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뇌졸중 후 보행 재활의 최신 경향 : 상향식 접근과 하향식 접근

Current Trend of Gait Rehabilitation After Stroke : Bottom-up Versus Top-down Approaches

한국신경근육재활학회지 2020년 10권 2호 p.57 ~ 80
오덕원,
소속 상세정보
오덕원 ( Oh Duck-Won ) - Cheongju University College of Health and Medical Science Department of Physical Therapy

Abstract


As neurological rehabilitation has been increasingly developed, there is a rapid close in gap between neuroscientific information and clinical application. Also, a variety of concepts have been established to apply therapeutic techniques in stroke rehabilitation, which are based on bottom-up and top-down approaches. Therefore, clinicians need to understand valuable knowledge with regard to the natures of these approaches, and know the current use of treatment techniques. Based on recent trend, advanced technology highlights to develop new neuromechanical tools and robot-assisted devices for improved rehabilitation effects and functional recovery. Despite inadequate evidences in clinical setting, these approaches are known to facilitate brain plasticity and functional recovery, thereby allowing developing specific devices and more efficient control system. Focusing on scientific interests to control the pathophysiology of neural plasticity after stroke and operate them in controlled environment, data on specific effects from treatment are promptly collected as treatment outcomes. This supports the great benefits of patient-therapist-specific approaches. Therefore, the understandings of bottom-up and top-down approaches are necessary to build the present and future concepts in treatment. This paper aims to provide valuable information about current trends in gait rehabilitation after stroke, including bottom-up and top-down approaches.

키워드

Stroke; Gait; Top-down approach; Bottom-up approach

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