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  • Cited by 2
  • Print publication year: 2003
  • Online publication date: August 2009

11 - Rehabilitation

    • By David Gow, Department of GI Sciences and Medicine, University of Manchester, Hope Hospital, Eccles Old Road, Salford M6 8HD, UK, Chris Fraser, Department of Medicine, Royal Bolton Hospital Farnworth, Bolton BL 4 OJR, UK, Shaheen Hamdy, Department of GI Sciences and Medicine, University of Manchester, Hope Hospital, Eccles Old Road, Salford M6 8HD, UK
  • Edited by Simon Boniface, Ulf Ziemann, Johann Wolfgang Goethe-Universität Frankfurt
  • Publisher: Cambridge University Press
  • DOI:
  • pp 264-287



Neurological rehabilitation can be defined as the institution of therapy to maximize the degree of recovery within a given individual following a neurological insult. It has been suggested that neurological rehabilitation is based around the phenomenon of neuronal plasticity which is thought to play a crucial role in recovery from neurological injury and in particular stroke. For the design and implementation of effective rehabilitative strategies it is essential to consider three components: (i) an understanding of the nature of the initial insult, (ii) an understanding of the manner in which recovery may occur and (iii) an objective measure of the result of therapeutic interventions employed.

Each of these components can be addressed in part with transcranial magnetic stimulation and the area of recovery from disability following stroke has received most attention. In particular, TMS has been used to investigate motor reorganization following stroke, which has led to a greater understanding of the potential recovery patterns that occur. TMS may also have a role in the induction of plasticity itself and has potential to become a rehabilitative tool in recovery from neurological injury.

In this chapter we will review how TMS has been utilized in the study of spontaneous recovery, explore the role of TMS in quantifying rehabilitation and examine how TMS has been applied to studies aimed at influencing the recovery process with therapeutic intervention.

Mechanisms of recovery from unilateral hemispheric stroke

Unilateral hemispheric stroke (UHS) has many advantages as a model for investigating recovery from neurological injury.

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