Neurological Diseases

There are significant numbers of people with neurological disabilities. The most part of them have a variety of impairments of arm function. The objectives of stroke rehabilitation are to reduce the impairments through therapy, achieve a maximum level of functional independence, minimize disability, successfully reintegrate back into home, family, and community, and re-establish a meaningful and gratifying life. The neurological recovery pattern of the upper limb will be different between Traumatic Brain Injury, Stroke or Multiple Sclerosis. In case of TBI, there is a progressive improvement up to one year (TBIMs) in the functional and motor recovery of the upper limb but when the impairment is secondary to a Multiple Sclerosis, the evolution depends on the natural history of the disease and the different clinical patterns: relapsing-remitting, secondary progressive, primary progressive. When the reason for the upper limb impairment is a Stroke the improvement usually stops after 6 months. Spinal Cord Injury has been considered a particular case. In fact the function of upper limb is normal in paraplegic patients and directly related to the level of lesion for tetraplegic patients. In this case a standardized orthotic aid or exercise more than a self-trained exercise are needed to decrease the disability.