emotion; walking; upper motor neuron lesions; motor skill training; cognitive impairment screening; fall prevention; dysphagia

The book Insights into Neurorehabilitation provides a series of new concepts to describe how emotions influence motor behavior. Movement itself also influences our emotions, but what role does the brain play in these phenomena? A brain region called the “cingulate motor area” is a hub that binds emotion and motion. The interactions between them drive many behaviors, including higher snacking frequency in adolescents, a stronger force evoked by anxiety or anger, a decrease in positive emotions after bed rest, and walking their dogs in dog owners. This mechanism also has an impact on motor skills training after upper motor neuron lesions, such as strokes.

How can people achieve automatic walking – or for that matter, even thinking, eating, or talking during walking? Does a spinal CPG (central pattern generator) control this process? Here, the book introduces the notion that the human brainstem is a controller for automatic walking. Four brain networks are also found to control human walking. Additionally, the weight-bearing pattern that appears during development is the result of brain and brainstem modulation, which in turn is based on biomechanical requirements and sensory inputs during walking. Therefore, a spinal CPG alone cannot achieve effective walking.

What should be the focus for training motor function after upper motor neuron injuries? Should it be, for example, movement patterns, biomechanical components/alignments, or meaningful motor tasks? Here, a unique answer is presented. The provided methods focus on building a rational force-exerting mode. To perform each motor action, people use a force-exerting mode to drive their muscles. It is the force-exerting mode that influences movement patterns and biomechanical alignments and, in turn, completes tasks. How a force-exerting mode differs from but accommodates movement patterns and biomechanical components, as well as other details on why the force-exerting mode is a “deeper” concept, is introduced in this book.

A graded-difficulty word-recall paradigm is provided for screening cognitive impairment. This method can be used to screen mild memory loss in a very efficient way.

Falls in the elderly may cause serious injuries and lead to them becoming a heavy burden. The book reviews many fall-risk screening methods and introduces why and how the STABLE protocol was developed. The STABLE protocol is characterized by its high sensitivity and ease of use. As a unique point, the STABLE protocol examines the personality traits (for example, whether the subject follows the instructions well, or the performance of the clock drawing test) and introduces why and how Tai Chi can build a conscientiousness personality trait to reduce fall risks. This may be especially important for active but impatient or careless older adults.

The book also provides a simple and easy-to-do protocol for screening swallowing difficulties, an oropharyngeal electrical-vibration stimulation method, a practical method to implement Flexible Endoscopic Evaluation of Swallowing (FEES) including a special insertion technique, dye use, and steps for disinfection. For example, insertion during FEES is always a challenge for many beginners; here, the 3-ortho principle should be the (know-how) solution you expect. Additionally, disinfection after FEES operation is important but practical steps are often lacking. In this book, on the other hand, related contents can meet actual needs.

Pengxu Wei, MD, PhD, is Director of the Integrative Rehabilitation Department of the National Research Centre for Rehabilitation Technical Aids, China. He is Vice-Chair of the Alzheimer’s Disease and Cognitive Rehabilitation Committee of the Chinese Association of Rehabilitative Medicine. He is the author of numerous journal articles.

Insights into Neurorehabilitation is available now at a 25% discount. Enter code PROMO25 to redeem.

Read Extract