Ne g l e c t – p a t h o p hy s i o l o g y, c l i n i c a l s ymp t oma t o l o g y, p r i n -c i p l e s o f r e h a b i l i t a t i o n
Katedra fyzioterapie a algoterapie Fakulty tělesné kultury Univerzity Palackého, vedoucí doc. MUDr. J. Opavský, CSc., OlomoucKlinika rehabilitačního a tělovýchovného lékařství Lékařské fakulty a Fakultní nemocnice, vedoucí MUDr. J. Malinčíková, PhD., Olom
Rehabil. fyz. Lék., , 2003, No. 2, pp. 72-76.
Recognition and integration of the bodily, spatial and motor pattern and subsequent activities area steady dynamic process disorders of which accompany motor disorders like a shadow. From thisperspective physiotherapy is a constant confrontation with neglect syndromes. The latter ply here,perhaps much more than in other fields of clinical neurophysiology laws of neuroplasticity, learning,memory, neuronal inhibition and synaptic inhibition. Neglect elements are found in as many as 80%patients after CVA. There is also a high incidence after traumatic brain injuries. De facto neglect isa syndromological continuum. It includes among others deficient orientation, deficient attention,deficient perception (sensory, extero-, proprio-, vestibulo-, visuo-, audio- etc.), deficient imagination(representation), deficient cognition, deficient integration, deficient plan of the motor task. For thesuccess of therapy it is essential to maintain attention and concentration on the performed task,adjust to this demand the rate and rhythm of therapy. Therapy will be significantly promoted by anemotional reward.We try to transform the therapeutic programme into a game, use positively actingobjects and subjects, we expose the maximum number of stimuli in the neglected space and avoidstimulation on the “sound“ side.We combine visual, tactile proprioceptive and acoustic stimuli.We combine as much as possible active and passive elements with emphasis on activity.We use visualcues. Similarly as any training in physiotherapy and rehabilitation in general, neglect functionaltherapy is a progressive procedure.To promote rehabilitation we can use also various aids, equimentand special procedures.An important part of rehabilitation of the patient with neglect is intense, early and multimodal trainingof the function of the hand.
neglect, rehabilitation, physiotherapy, hand
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