What are the basic principles of neurological rehabilitation?

  For a long time, due to the influence of the view that “nerve cells cannot be regenerated after death”, academics have always believed that it is difficult to recover after serious neurological injury. The practice of clinical rehabilitation medicine confirms that neurological diseases and post-injury functions can be recovered; the brain is plastic, and brain functions can be reorganized after brain injury. Many patients with brain injury have recovered their damaged neurological functions and even returned to work after rehabilitation, and there are many such examples. Therefore, a good grasp of the principles of rehabilitation is related to how to make the best recovery of neurological injury.  Principles of neurological rehabilitation: early rehabilitation.  Generally speaking, once a patient’s condition has stabilized for 48 to 72 hours, rehabilitation can be considered to begin. The purpose of early rehabilitation is to preserve the patient’s remaining functions to the greatest extent possible and to avoid the “disuse syndrome” caused by “braking” or “disuse”; secondary prevention of disability.  Principles of Neurological Rehabilitation: Active Rehabilitation.  With the in-depth research on the theory and practice of neuroplasticity and functional reorganization, it is clear that the recovery and reconstruction of neurological function after injury is largely practice-dependent, time-dependent and dose-dependent. Active rehabilitation emphasizes the patient’s initiative to accomplish neurological functional activities rather than relying on passive movements.  Therefore, in order to achieve “maximum” effect, neurorehabilitation must rely on the patient’s active participation in all neurological activities. Passive rehabilitation methods should be minimized.  Neurological rehabilitation principle: Appropriate rehabilitation.  This principle is relative to the improper use of rehabilitation techniques. Only when appropriate rehabilitation techniques are used can neurological function follow the correct rehabilitation trajectory and take fewer detours. For example, spasticity is a necessary stage in the rehabilitation process of almost every brain injury patient. Improper training of upper and lower extremity strength can exacerbate the spasticity pattern of upper extremity flexors and lower extremity extensors, ultimately leaving the patient with a disability. In this way, it can even be said that “improper training is worse than no training”.  Neurological rehabilitation principle: intensive rehabilitation.  In order to develop an appropriate rehabilitation program according to the patient’s actual remaining function and potential ability to recover, and to enable the patient to make real functional progress through repeated practice, it is necessary to give the necessary “time” to “practice” this function, and A certain “dose” of this function must be achieved. If the time spent is too little and the dosage required is too low, the rehabilitation effect will not be achieved; on the contrary, if the time and dosage are beyond the patient’s ability, it will be counterproductive and the patient’s function will not progress, but will regress and even produce serious comorbidities and complications, so that the rehabilitation activities have to be stopped.  Principles of Neurological Rehabilitation: Comprehensive Rehabilitation.  The ultimate goal of disease treatment and rehabilitation is not only the cure of the disease itself and the stabilization of the condition, but also the improvement of the individual’s mobility and social participation. In addition to evaluating the morphology and function of organs and organs at the physical level, it is important to quantify the individual’s function or health, and to carefully quantify the individual’s ability to move and participate in society. When examining the consequences of rehabilitation, it is important to use the “activity” and “participation” scores as the basis. In other words, the three levels of rehabilitation are physical, activity and participation.  Neurological rehabilitation principle: individualized rehabilitation.  When conducting acute or early rehabilitation training, the risk of rehabilitative treatment should be assessed first. A complete rehabilitation plan should then be carefully written regarding the nature, intensity, duration, frequency, and even specific rehabilitation methods that the patient may endure, possible accidents, and ways to handle them. As the patient develops a response to the rehabilitation treatment, then gradually adjust the nature and dosage of the rehabilitation treatment. The development of an individualized rehabilitation plan based on the patient’s specific situation at the time is the central issue in achieving functional recovery, and should be tailored to the individual and the time of day.