Regenerative Rehabilitation

Regenerative rehabilitation is the combination of regenerative biology and physical therapy approaches. While cell, extracellular matrix and growth factors support the self-repair of damaged tissues, therapeutic exercise and stimulation approaches, robotic and other assistive devices guide the healing process and restore functionality. Classical physical therapy methods such as mechanical, thermal and electrical stimulation also contribute to the growth and development of stem cells in the laboratory environment. Close collaboration between rehabilitation medicine and regenerative medicine, both at the laboratory and clinical level, is essential for the best results.

Skeletal Muscles

Biological skeletons that facilitate the construction of the extracellular matrix are being investigated to ameliorate the loss of muscle mass. When extracellular matrix is ​​transferred to severely damaged muscle tissue, positive effects such as muscle tissue growth, increase in nerve tissue regeneration, and improvement in nerve conduction in the affected area have been observed. Mechanical, thermal and electrical stimuli are given for cell culture and proper development of tissues in the laboratory. After transplantation, physical activity and rehabilitation are essential for the cells to take hold.

Brain Plasticity

The combined use of robotic devices , stem cell therapies , and brain-computer interface technologies may be effective in the treatment of stroke-related hemiplegia . Although the optimal rehabilitation strategy after stroke is still not clear, it is thought that robotic devices provide ample repetitions, high precision, personalized difficulty level and purposeful exercises can increase the recovery rate. Although there is supporting evidence in this direction, more studies are needed.

Animal experiments allow to investigate the combined effect of stem cell transplantation and physical therapy in recovery after brain injury. Animals are used for many experiments that cannot be performed on humans. For example, in an experiment on mice, stem cell transplantation and treadmill training after brain injury were found to be more effective than stem cell transplantation alone. In mice that received physical therapy, stem cells spread more to the nervous system, gave longer branches, and made more connections. Functionally, these mice improved more. 

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Bone

The possibilities of regenerative medicine in bone fractures and losses are being investigated intensively. Rehabilitation strategies such as weight bearing time, ultrasound therapy, low-intensity mechanical stimulation, cellular, genetic and biological regenerative medicine strategies are some of the areas that are subject to studies in orthopedic rehabilitation. In vitro experiments and animal experiments show promise for the combination of regenerative medicine and rehabilitation medicine.

Mesenchymal stem cell transplantations , which are frequently used as a non-operative method to solve the pain and limitation of movement caused by knee calcification (osteoarthritis) , may give better results if combined with rehabilitation. 

Conclusion

We can liken regenerative medicine methods to plowing and fertilizing the soil. Especially the nervous tissue has a low self-repair capacity under normal conditions. Tissue loss may also hinder healing in large muscle and bone mass losses. Tools such as stem cells, growth factors, extracellular matrix skeletons promote tissue self-renewal. That is, he ploughs the field, fertilizes, sows the seeds. However, in order to create a beautiful garden at the end of the job, weeding, pruning of growing plants and landscaping are necessary. Physical therapy and rehabilitation is like gardening in this respect. If the right movements and exercises are done for a sufficient time and intensity, if appropriate sensory stimuli are given, and if appropriate devices are used to balance the weak and strong sides of the body, an improvement in the desired direction will occur.

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