Affiliations: Klinik Berlin, Dept. for Neurolog. Rehabilitation,
Freien Universität Berlin am Universitätsklinikum Benjamin Franklin,
Berlin, Germany
Note: [] Correspondence to: Dr. T. Platz, Klinik Berlin, Kladower Damm
223, D-14089 Berlin, Germany; Tel.: +49-30-36503-103; Fax +49-30-36503-123
Abstract: A long-term goal in motor rehabilitation is that treatment is not
selected on the basis of 'schools of thought', but rather, based on
knowledge about efficacy and effectiveness of specific interventions for
specific situations (e.g. functional syndromes). Motor dysfunction after stroke
or TBI can be caused by many different functional syndromes such as paresis,
ataxia, deafferentaion, visuo-perceptual deficits, or apraxia. Examples are
provided showing that theory-based analysis of motor behavior makes it possible
to describe 'syndrome-specific motor deficits'. Its potential
implications for motor rehabilitation are that our understanding of altered
motor behavior as well as specific therapeutic approaches might be promoted. A
methodological prerequisite for clinical trials in rehabilitation is knowledge
about test properties of assessment tools in follow-up situations such as
test-retest reliability and responsiveness to change. Test-retest reliability
assesses whether a test can produce stable measures with test repetition, while
sensitivity to change reflects whether a test detects changes that occur over
time. Exemplifying these considerations, a reliability and validity study of a
kinematic arm movement analysis is summarized. In terms of new therapeutic
developments, two examples of clinical therapeutic studies are provided
assessing the efficacy of specific inter-ventions for specific situations in
arm and gait rehabilitation: the Arm Ability Training for high functioning
hemiparetic stroke and TBI patients, and the treadmill training for
non-ambulatory hemiparetic patients. In addition, a new technical development,
a machine-controlled gait trainer ist introduced.
