著者

西脇 香織 近藤 国嗣 里宇 明元 千野 直一

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

リハビリテーション医学 (ISSN:0034351X)

巻号頁・発行日

vol.39, no.5, pp.257-266, 2002-05-18 (Released:2009-10-28)

参考文献数

36

被引用文献数

3 1

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Peripheral nerves have a potency to regenerate vigorously after injury, but often it is difficult to achieve a sufficient functional recovery. Although advances in microsurgery and a better understanding of nerve regeneration have improved the outcomes of nerve repair, a delayed and misdirected reinnervation still be a problem hindering functional restoration. Rehabilitation managements of peripheral nerve injury, such as electrical stimulation, exercise training and other approaches, have been in clinical use, but their effects on promoting reinnervation remain controversial. In this paper we review the basic studies which have investigated the mechanisms and efficacies of electrical stimulation, exercise training and motor/sensory reeducation. Electrical stimulation could elicit effects on the regenerated nerves, but inappropriate stimulation conditions might disturb regeneration. Exercise training often improves functional recovery after nerve injury, but overloaded and forced exercise might have a detrimental effect. The peripheral axonal misdirection is reflected in a cortical reorganizational changes. Some studies have revealed beneficial changes in the cortical map after motor/sensory reeducation programs in monkeys with nerve injury, which may explain the improved functional outcomes after rehabilitation in humans.