The development of a rational scientific knowledge base and its practical application are critical to the generation of effective clinical practice. In neurological physiotherapy, new theoretical concepts come from an increased understanding of pathological and adaptive processes and from the rapidly developing fields associated with human movement. An increased understanding of the structure, function and adaptability of muscle; motor performance and linked segment dynamics; the acquisition of skill; and cognition-perception-action inter-relationships/links and the physiology of fitness, together with advances in our understanding of neural adaptability and its relationship to use and experience, should enable the development of more rational clinical methods. The purpose of this book is to explicate the way in which the gap between science and clinical practice may be bridged in movement rehabilitation. The book sets out to emphasize the need for those who work in movement rehabilitation to develop their knowledge base, and to utilize clinical methods which are grounded in the scientific understanding of the time and for which there is evidence of effectiveness in order to enable individuals with neural lesions to optimize their functional effectiveness.
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Janet Carr and Roberta Shepherd head up a new team of eminent authors for the second edition of this definitive text on neurological physiotherapy. In the first edition, the authors described a model of neurological rehabilitation for individuals with motor dysfunction based on scientific research in the areas of neuromuscular control, biomechanics, motor skill learning, and the link between cognition and action, together with developments in pathology and adaptation.
The new edition continues to advance this model while identifying and incorporating the many advances that have occurred in the last decade in the understanding and treatment of adults with neurological conditions, whether caused by accident or disease. Among these advances is the knowledge that the brain retains a plastic potential to reorganize, even in old and/or lesioned brains, and that neural plasticity can be influenced by task-related mental and physical practice in a stimulating environment. There is also an increasing body of knowledge related to the musculoskeletal system's adaptability and the need to prevent length and stiffness- related changes in muscle contractility, together with loss of aerobic fitness and endurance. There is an expanding body of clinical research that appears to support the model provided here. The training guidelines outlined in Neurological Rehabilitation are based on biomechanical constructs and motor relearning research, applied to enhance brain reorganization and muscle contractility, and encourage functional recovery of the patient. It connects science and clinical practice enabling students and practitioners to develop their knowledge and use new clinical methods based on modern scientific understanding.
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