Neural plasticity and neurorehabilitation: teaching the new brain old tricks.
ABSTRACT Following brain injury or disease there are widespread biochemical, anatomical and physiological changes that result in what might be considered a new, very different brain. This adapted brain is forced to reacquire behaviors lost as a result of the injury or disease and relies on neural plasticity within the residual neural circuits. The same fundamental neural and behavioral signals driving plasticity during learning in the intact brain are engaged during relearning in the damaged/diseased brain. The field of neurorehabilitation is now beginning to capitalize on this body of work to develop neurobiologically informed therapies focused on key behavioral and neural signals driving neural plasticity. Further, how neural plasticity may act to drive different neural strategies underlying functional improvement after brain injury is being revealed. The understanding of the relationship between these different neural strategies, mechanisms of neural plasticity, and changes in behavior may facilitate the development of novel, more effective rehabilitation interventions for treating brain injury and disease. LEARNING OUTCOMES: Readers will be able to: (a) define neural plasticity, (b) understand how learning in the intact and damaged brain can drive neural plasticity, (c) identify the three basic neural strategies mediating functional improvement, and (d) understand how adjuvant therapies have the potential to upregulate plasticity and enhance functional recovery.
Article: Home-Based Balance Training Using the Wii Balance Board: A Randomized, Crossover Pilot Study in Multiple Sclerosis.[show abstract] [hide abstract]
ABSTRACT: OBJECTIVE: . To evaluate the effectiveness of a home-based rehabilitation of balance using the Nintendo Wii Balance Board System (WBBS) in patients affected by multiple sclerosis (MS). METHODS: . In this 24-week, randomized, 2-period crossover pilot study, 36 patients having an objective balance disorder were randomly assigned in a 1:1 ratio to 2 counterbalanced arms. Group A started a 12-week period of home-based WBBS training followed by a 12-week period without any intervention; group B received the treatment in reverse order. As endpoints, we considered the mean difference (compared with baseline) in force platform measures (ie, the displacement of body center of pressure in 30 seconds), 4-step square test (FSST), 25-foot timed walking test (25-FWT), and 29-item MS Impact Scale (MSIS-29), as evaluated after 12 weeks and at the end of the 24-week study period. RESULTS: . The 2 groups did not differ in baseline characteristics. Repeated-measures analyses of variance showed significant time × treatment effects, indicating that WBBS was effective in ameliorating force platform measures (F = 4.608, P = .016), FSST (F = 3.745, P = .034), 25-FWT (F = 3.339, P = .048), and MSIS-29 (F = 4.282, P = .023). Five adverse events attributable to the WBSS training (knee or low back pain) were recorded, but only 1 patient had to retire from the study. CONCLUSION: . A home-based WBBS training might potentially provide an effective, engaging, balance rehabilitation solution for people with MS. However, the risk of WBBS training-related injuries should be carefully balanced with benefits. Further studies, including cost-effectiveness analyses, are warranted to establish whether WBBS may be useful in the home setting.Neurorehabilitation and neural repair 03/2013; · 4.49 Impact Factor
Chapter: What technology can and cannot offer an ageing population: Current situation and future approach[show abstract] [hide abstract]
ABSTRACT: Research in intelligent interactive systems can offer valuable assistance to elderly and disabled populations by helping them to achieve greater levels of engagement with the world. Many users find it difficult to use existing interaction devices, either for physical or age-related impairments. However, research on intelligent voice recognition, adaptable pointing, browsing and navigation, and affect and gesture recognition can hugely benefit such users. Additionally, systems and services developed for elderly or disabled people often find useful applications for their able-bodied counterparts. A Multimodal End-2-End Approach to Accessible Computing illustrates the state-of-the-art of technology and presents a vision for accessibility in the near future. It considers challenges faced by accessibility practitioners at research institutes, industries and legislative institutions throughout the world, and explores the different phases of delivering accessible products and services through design, development, deployment and maintenance. A collection of eminent researchers cover topics on developing and standardizing user models for inclusive design, adaptable multimodal system development for digital TV and ubiquitous devices. With a foreword from the BBC’s Head of Technology and organiser of the Switchover Help Scheme, and an End Note from the chairman of the ITU-T’s Focus Group on Audiovisual Media Accessibility (presenting a vision for accessible computing), this book will be an invaluable resource for researchers and practitioners.05/2013: pages 1-21; , ISBN: 978-1-4471-5081-7