Neuropsychological rehabilitation: this is used in patients
Possibly we know someone who has suffered some type of accident that has diminished their mental abilities, or we have seen it in a movie or read it in a book. Car accidents, strokes, dementias ... all this has or can have a great effect on our nervous system.
In these cases, after taking the person to the hospital and once their situation is stable and not in danger, they proceed to assess their abilities and when alterations are detected, they end up performing neurorehabilitation, or neuropsychological rehabilitation . Throughout this article we will talk about this type of rehabilitation.
- Related article: "Neurological disorders in information processing"
What is neuropsychological rehabilitation?
Neuropsychological rehabilitation is understood as therapeutic process by which people who have suffered some type of brain injury are treated in order that these recover or at least better the cognitive skills and functionality in daily life that have lost product of such injuries.
The great cerebral plasticity that we have, especially in childhood but still in force for the rest of our lives, allows that in many cases the recovery or partial or total improvement of the lost functions is possible. Of course, this will not always be possible, in which case other strategies may be used so that said loss does not generate a disability.
Rehabilitation is usually carried out by a multidisciplinary team of different professionals in the field of health who contribute the knowledge and techniques from their respective disciplines to improve the patient's situation. Among them we find doctors, clinical psychologists and neuropsychologists, occupational therapists, speech therapists and physiotherapists, among others.
Throughout the process, it is intended to generate an explanatory model that allows the patient and his environment to understand what has happened and their affections, to accompany the coping with this fact and finally to alleviate or remedy the deficits caused by the injuries, either by recovering functions or through the application of different mechanisms in order to make up for the difficulties.
The kind of help given to patients
It is important that this neuropsychological rehabilitation or neuropsychological rehabilitation has ecological validity, that is to say that what is carried out will be useful for the patient in his day-to-day practice.
The treatment must be personalized and be adjusted to the capabilities of the patient, as well as aimed at their functional recovery. Some variables to consider are the type, area, severity and cause of the injury, the cognitive and functional capacity prior to it and aspects such as sex or age.
The ways of acting and the concrete techniques that are used, therefore, will vary greatly in each case. Sometimes it may be necessary to perform a rehabilitation in addition to social skills training, occupational rehabilitation and behavior modification techniques, as well as therapy to alleviate disturbances derived from the experience of their state and family orientation.
In the same way, we must bear in mind that sometimes it is not sought to improve the patient's capabilities or recover, but keep your mental functions as long as possible . Finally, we must bear in mind that rehabilitation must be plastic and take into account the evolution of the patient: it will be necessary to carry out a follow-up and evaluation in order to adjust the rehabilitation to the patient's condition.
Approaches within the rehabilitation
Within neuropsychological rehabilitation we can act in different ways in order that the patient can recover the functionality . These are not mutually exclusive ways of acting, but they can overlap. It is more about different ways of approaching the treatment, focusing it towards the possibility of recovering the lost functions. Specifically, we can find the following three major approaches, although optimization can be added as a fourth approach to be taken into account.
Restoration or restoration of functions
It is understood as such the neurorehabilitation approach that focuses on the recovery of the same mechanisms that the subject has lost or seen diminished due to brain damage suffered. We work through the stimulation of these functions, seeking to retrain the subject in its application and reconstruct the function. But nevertheless recovery is not always possible , especially when we talk about large brain injuries.
Compensation of functions
When it is not possible to recover the lost functions, the treatment will focus on optimizing and enhancing other skills so that they can compensate for those that have been lost and that such loss does not generate a disability. It is about using what the patient has preserved so that it can unfold.
Substitution
In part similar to the compensation strategy, substitution seeks that through different means and strategies the subject is capable of compensate for cognitive and functional deficits , using different alternative skills or even external means such as alarms or agendas.
Optimization
Beyond compensating or replacing lost skills, neuropsychological rehabilitation can act in a way that improves the capabilities and potential of the person to whom it is performed.
What is rehabilitated?
Neuropsychological rehabilitation is an element that must take into account the subject in a holistic way, that is, as a whole. But nevertheless, generally rehabilitation focuses on specific skills , being some of the most usual the following ones.
1. Attention
Attention capacity may be diminished due to brain injury , requiring neuropsychological rehabilitation.
- Related article: "Selective attention: definition and theories"
2. Memory
Memory is one of the most important basic skills in our day to day life, and it is common for neuropsychological rehabilitation to try to facilitate recall.
It can fail the memory of what happened in the past, the ability to record new information, the prospective memory (which I have to do later) or recognition, among others. Different programs and techniques, such as reminiscence, can help to maintain memory or to exercise it .
3. Executive functions
The set of executive functions is one of the aspects in which more neuropsychological rehabilitation is performed, these skills being practically essential to achieve lead an autonomous and functional life .
4. Psychomotor
Movement is another of the abilities that can be affected due to a brain injury. From the emission of uncontrolled movements to immobility, passing also through apraxias or loss / diminution of the capacity to perform more or less complex actions and carry out coordinated sequenced movements, may require neurorehabilitation.
5. Language
Aphasias are losses or deficits in the ability to communicate through language due to a brain injury, being a frequent problem. The problem can be found in fluency and expression, comprehension or repetition . It is a skill very worked at the rehabilitation level.
6. Perceptual rehabilitation
It is very common for a brain injury to occur perceptual alterations, or some type of agnosia or lack of recognition of stimulation. Improvements in this aspect can occur through neuropsychological rehabilitation.
- Perhaps you are interested: "Visual agnosia: the inability to understand visual stimuli"
Problems in which it is usually applied
There is a large number of problems in which a brain injury is generated and in which the application of neuropsychological rehabilitation may be required. Among them, some of the most common are the following.
1. Cranioencephalic traumatisms
Cranioencephalic traumatisms are a very common cause of brain injuries, often generated by traffic accidents, falls or even for assaults. The symptoms and impaired functions will depend to a great extent on the location and extension of the lesion.
2. Cerebrovascular accidents
Strokes, whether in the form of ischemia or hemorrhage, are a major problem that has become one of the main causes of death in the population. They produce either the flooding or the blockage and cessation of oxygen supply to part of the brain. This causes a large number of neurons to die , which depending on the area in which neuronal death occurs will generate deficits that may be more or less permanent. Neuropsychological rehabilitation is a great help to recover or compensate for lost skills.
3. Cognitive impairment
Although it may not become dementia, Cognitive impairment implies a decline in some functions that can be alleviated through neuropsychological rehabilitation.
4. Dementia and neurodegenerative diseases
In this case, neuropsychological rehabilitation does not focus on the recovery of functions but on their preservation for as long as possible.
Memory, attention and executive abilities are the main areas to be rehabilitated, although language and psychomotricity are also used. Alzheimer's, dementia due to Parkinson's disease, Pick's disease, frontotemporal dementias or Huntington's disease are some of the best known.
5. Intellectual disability and neurodevelopmental disorders
Although technically we would not be talking about rehabilitation in itself, the presence of intellectual disability or neurodevelopmental disorders may require this type of techniques in order to train and generate function optimization .
6. Epilepsy
The suffering of epileptic seizures can cause alterations and decreases in cognitive functions and functioning in daily life. Neuropsychological rehabilitation may be necessary in some cases.
- Maybe you're interested: "Epilepsy: definition, causes, diagnosis and treatment"
7. Neurosurgery
Sometimes it may be necessary to resort to neurosurgery to solve some kind of medical problem, as for example in the case of the aforementioned epilepsy or a brain tumor. These interventions can save lives or avoid large problems arising from different conditions. However, they can generate difficulties and decrease some functions, which may require neurorehabilitation to return to normal.
8. Poisoning or effects of prolonged substance use
Some substances can also cause brain damage, we are talking about drugs poisoning by the consumption of some toxic element . If such damage occurs, neuropsychological rehabilitation can help to recover to some degree the functionality and functions that may have been damaged.
Bibliographic references:
- Santos, J.L. and Bausela, E. (2005). Neuropsychological rehabilitation. Papers of the Psychologist, 26 (90): 15-21. General Council of Official Colleges of Psychologists. Madrid Spain.
- Tirapu, J. (2007). The neuropsychological evaluation. Psychosocial Intervention, 16 (2). Madrid Spain.
