神経疾患における期待されるリハビリテーション医学の進歩

抄録

Japanese Association of Rehabilitation Medicine has added a new object of rehabilitation medicine, “Improvements of Activities in Human”. It is expected that such a fundamental revision of rehabilitation medicine will promote rehabilitation treatment especially for patients with neuromuscular diseases. The efficacy of exercise therapy is preventing the harmful effects of bed rest, improving physiological function, and maintaining and improving ADL. Some cytokines are secreted from skeletal muscle during exercise and are beneficial for metabolism and immune function. A typical cytokine IL–6 was considered an inflammatory cytokine, however to exhibit anti–inflammatory effects. Promoting active exercise therapy for patients with neuromuscular disease has been contraindicated. For example, overuse weakness in patients with Charcot–Marie–Tooth disease was a common debate, however, most of physicians agree that exercise therapy increases muscle strength in them. It was expected that regenerative medicine and robot–based rehabilitation treatments are being actively developed, and we have reported the effectiveness in combines of passive movement and functional electrical stimulation. The first step to advance rehabilitation medicine should be education in physicians and therapists. Under and post–graduate education for physicians and therapists should be insufficient for understanding the exercise physiology and acquiring knowledge of pathophysiology for people with disabilities. We hope that rehabilitation medicine and medical care will be advanced to improve the activities of patients with neurological disorders.