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Neurorehabilitation needs a qualitative perspective: a case exemplar from stroke recovery and rehabilitation
Marika Demers1,2, Carolee J Winstein3
1Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada.
Abstract:
Neurorehabilitation is a medical process using neuroplasticity to help people recover from nervous system damage (like stroke, injury or disease) by improving function, independence, and quality of life through therapies (physio, occupational, speech) to retrain the brain and learn new ways to perform daily tasks, addressing physical, cognitive, and emotional needs. This process is shaped by the dynamic interaction of the person, the environment, and the task. Quantitative methods rooted in the science of experience-dependent plasticity, and rigorous clinical trial designs have produced significant advances, including the development of novel neurotechnologies. However, the comprehensive translation of these advances into meaningful outcomes for people living with a neurological condition requires a broader perspective. Central to this perspective is the recognition that the recovery process, includes motor/physical, sensory/perceptual, cognitive, affective, and psychosocial dimensions. We emphasize the integration of qualitative methods into neurorehabilitation research to provide for better translation and a more comprehensive understanding of the process. This perspective is organized into four thematic sections: foundations/current issues; integration of lived experience to improve research and current practice; recommendations for behavioral interventions; and integration of qualitative methods into clinically less mature topics to reveal mechanisms that quantitative data alone cannot capture.
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