JNER at 15 years: analysis of the state of neuroengineering and rehabilitation.

On JNER's 15th anniversary, this editorial analyzes the state of the field of neuroengineering and rehabilitation. I first discuss some ways that the nature of neurorehabilitation research has evolved in the past 15 years based on my perspective as editor-in-chief of JNER and a researcher in the field. I highlight increasing reliance on advanced technologies, improved rigor and openness of research, and three, related, new paradigms - wearable devices, the Cybathlon competition, and human augmentation studies - indicators that neurorehabilitation is squarely in the age of wearability. Then, I briefly speculate on how the field might make progress going forward, highlighting the need for new models of training and learning driven by big data, better personalization and targeting, and an increase in the quantity and quality of usability and uptake studies to improve translation.

[Neuropsychological rehabilitation in the 20th century]. / La rehabilitación neuropsicológica en el siglo XX.

INTRODUCTION: The first documents describing techniques and procedures to improve the cognitive functioning of people with brain injuries date back to the 17th century. Yet, governments show little interest in it and allocate scarce economic, personal and material resources, possibly because of the high mortality rate associated with brain injuries and the limited life expectancy of those who survive. It was not until the 20th century that neuropsychological rehabilitation, as it is conceived today, took its first steps. DEVELOPMENT: The evolution of neuropsychological rehabilitation over the last century can be structured in three periods: establishment, expansion and consolidation. The first two are closely related to the procedures developed in times of war (mainly the First and Second World Wars), and the period of consolidation is linked with the transfer of the advances made in the military field to the civilian population and the advent of digital technologies in cognitive rehabilitation. CONCLUSIONS: The history of neuropsychological rehabilitation in the 20th century shows two major conceptual changes, linked to profound modifications in the welfare policies deployed by various Western governments. The first took place during the First World War, when, in response to the growing number of veterans with brain injuries, governments decided to set up neurorehabilitation centres. And the second occurred in the 60s and 70s, when different governments transferred and generalised the advances achieved in the military sphere to the civilian population.

TITLE: La rehabilitación neuropsicológica en el siglo XX.Introducción. Los primeros documentos que describen técnicas y procedimientos para mejorar el funcionamiento cognitivo de las personas con lesiones cerebrales datan del siglo XVII. Sin embargo, los gobiernos apenas muestran interés y destinan escasos recursos económicos, personales y materiales, posiblemente por la elevada tasa de mortalidad asociada a las lesiones cerebrales y la limitada esperanza de vida de quienes sobreviven. No es hasta el siglo XX cuando la rehabilitación neuropsicológica, como se concibe actualmente, da sus primeros pasos. Desarrollo. La evolución de la rehabilitación neuropsicológica en el transcurso del pasado siglo puede estructurarse en tres períodos: período constitutivo, período de expansión y período de consolidación. Los dos primeros se relacionan estrechamente con las intervenciones desarrolladas en tiempos de guerra (Primera y Segunda Guerra Mundial, principalmente), y el período de consolidación, con la transferencia de los avances logrados en el ámbito militar a la población civil y la irrupción de las tecnologías digitales en rehabilitación cognitiva. Conclusiones. La historia de la rehabilitación neuropsicológica del siglo XX muestra dos grandes cambios conceptuales, ligados a profundos cambios en las políticas asistenciales desplegadas por diversos gobiernos occidentales. El primero tiene lugar durante la Primera Guerra Mundial, cuando, en respuesta al creciente número de veteranos con lesiones cerebrales, los gobiernos optan por crear centros de neurorrehabilitación. Y el segundo, en las décadas de los años sesenta y setenta, cuando distintos gobiernos transfieren y generalizan a la población civil los avances logrados en la esfera militar.

Ludwig Guttmann's Academic Relationship with Postwar Germany.

Sir Ludwig Guttmann's pioneering work in the treatment of spinal injury not only improved the care for patients with paraplegia up to now but revolutionized basic principles of neurorehabilitation. A wide selection of publications honors the personal and academic life of this singular German neurologist and neurosurgeon of Jewish descent. When the Nazis came into power, Guttmann was dismissed from his hospital workplace, humiliated, and later forced to leave Germany. Surprisingly, after the Second World War, the psychiatrist Friedrich Panse, who had been a member of the Nazi party, initiated Guttmann's academic rehabilitation up to his nomination as emeritus professor of Cologne University in 1964. The present article recounts the difficult academic restitution and poses the question why Guttmann sought to re-establish connections to Germany, a country that had expelled him so harshly some decades before.

Linking spinal cord injury rehabilitation between the World Wars: The R. Tait McKenzie legacy.

Spinal cord injury (SCI) medicine emerged after World War II due to mass casualties, which required specialized treatment centers. This approach to categorical care, however, was first developed during World War I, led by pioneers R. Tait McKenzie and George Deaver, who demonstrated that soldiers disabled by paralysis could return to society through fitness/mobility, recreational and vocational training. McKenzie, a Canadian and the first professor of physical therapy in the US, influenced Deaver and military physicians in Britain, Canada, and the U.S. with his achievements and publications. Although early mortality from SCI was high, advances in the treatment of skin and bladder complications coupled with rehabilitation developed through lessons learned in World War I, resulted in major changes in survival and quality of life for veterans of World War II in England, US, and Canada. Harry Botterell and Al Jousse, founders of Lyndhurst Lodge, the first SCI center in Canada, adopted Deaver's principles and techniques of rehabilitation and Donald Munro's approach to medical complications. The consequences of failing to organize continuity of care in World War I were recognized both by consumers and physicians. Together with John Counsell, a World War II veteran, they formed the Canadian Paraplegic Association, which "revolutionized" the care of veterans with SCI, as well as civilians, women, and children.

[Frenkel: one of the forerunners of neurorehabilitation?]. / Frenkel: un precursor de la neurorrehabilitacion?

Neurorehabilitation is understood as the process intended to reduce the deficiency, limitation of activity and restriction of participation experienced by people as a result of a neurological diseases, and where the professionals involved in this field will aim to reduce the functional involvement degree of the patient. Due to the ignorance existed about the plastic capacity in the nervous system in humans, the scientific origins of neurological rehabilitation is relatively recent, which are located around the Second World War. However, there are signs that the neurologist Heinrich Sebastian Frenkel (1860-1931) was able to establish the basis of neurorehabilitation before that time. There are historical concerning regarding the work conducted and published by Frenkel that would support the hypothesis, based on the characteristics of their treatment employed and documented methodologies, that what he called 'Ubungstherapie' (neurological gymnastic), it could be considered as the basis of what we consider today as modern neurorehabilitation. This knowledge could have been used by many authors who introduced those experiences and lessons learned to the multiple therapeutic methods that emerged after, even the most innovative and technological, while the roots of neurorehabilitation could be found at the end of the 19th century.

TITLE: Frenkel: un precursor de la neurorrehabilitacion?El termino 'neurorrehabilitacion' es entendido como el proceso destinado a reducir la deficiencia, la limitacion de la actividad y la restriccion de la participacion que padecen las personas como consecuencia de una enfermedad neurologica, y en el que los profesionales involucrados en dicho ambito tendran como objetivo la reduccion del grado de afectacion funcional del paciente. Debido al desconocimiento que existio en relacion con la capacidad plastica que presenta el sistema nervioso humano, los origenes cientificos de la rehabilitacion neurologica son relativamente recientes, y se situan alrededor de la Segunda Guerra Mundial. Sin embargo, existen indicios de que el neurologo Heinrich Sebastian Frenkel (1860-1931) pudo establecer las bases de la neurorrehabilitacion antes de esa epoca. En relacion con los trabajos realizados y publicados por Frenkel, existen referentes historicos que apoyarian la hipotesis de que, considerando sus metodologias de tratamiento empleadas y documentadas, lo que denomino Ubungstherapie (gimnasia neurologica) podria considerarse la base de la neurorrehabilitacion moderna. Estos conocimientos pudieron haberse tenido en cuenta por multitud de autores que introdujeron dichas experiencias y aprendizajes en los diversos metodos terapeuticos que surgieron con posterioridad, incluso los mas novedosos y tecnologicos, si bien las raices de la neurorrehabilitacion aplicada podrian encontrarse a finales del siglo XIX.