Steps to Follow : The Comprehensive Treatment of Patients with Hemiplegia (2nd completely rev. ed. 2000)

A true paradigm shift is taking place in the field of neurology.

Earlier it was regarded as the science of exact diagnosis of incurable illnesses, re­ signed to the dogma that damage to the central nervous system could not be repaired: "Once development is complete, the sources of growth and regeneration ofaxons and dendrites are irretrievably lost.

In the adult brain the nerve paths are fixed and immutable - everything can die, but nothing can be regenerated" (Cajal1928).

Even then this could have been countered with what holds today: rehabilitation does not take place in the test tube, being supported only a short time later by an authoritative source, the professor of neurology and neurosurgery in Breslau, Otfried Foerster.

He wrote a 100-page article about thera­ peutic exercises which appeared in the Handbuch der Neurologie (also published by Springer-Verlag).

The following sentences from his intro­ duction illustrate his opinion of the importance of therapeutic exercises and areclose to our views today (Foerster 1936): "There is no doubt that most motor disturbances caused by lesions of the nervous system are more or less completely compensated as a re­ sult of a tendency inherent to the organism to carry out as expedient­ ly as possible the tasks of which it is capable under normal circum­ stances, using all the forces still available to it with the remaining un­ damaged parts of the nervous system, even following injury to its sub­