Expressive aphasia, also known as Broca's aphasia, is a type of aphasia characterized by partial loss of the ability to produce language, although comprehension generally remains intact. A person with expressive aphasia will exhibit effortful speech. Speech generally includes important content words, but leaves out function words that have only grammatical significance and not real-world meaning, such as prepositions and articles. This is known as "telegraphic speech". The person's intended message may still be understood but his or her sentence will not be grammatically correct. In very severe forms of expressive aphasia, a person may only speak using single word utterances. Typically, comprehension is mildly to moderately impaired in expressive aphasia due to difficulty understanding complex grammar.
Hemiparesis, or unilateral paresis, is weakness of one entire side of the body. Hemiplegia is, in its most severe form, complete paralysis of half of the body. Hemiparesis and hemiplegia can be caused by different medical conditions, including congenital causes, trauma, tumors, or stroke.
Apraxia is a motor disorder caused by damage to the brain in which the individual has difficulty with the motor planning to perform tasks or movements when asked, provided that the request or command is understood and the individual is willing to perform the task. The nature of the brain damage determines the severity, and the absence of sensory loss or paralysis helps to explain the level of difficulty.
Kinesiology is the scientific study of human or non-human body movement. Kinesiology addresses physiological, biomechanical, and psychological dynamic principles and mechanisms of movement. Applications of kinesiology to human health include biomechanics and orthopedics; strength and conditioning; sport psychology; methods of rehabilitation, such as physical and occupational therapy; and sport and exercise. Studies of human and animal motion include measures from motion tracking systems, electrophysiology of muscle and brain activity, various methods for monitoring physiological function, and other behavioral and cognitive research techniques.
The primary goals of stroke management are to reduce brain injury and promote maximum patient recovery. Rapid detection and appropriate emergency medical care are essential for optimizing health outcomes. When available, patients are admitted to an acute stroke unit for treatment. These units specialize in providing medical and surgical care aimed at stabilizing the patient's medical status. Standardized assessments are also performed to aid in the development of an appropriate care plan. Current research suggests that stroke units may be effective in reducing in-hospital fatality rates and the length of hospital stays.
The Bobath concept is an approach to neurological rehabilitation that is applied in patient assessment and treatment. The goal of applying the Bobath concept is to promote motor learning for efficient motor control in various environments, thereby improving participation and function. This is done through specific patient handling skills to guide patients through initiation and completion of intended tasks. This approach to neurological rehabilitation is multidisciplinary, primarily involving physiotherapists, occupational therapists and speech and language therapists. In the United States, the Bobath concept is also known as 'neuro-developmental treatment' (NDT).
A mirror box is a box with two mirrors in the center, invented by Vilayanur S. Ramachandran to help alleviate phantom limb pain, in which patients feel they still have a limb after having it amputated. The wider use of mirrors in this way is known as mirror therapy or mirror visual feedback (MVF).
Neuroplasticity, also known as brain plasticity, neuroelasticity, or neural plasticity, is the ability of the brain to change throughout an individual's life, e.g., brain activity associated with a given function can be transferred to a different location, the proportion of grey matter can change, and synapses may strengthen or weaken over time. Research in the latter half of the 20th century showed that many aspects of the brain can be altered even through adulthood. However, the developing brain exhibits a higher degree of plasticity than the adult brain.
Monoplegia is paralysis of a single limb, usually an arm. Common symptoms associated with monoplegic patients are weakness, numbness, and pain in the affected limb. Monoplegia is a type of paralysis that falls under hemiplegia. While hemiplegia is paralysis of half of the body, monoplegia is localized to a single limb or to a specific region of the body. Monoplegia of the upper limb is sometimes referred to as brachial monoplegia, and that of the lower limb is called crural monoplegia. Monoplegia in the lower extremities is not as common of an occurrence as in the upper extremities. Monoparesis is a similar, but less severe, condition because one limb is very weak, not paralyzed. For more information, see paresis.
The Silver Spring monkeys were 17 wild-born macaque monkeys from the Philippines who were kept in the Institute for Behavioral Research in Silver Spring, Maryland. From 1981 until 1991, they became what one writer called the most famous lab animals in history, as a result of a battle between animal researchers, animal advocates, politicians, and the courts over whether to use them in research or release them to a sanctuary. Within the scientific community, the monkeys became known for their use in experiments into neuroplasticity—the ability of the adult primate brain to reorganize itself.
Edward Taub is a behavioral neuroscientist on the faculty at the University of Alabama at Birmingham. He is best known for his involvement in the Silver Spring monkeys case and for making major breakthroughs in the area of neuroplasticity and discovering/developing constraint-induced movement therapy; a family of techniques which helps the rehabilitation of people who have developed learned non-use as a result of suffering neurological injuries from a stroke or other cause.
Neuroergonomics is the application of neuroscience to ergonomics. Traditional ergonomic studies rely predominantly on psychological explanations to address human factors issues such as: work performance, operational safety, and workplace-related risks. Neuroergonomics, in contrast, addresses the biological substrates of ergonomic concerns, with an emphasis on the role of the human nervous system.
Over time, the approach to cerebral palsy management has shifted away from narrow attempts to fix individual physical problems – such as spasticity in a particular limb – to making such treatments part of a larger goal of maximizing the person's independence and community engagement. Much of childhood therapy is aimed at improving gait and walking. Approximately 60% of people with CP are able to walk independently or with aids at adulthood. However, the evidence base for the effectiveness of intervention programs reflecting the philosophy of independence has not yet caught up: effective interventions for body structures and functions have a strong evidence base, but evidence is lacking for effective interventions targeted toward participation, environment, or personal factors. There is also no good evidence to show that an intervention that is effective at the body-specific level will result in an improvement at the activity level, or vice versa. Although such cross-over benefit might happen, not enough high-quality studies have been done to demonstrate it.
Sensory stimulation therapy (SST) is an experimental therapy that aims to utilize neural plasticity mechanisms to aid in the recovery of somatosensory function after stroke or cognitive ageing. Stroke and cognitive ageing are well known sources of cognitive loss, the former by neuronal death, the later by weakening of neural connections. As SS implies a patient will have a desired sense stimulated in a predetermined fashion at a known frequency. It has been found that this technique can be used to reduce as much as 30 years of cognitive ageing, and can both improve two point discrimination thresholds and also impair them.
Spastic hemiplegia is a neuromuscular condition of spasticity that results in the muscles on one side of the body being in a constant state of contraction. It is the "one-sided version" of spastic diplegia. It falls under the mobility impairment umbrella of cerebral palsy. About 20–30% of people with cerebral palsy have spastic hemiplegia. Due to brain or nerve damage, the brain is constantly sending action potentials to the neuromuscular junctions on the affected side of the body. Similar to strokes, damage on the left side of the brain affects the right side of the body and damage on the right side of the brain affects the left side of the body. The affected side of the body is rigid, weak and has low functional abilities. In most cases, the upper extremity is much more affected than the lower extremity. This could be due to preference of hand usage during early development. If both arms are affected, the condition is referred to as double hemiplegia. Some patients with spastic hemiplegia only suffer minor impairments, where in severe cases one side of the body could be completely paralyzed. The severity of spastic hemiplegia is dependent upon the degree of the brain or nerve damage.
Arno Villringer is a director at the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig, Germany; director of the Department of Cognitive Neurology at University Hospital Leipzig; and Academic Director of the Berlin School of Mind and Brain and the Mind&Brain Institute, Berlin. He holds a full professorship at University of Leipzig and an honorary professorship at Charité, Humboldt-Universität zu Berlin.
Restorative neurology is a branch of neurology dedicated to improving functions of the impaired nervous system through selective structural or functional modification of abnormal neurocontrol according to underlying mechanisms and clinically unrecognized residual functions. When impaired, the body naturally reconstructs new neurological pathways and redirects activity. The field of restorative neurology works to accentuate these new pathways and primarily focuses on the theory of the plasticity of an impaired nervous system. Its main goal is to take a broken down and disordered nervous system and return it to a state of normal function. Certain treatment strategies are used to augment instead of fully replace any performance of surviving and also improving the potential of motor neuron functions. This rehabilitation of motor neurons allows patients a therapeutic approach to recovery opposed to physical structural reconstruction. It is applied in a wide range of disorders of the nervous system, including upper motor neuron dysfunctions like spinal cord injury, cerebral palsy, multiple sclerosis and acquired brain injury including stroke, and neuromuscular diseases as well as for control of pain and spasticity. Instead of applying a reconstructive neurobiological approach, i.e. structural modifications, restorative neurology relies on improving residual function. While subspecialties like neurosurgery and pharmacology exist and are useful in diagnosing and treating conditions of the nervous system, restorative neurology takes a pathophysiological approach. Instead of heavily relying on neurochemistry or perhaps an anatomical discipline, restorative neurology encompasses many fields and blends them together.
Cortical remapping, also referred to as cortical reorganization, is when a cortical map is affected by a stimulus, is changed and then creates a 'new' cortical map. Every part of the body is connected to a corresponding area in the brain which creates a cortical map. When something happens to disrupt the cortical maps such as an amputation or a change in neuronal characteristics, the map is no longer relevant. The part of the brain that is in charge of the amputated limb or neuronal change will be dominated by adjacent cortical regions that are still receiving input, thus creating a remapped area. Remapping can occur in the sensory or motor system. The mechanism for each system may be quite different. Cortical remapping in the somatosensory system happens when there has been a decrease in sensory input to the brain due to deafferentation or amputation, as well as a sensory input increase to an area of the brain. Motor system remapping receives more limited feedback that can be difficult to interpret.
Peter G. Levine is an American medical researcher and science educator and authority on stroke recovery. His articles have been published extensively in peer-reviewed journals on brain plasticity as it relates to stroke, with emphasis on modified constraint induced therapy, cortical reorganization, telerehabilitation, electrical stimulation, electromyography-triggered stimulation, mental practice, corticalplasticity, acquired brain injury, spasticity, sensation recovery, evidence-based practice, outcome measures, and others. His articles have been widely cited by the medical community. His 2013 book Stronger After Stroke is regarded as an authoritative guide for patients and therapists dealing with stroke and it has received numerous positive reviews, and has been translated into Indonesian and Japanese. His seminars throughout the United States were described by one reviewer as "funny, entertaining, engaging, dynamic, well organized, passionate and lighthearted." He was a researcher and co-director at the Neuromotor Recovery and Rehabilitation Laboratory at the University of Cincinnati College of Medicine. Before that, he was a researcher at the Human Performance & Motion Analysis Laboratory, which is the research arm of the Kessler Institute for Rehabilitation. He lives in Wyoming, Ohio.
