Abstract
The REF (Reorganization of Elementary Functions) model describes the dynamic neural and cognitive reorganizations mediating behavioural and conscious flexibility. These mechanisms have phylogenetically evolved to enable such flexibility in intact individuals. It is, however, the same mechanisms, which mediate the functional recovery after brain injury. Thus, the REF-model provides a theoretical framework for the understanding of the posttraumatic reorganization of the injured brain and for the development of improved therapeutic procedures in the cognitive rehabilitation of brain injured patients. A key feature of the model is that the "reprogramming" of the injured brain depends crucially on the feedback to the patient in the specific training situation. The resultant cognitive strategies may lead to proficient task solutions in the training situation (e.g. in the clinical setting) while not being able to generalize to the daily life of the patient. It is therefore important to develop more "ecologically valid" training methods in the therapeutic settings and to continue the rehabilitative training into the daily life of the patient. The use of advanced technologies is one of the promising ways to "bring reality into the institution" and to "bring training into the real world". Frequently, however, traditional methods of training and testing cannot easily be translated into advanced technology applications. Such efforts have to be undertaken as part of a thorough research process. This research process, on the other hand, provides a deeper insight into previously overlooked neural and cognitive mechanisms of the normal and injured brain. It is also possible to achieve an improved generalization from clinical training to reallife situations by specifically aiming the training at the development of what is in the REF-model called Algorithmic Modules (AMs). An AM participates in many different cognitive programmes (each of which is related to a specific task). Rehabilitative training aimed at improving AMs can therefore give the patient basic mechanisms, which can be applied broadly. The REF-model stresses that the prognosis regarding posttraumatic cognitive rehabilitation depends significantly on the pretraumatic experience of the patient. And that the rehabilitative training has to be tailored to the "cognitive profile" of the patient. The REF-model reconciles the concepts of "functional localization" and "functional recovery" by describing a connectionist network (with a high flexibility and potential for reprogramming) within which the basic units are strictly localized basic information processing units. This theoretical reconceptualisation highlights important challenges to neurorehabilitation and points the way towards an improved clinical practise,
| Originalsprog | Engelsk |
|---|---|
| Titel | Brain Damage : Causes, Management and Prognosis |
| Redaktører | Aleric J. Schäfer, Johann Müller |
| Udgivelsessted | Hauppauge, NY |
| Forlag | Nova Science Publishers |
| Publikationsdato | sep. 2012 |
| Sider | 1-40 |
| Kapitel | 1 |
| Status | Udgivet - sep. 2012 |
Emneord
- Det Samfundsvidenskabelige Fakultet
- Hjerne
- hjernens plasticitet
- Hjerneskade
- Rehabilitering
- Funktionel genopretning
- REF-modellen
- Neural plasticitet
- neural organisation
- Kognition
- Problemløsning
- Indlæring
- Hukommelse
- Hjerneskadebehandling
- genopretning