earticle

영어

In stroke rehabilitation, a final goal addresses the successful return to premorbid life and community re-integration, which includes functional recovery and active participation in everyday activities. Individuals with post-stroke hemiparesis have been characterized by sensory and motor paralysis, decreased strength and endurance, spasticity, loss of dexterity, and cognitive deficit. These factors contribute to producing a variety of functional problems in gross and fine motors. In particular, reduced standing balance and walking dysfunction are major components to hinder independence in daily life after stroke; therefore, the recovery of walking function is considered as ultimate goal in stroke rehabilitation. Based on neurophysiological knowledge, numerous traditional approaches such as neurodevelopmental treatment, proprioceptive neuromuscular facilitation, and Brunnstrom and Rood approaches have been commonly used to restore their function, providing theoretical conception and therapeutic procedures to manage stroke patients. Taken under research-based results, recent trends have proven clinical efficacy of task-oriented training, which demonstrates motor learning principles and its contributions in neurological rehabilitation. However, despite training effects, adding basic procedures including the correction of joint malalignment and restoration of kinetic linkage of the body did not have great interest as possible option for reinforcing functional gains in stroke. It requires the development of more organized therapeutic approach based on resolving leading causes to functional problems. Novel concept of ‘Neuromuscular Control and Reset (NCR)’ provides possible mechanism of problem-solving strategies for detecting neutral positions of misaligned joints and keeping them by resetting the ability of neuromuscular control, which facilitates optimal motor control patterns in safe and effective templates. It comprises specific processes to address the correction of pathological joint mechanics, recovery of movement mechanics, and improvement of functional activities. This study describes the theoretical background for applying the NCR concept to regain the level of functional performance of patients with post-stroke hemiparesis.