 SLEEP DISORDERS......Page 381 SUMMARY......Page 382 Part III. Rehabilitation of Specific Neurologic Disorders......Page 391 EPIDEMIOLOGY......Page 393 MEDICAL INTERVENTIONS......Page 395 INPATIENT REHABILITATION......Page 403 OUTPATIENT REHABILITATION......Page 407 OUTCOMES OF IMPAIRMENTS......Page 410 OUTCOMES OF DISABILITIES......Page 417 CLINICAL TRIALS OF FUNCTIONAL INTERVENTIONS......Page 422 TRIALS OF INTERVENTIONS FOR APHASIA......Page 438 TRIALS FOR COGNITIVE AND AFFECTIVE DISORDERS......Page 443 SUMMARY......Page 454 EPIDEMIOLOGY......Page 469 MEDICAL REHABILITATIVE MANAGEMENT......Page 476 SENSORIMOTOR CHANGES AFTER PARTIAL AND COMPLETE INJURY......Page 484 FUNCTIONAL OUTCOMES......Page 491 TRIALS OF SPECIFIC INTERVENTIONS......Page 495 LONG-TERM CARE......Page 503 SUMMARY......Page 507 11. TRAUMATIC BRAIN INJURY......Page 515 EPIDEMIOLOGY......Page 516 PATHOPHYSIOLOGY......Page 517 NEUROMEDICAL COMPLICATIONS......Page 521 ASSESSMENTS AND OUTCOME MEASURES......Page 528 PREDICTORS OF FUNCTIONAL OUTCOME......Page 531 LEVELS OF REHABILITATIVE CARE......Page 533 REHABILITATION INTERVENTIONS AND THEIR EFFICACY......Page 537 SPECIAL POPULATIONS......Page 553 ETHICAL ISSUES......Page 555 SUMMARY......Page 556 12. OTHER CENTRAL AND PERIPHERAL DISORDERS......Page 565 DISORDERS OF THE MOTOR UNIT......Page 566 PARKINSON’S DISEASE......Page 575 MULTIPLE SCLEROSIS......Page 577 PEDIATRIC DISEASES......Page 583 BALANCE DISORDERS......Page 585 CONVERSION DISORDERS WITH NEUROLOGIC SYMPTOMS......Page 588 SUMMARY......Page 589 A......Page 597 B......Page 598 C......Page 600 D......Page 601 E......Page 602 G......Page 603 H......Page 604 M......Page 605 N......Page 607 P......Page 609 S......Page 611 T......Page 615 V......Page 616 Z......Page 617 The Second Edition of this single-authored volume integrates multiple disciplines of basic and clinical research to help clinicians further develop the best possible care for the rehabilitation of patients with neurologic diseases. From the readable descriptions of the structures and functions of pathways for movement and cognition, the reader comes to understand the potential for training induced, pharmacologic, and near-future biologic interventions to enhance recovery. Dr. Dobkin shows how functional neuroimaging serves as a marker for whether physical, cognitive, and neuromodulating therapies work and how they sculpt the plasticity of the brain. Themes, such as how the manipulation of sensory experience can serve as a formidable tool for rehabilitation, run throughout the text, built from the level of the synapse to behaviors such as grasping, walking, and thinking. From illustrating how we may one day repair the brain and spinal cord to how to retrain spared and new pathways, Dr. Dobkin draws insights from a broad swath of fundamental research to give clinicians tools they can translate into bedside practices. The book treats the medical complications and therapeutic approaches to neurologic diseases as an interconnected matrix. The management of common medical issues, impairments, and disabilities are described across diseases. Special problems posed by patients with stroke, myelopathies, brain injury, multiple sclerosis, degenerative diseases, and motor unit disorders receive individual comment. Short-term and delayed pulse interventions for patients, along with clinical trials, are dissected and put into perspective. The First Edition of this book was titled Neurologic Rehabilitation. The title has been changed to reflect Dr. Dobkin's sense that fundamental research now drives the field of neurologic rehabilitation even more than it could in 1996 when the First Edition was published. The Second Edition features entirely new chapters on functional neuroimaging of recovery; neurostimulators and neuroprosteses; integration into the book of many new clinical and neuroscientific observations relevant to the clinician; and extensive updating and expansion of all chapters. Readers, whether clinicians serving the rehabilitation team, or students or researchers in neuroscience, neurology, physical medicine, allied health, or bioengineering, will acquire new insights and tools for creative pursuits that aim to lessen the disabilities of patients. This work translates neuroscientific research to illuminate ongoing and future practices for the rehabilitation of patients with neurologic diseases. It dissects fundamental concepts to define what researchers must consider as they pursue best practices and areas ripe for exploration Bruce H. Dobkin. Rev. Ed. Of: Neurologic Rehabilitation / Bruce H. Dobkin. C1996. Includes Bibliographical References And Index.