Abstract
We examined the effect of a neurocognitive rehabilitation method in a young patient with upper limb impairment after cerebral hemorrhage.The "Perfetti" Neurocognitive Rehabilitation considers rehabilitation as a process of relearning, so every moment is necessary to use the parameters of the movement (spatiality, temporality) that do not fall into the so-called neuromotor methods. It proposes the learning of movements, through cognitive exercises. In the context of therapeutic exercise, the patient is encouraged to solve the "problem" related to movement through the use of "perceptive hypothesis". The method is based on the recovery of learning, on the conception of the body as a receptorial surface and the idea that the movement represents a phenomenon of knowledge. The patient made neurocognitive therapeutic exercise associated with high intensity focused acoustic waves to optimize muscle tone and hydrokinesitherapy at the frequency of 3 sessions per week for 6 months. The assessment was performed at the beginning (T0), mid (T1) and the end (T2) of the rehabilitation program, through: Multi Joint System; R.O.M. goniometric examination of the upper limb; Myometry; Fugl-Meyer Scale for the functional evaluation of the hemiplegic upper limb; Ashworth scale for spasticity. At the end of the rehabilitation program, we found improvement in upper limb proprioception; decrease in muscle tone at myometry in the upper limb flexors; increase in passive ROM of the shoulder; increase in the The Fugl-Meyer score; decrease in the Ashworth scale score.The proposed rehabilitation program is effective in improving the functional ability of the person with severe spasticity of the upper limb and functional deficit in the outcome of cerebral hemorrhage. The integration of functional neurocognitive rehabilitation in the treatment program is able to promote not only the recovery of the movement, understood as recovery of the articular range, but also the cognitive processes, perception, attention and the ability to solve problems through the stimulation of neuroplasticity.
