Exercise Therapy for Recovery from Hemiplegia: Theory and Practice of Repetitive Facilitative Exercise

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This book introduces an innovative, efficient, and patient-friendly neural net constructive therapy for patients with mild to severe hemiplegia, not only in the recovery phase but also in acute and chronic phases. The explanations are supported by extensive photographs of each position and a set of 72 video clips to help readers follow and reproduce the techniques. This book explains the theory of Repetitive Facilitative Exercise (RFE), which is a combination of repetitive volitional flexion and extension movements from neurofacilitation approaches. This exercise is aimed at achieving the intended movements and lessening synergistic movement patterns by reconstructing and strengthening the neuropathways of the injured nerve tract. Instead of interpreting disorders based on reflex theory and constructing treatment methods, the new approach considers scientific treatment methods that emphasize the formation of neural pathways by improving synapse formation and transmission efficiency based on functional localization, central programs, and neural nets. Chapters provide a basic theory of RFE, offering the underlying mechanisms of nerve tract formation/strengthening, such as functional localization, voluntary movement, plasticity, and neural lateral sprouting, giving readers a comprehensive understanding of the prompt and repetitive therapy. This is followed by an exposition of practice and techniques, planning of treatment programs, and facilitation techniques for voluntary movements of the upper limb, individual fingers, and lower limb. Finally, the book introduces RFE to facilitate and enhance motor skills in walking and other functions. 

Exercise Therapy for Recovery from Hemiplegia - Theory and Practice of Repetitive Facilitative Exercise will provide rehabilitation therapists, physiotherapists, occupational therapists, and medical doctors a refreshing alternative theory and practice to current approaches. Neuroscience researchers, stroke patients, and their families would find this book informative. 


Author(s): Kazumi Kawahira, Megumi Shimodozono, Tomokazu Noma
Publisher: Springer
Year: 2022

Language: English
Pages: 180
City: Singapore

Preface for the Third Edition in Japanese
Preface for the First Edition in Japanese
Contents
Part I: Basics
1: Theory of Repetitive Facilitative Exercise
1.1 Different Functions in Different Parts of the Brain
1.2 Voluntary Movement
1.2.1 Mechanism of Voluntary Movement
1.2.2 Central Programming of Voluntary Movements and Reflex Theory
1.3 The Process of Learning Movements
1.3.1 “Learning Without Error”—Repetitive Excitatory Transmission to the Target Neural Pathway
1.3.2 Improvement of Excitatory Transmission Efficiency Across Synapses and Strengthening Links Between Neurons by Excitatory Transmission
1.4 Proof of Plasticity
1.5 The Mechanism of Functional Recovery and Plasticity
1.5.1 Plasticity of the Brain
1.5.2 Reconstructing the Functions in the Intact Hemisphere
1.6 Mechanism of Plasticity
1.6.1 Sprouting
1.6.2 Unmasking
1.7 Problems of the Neuromuscular Facilitation Technique in Promoting Recovery from Hemiplegia
1.8 Four Key Points to Facilitate Recovery from Hemiplegia
1.9 Outcome of Repetitive Facilitative Exercise
1.9.1 Effectiveness of the Repetitive Facilitative Exercise for the Affected Upper Limb (Fig. 1.25)
1.9.2 Outcome of Repetitive Facilitative Exercise for a Hemiplegic Trunk
1.9.3 Outcome of Repetitive Facilitative Exercise for Hemiplegic Lower Limbs
1.10 Repetitive Facilitative Exercise as the Primary Therapy in Combination with Other Supportive Therapies
1.10.1 Theory of Combination Therapy
1.10.2 NMES: Neuromuscular Electrical Stimulation
1.10.3 Vibratory Stimulation
1.10.4 Combination Therapy with Continuous Electrical Stimulation/Vibratory Stimuli
1.10.5 Transcranial Magnetic Stimulation (TMS)
1.10.6 Botulinum Toxin Therapy
1.10.7 Therapy for Visual Field Defect and External Ophthalamoplegia
References
Part II: Practice
2: Principles and Basic Techniques for Repetitive Facilitative Exercise
2.1 Principles of the Exercise
2.2 Basic Procedure for Repetitive Facilitative Exercise
2.3 Enabling the Movement Exactly as Intended
2.4 Improvement of Paralysis (Isolation from Synergistic Movements)
2.5 Principles of Spasticity Control
3: Planning Treatment Program
3.1 Points to Consider When Preparing Treatment Programs Including the Repetitive Facilitative Exercise
3.2 Methods of Maintaining Patient Concentration
3.3 The Purpose of Repetitive Facilitative Exercise
References
4: Repetitive Facilitative Exercise for the Upper Limb
4.1 The Principles Underlying Upper Limb Exercise Therapy
4.2 Basic Repetitive Facilitative Exercise for Shoulder and Prevention of Pain
4.2.1 Shoulder Joint Flexion and Manipulation
4.2.2 Procedure to Suppress Spasticity of the Flexor Muscles in the Fingers and Forearm (Supine Position)
4.2.3 Repetitive Facilitative Exercise to Increase the Excitement Level of the Target Nerve Tract (Fig. 4.10)
4.3 How to Perform Upper Limb Exercise Therapy
4.4 Repetitive Facilitative Exercise for the Shoulder
4.5 Repetitive Facilitative Exercise for Upper Limb
4.6 Repetitive Facilitation Exercise for the Elbow
4.7 Repetitive Facilitative Exercise for the Hand and Wrist Joint
4.8 Repetitive Facilitative Exercise for the Hand
5: Repetitive Facilitative Exercise for the Lower Limb
5.1 Principles of Physical Therapy for the Lower Limb
5.2 Basic Treatment Techniques
5.3 Procedure for Lower Limb Exercise
5.4 Repetitive Facilitative Exercise for the Hip Joint
5.5 Repetitive Facilitative Exercise for the Lower Limb
5.6 Repetitive Facilitative Exercise for the Knee
5.7 Repetitive Facilitative Exercise for the Ankle
6: Walking Training to Utilize the Function of the Affected Lower Limb
6.1 Training for Standing Balance
6.1.1 Purpose
6.1.2 Exercise for a Patient with Unstable Standing Balance
6.2 Lower Limb Brace and Cane
6.2.1 Appropriate Use of the Lower Limb Brace
6.2.2 Choice and Usage of Canes (Fig. 6.5)
6.2.3 Raised Shoe Insole for the Unaffected Heel
6.3 Walking Training
Reference
7: Basic Natural Movements (Rolling Over, Sitting Up, Standing Up, and Sitting Down from a Standing Position)
Afterword
A. Challenges for the Neuromuscular Facilitation Technique and RFE
B. What RFE Should Aim for
C. Closing