History of EFNR Teaching Courses on Neurorehabilitation

The over a decade-long history of the European Teaching Courses on Neurorehabilitation highlights the importance of creating platforms for exchanging the latest scientific information, fostering discussions through teaching-oriented workshops, and investigating multimodal approaches for one of the most pressing subjects in neurosciences.  Reaching its 12th edition in 2022, the scientific event is coordinated by Prof. Dafin Muresanu, the President of the European Federation of NeuroRehabilitation Societies (EFNR), as Course Director and Prof. Volker Homberg, the WFNR President Elect, as Co-Chairman, and Prof. Heinrich Binder in the earlier editions. Furthermore, the outstanding event is endorsed by the World Federation of Neurorehabilitation (WFNR) and European Federation of Neurorehabilitation Societies (EFNR) and organized by the Foundation of the Society for the Study of Neuroprotection and Neuroplasticity, together with the Romanian Society of Neurology and “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania.

1st Teaching Course on Neurorehabilitation

The history of the European Teaching Course on Neurorehabilitation began on 8-12 April 2011, in Cluj-Napoca, Romania, when the first course was structured into 3 modules:

• “Basic structure of rehabilitation, Goal finding and monitoring processes and the health model of rehabilitation”
• “Principles of reorganization and recovery of the nervous system, elementary assessment tools and epistemology of neurorehabilitation”
• “Special Topics”.

The first module addressed broad topics from rehabilitation, such as ethical and legal aspects, team organization, and goal setting and monitoring. The second module was structured into two parts and approached neurorehabilitation from the perspective of research and clinical trials, pharmacology, and nursing, defining outcomes and diagnostic tools’ applicability. Finally, the last module brought together romanian speakers to discuss on cortical excitability changes in stroke patients, early neurorehabilitation after stroke, rehabilitation nursing, therapeutic aspects of lumbar sciatica, and pain management.

The complete program and list of speakers can be accessed here.

2nd Teaching Course on Neurorehabilitation

The 2nd teaching course was also set in Cluj-Napoca (Romania) on 24-26 April 2012 and was developed in conjunction with the 1st Congress of the Romanian Society for Neuropsychological Rehabilitation. It began with an introductory course in neurological clinical examination by Prof. Volker Homberg, after which the two modules were introduced:

• “Basic structure of rehabilitation. Goal finding and monitoring processes and the health model of rehabilitation”
• “Principles of Reorganisation and Recovery of the Nervous System and Ways to Influence these Processes, Elementary Assessment Tools and Epistemology of Neurorehabilitation”.

The former addressed topics such as the organization of a rehabilitation team, goal finding and monitoring of the neurorehabilitation process, the bio-psycho-social paradigm, comprehensive approaches to rehabilitation medicine and the definition of outcomes. The latter, set on the 2nd day of the congress, showcased principles of learning, neurorecovery and neuromodulation, World Health Organization (WHO) perspectives on disability, nonpharmacologic treatment for neuropathic pain, and neurorehabilitation, the value of Transcranial Magnetic Stimulation (TMS) for prognostic and diagnosis of motor dysfunctions, pain assessment in the rehabilitation of Parkinson’s disease, functional electrical stimulation in neurological rehabilitation. On the last day of the congress, Klaus von Wild (Germany) offered a keynote lecture on vocational rehabilitation following brain and spinal cord lesions. The day continued with presentations on assessment tools for nursing problems, the role of neuroplasticity, mood and behavior disorders after TBI, mobility impairments in Multiple Sclerosis (MS), Post-stroke rehabilitation, robotic-assisted gait training, right hemisphere stroke syndrome, rehabilitation in disk herniation sciatica, stem cell therapy. Speakers and audience members from multiple countries participated in the scientific event, sharing expertise, discussing pressing topics, and discovering new avenues for neurorehabilitation.

The complete program and list of speakers can be accessed here.

3rd Teaching Course on Neurorehabilitation

On 27-29 June 2013 in Bucharest (Romania), the 3rd Teaching Course of Rehabilitation took place in conjunction with the second European Congress for Neurorehabilitation, with the endorsement of the World Federation of Neurorehabilitation (WFNR) and other European Neurorehabilitation Societies. The events, under the title of “NEUROREHABILITATION IN EUROPE: WHERE ARE WE?”, were addressed to a larger set of scientists and practitioners with an interest in neurorehabilitation (physicians, nurses, therapists, basic scientists etc.), outlining the place of neurorehabilitation in Europe, future perspectives in education and science, and the optimization of services. The introductory session offered a course in neurologic clinical examination by Prof. Volker Hömberg (Germany). Similarly to previous years, the course was also structured into modules:

• “Principles of reorganisation and recovery of the nervous system and ways to influence these processes, elementary assessment tools and epistemology of neurorehabilitation”
• “Special aspects in various diseases and nursing”
• “Basic structure of rehabilitation, Goal finding and monitoring processes and the health model of rehabilitation”
• “Principles of reorganisation and recovery of the nervous system and ways to influence these processes, elementary assessment tools and epistemology of neurorehabilitation”;

The first module showcased neuromodulation, translational neuroscience and basic learning principles. In contrast, the second one tackled topics such as functional rehabilitation for Parkinson’s disease (PD), rehabilitation nursing, functional electrical stimulation for Parkinson’s disease and chronic stroke, medical rehabilitation for the neurogenic bladder, fatigue and therapeutic exercises, and voluntary motor control. The second day introduced the 3rd module, where subjects such as bio-psycho-social paradigms in understanding disease, organisation of rehabilitation teams, goal setting and monitoring, and ethical and legal aspects were discussed. Finally, the 4th and last module of the event showcased international speakers’ presentations on neurological diagnostics tools, peripheral nerve microenvironment, assessment tools and treatment goals in MS, evidence-based medicine and clinical trial design, and assessment tools for nursing problems. The sessions represented an inspiring model of good practices in multidisciplinarity and collaborative approaches.

The complete program and list of speakers can be accessed here.

4th Teaching Course on Neurorehabilitation

The next and 4th edition took place on 26-29 June 2014 in Cluj-Napoca (Romania) and aimed to support the exchange of scientific information and provide space for teaching-oriented workshops, targeting a multidisciplinary audience by focusing on workshops and interactive approaches. The inaugural day introduced the first session, addressing the concepts of evidence-based medicine, motor learning, and neurotechnologies. Further on, Session 2 focused on pharmacological support in neurorehabilitation, the role of neuropeptides and motor rehabilitation, while the 3rd session offered a glimpse into ICF in neurorehabilitation, the use of imaging after ischemic stroke, non-invasive brain stimulation and pain management in stroke. Topics such as endoneurial Microenvironment, fatigue in Parkinson’s disease, neurorehabilitation in Parkinson’s disease, and patient safety in neurorehabilitation were addressed in the 4th and last session of the day. The first day closed with a Cultural Event followed by a Dinner Reception at the National Theater Cluj-Napoca. The second day began with Session 5, which introduced the large subject of Parkinson’s disease with topics of dopaminergic stimulation, multidisciplinary approaches, recommendations for standardized assessment, and continuous dopaminergic stimulation therapy. During Session 6, the speakers discussed challenges in diagnosing vertigo patients, gait and posture, and musculoskeletal requirements. In contrast, session 7 approached thiamine derivatives as therapeutic approaches, antioxidant agents, and neurological complications in diabetes. Session 8, the last of the day, discussed mobility and walking ability in Multiple Sclerosis (MS) patients, rehabilitation in MS, goal setting and monitoring, and early rehab for brain injury. On the 28th of June, the interactiveness of the event was showcased through two workshops:

• “EU Project BMBS COST BM1101 ACTION – Romanian Network for the Study of Dystonia” moderated by Prof. Ovidiu Băjenaru
• “Neurorehabilitation in Parkinson’s Disease – the Caregivers’ Perspective”, moderated by Prof. Mihaela Simu & Prof. Aurora Constantinescu.

Finally, to highlight the hands-on perspective on neurorehabilitation, the 4th edition closed with a Visit to Regional Excellence Center in Neurorehabilitation – Rehabilitation Hospital.

The complete program and list of speakers can be accessed here.

5th Teaching Course on Neurorehabilitation

2015 showcased the 5th edition of the European Teaching Course on Neurorehabilitation in conjunction with the 14th Congress of the European Society for Clinical Neuropharmacology as “RoNeuro Brain Days”. During 1-4 June, in Cluj-Napoca (Romania), the much-expected event included 7 sessions on the first day, the initial one addressing diabetic brain-potential neurorestorative therapeutic approaches, Exosomes and microRNAs, and co-ultramicronized palmitoylethanolamide/luteolin. Further on, the second session approached neurootology, motor rehabilitation, and robots in neurorehabilitation. Next, Session 3 addressed ALS, autonomous systems in early rehabilitation, and early rehabilitation in neurodegenerative diseases. For the 4th session, speakers discussed the management of dysphagia after stroke, pressure ulcers in the early phase after stroke, and post-stroke non-invasive brain stimulation, while the 5th session highlighted neurorehabilitation in patients with focal dystonia, vascular Parkinsonism, pain and sleep disturbances in PD. Moreover, Session 6 centred around Parkinson’s disease (PD), addressing novel pharmacological approaches, continuous drug delivery in early- and late-stage PD, Levodopa—carbidopa intestinal gel, and brainstem auditory evoked potentials in advanced PD. The last session of the day addressed medically unexplained symptoms in neurology, principles of neurorehabilitation in vestibular system disorders, and clinical research in neurorehabilitation within the framework of evidence-based medicine. The second day of the congress, June 3rd began with session 8. This session covered propaedeutics for rehabilitation in CNS traumatology, nutritional care of neurologically disabled patients, and stroke treatments. The following session, Session 9, showcased insight into TBI research and neurological therapy in maxillofacial surgery. Later on, the 10th session of the event discussed perspectives on diabetic neuropathy and demyelinating polyneuropathies. The session was followed by the 14TH CONGRESS OF EUROPEAN SOCIETY for CLINICAL NEUROPHARMACOLOGY. On the last day, June 4th, the teaching course continued with presentations on neurotrophic factors in post-stroke brain protection and recovery, seizures, and high-density EEG. Further on, several speakers addressed chronic inflammatory demyelinating polyneuropathy, visual symptoms in PD, the role of motor control and eye-hand coordination in neurorehabilitation, and clinical and therapeutic aspects in lumbar sciatica by disc herniation. During session 13, topics of pre- and post-ischemic conditioning, risk factors and secondary prevention of ischemic stroke, motor and pharmacological interventions in stroke rehabilitation, and Transcranial Magnetic Stimulation (TMS) were discussed by speakers from the Republic of Moldova, while the last session of the day covered chronic migraine, altered states of consciousness and epidemiology of MS in the Republic Of Moldova. Within the 14th session, the 2015 edition presented novel approaches to rehabilitation, uncovered inspiring aspects related to the brain’s restorative functions, underlined the importance of new technologies for neurorehabilitation, showcased relevant findings in some of the most challenging neurologic pathologies, and once again underlined the importance of multimodal approaches to neurorehabilitation.

The complete program and list of speakers can be accessed here.

6th Teaching Course on Neurorehabilitation

In 2016, the much-expected 6th European Teaching Course on Neurorehabilitation under “RoNeuro Brain Days” took place on 1-3 June 2016 in Cluj-Napoca, Romania. The event opened, on June 1st, with a presentation by Prof. Volker Homberg (Germany) on WFNR and EFNRS activities update and European Curriculum for Residency Training in Neurorehabilitation, followed by the first session also on updates and critical concepts in neurorehabilitation and shifting paradigms in brain protection and recovery. Additionally, the following session discussed the roles of restoration versus compensation, motor learning and biomarkers. Later on, individualized rehabilitation and saccades’ role in movement disorders and surgical approaches were discussed. The event continued with insights into neuromodulation, assessment of diminished states of consciousness, and epilepsy as a dynamic disorder of neural networks. For Session 5, discussions centred around the subjects of vascular cognitive disorder inherited small vessel diseases, modulation of cerebral microvessel structure and permeability in vascular cognitive impairment, co-ultramicronized palmitoylethanolamide/luteolin promotes oligodendrocyte maturation, precursor cell survival, and autoimmune encephalomyelitis. For Session 6, Romanian speakers presented the role of antioxidants in neurorehabilitation, Benfotiamine’s therapeutic potential, and electroneuromyography in evaluating peripheral nerve lesions’ outcomes. Later on, during session 7, current concepts on Guillain-Barré syndrome, orthostatic hypotension in PD, and gait disturbances in PD were discussed. The last session of the day introduced novel approaches to Functional Magnetic Stimulation in neurorehabilitation, the effects of aerobic training after stroke, and the modulation of water buffering as a treatment option for oedema in ischemic stroke. For the 2nd day, speakers from Rep. of Moldova covered presentations on brain neuroplasticity in acute ischemic stroke, intravenous thrombolysis in acute ischemic stroke, and pathogenic aspects of ischemic stroke in patients with metabolic syndrome. Later in the day, Session 10 showcased the works of Romanian speakers on secondary post-stroke prevention and neurorehabilitation, Modern interventional treatment in acute stroke in Romania, and management of osteoporosis and fracture in neurological pathology. In the 11th session, Natan Bornstein (Israel) offered an INTRODUCTION TO THE ESO EAST PROGRAM, after which speakers discussed national stroke registries, the Romanian stroke registry, stroke peculiarities in Moldova’s population, and the Moldavian Republic stroke registry. The day ended with Session 12, where inspiring research trials (CARS trial, CREGS-S trial) were discussed, and future directions for acute stroke therapy were presented. The once again inspiring presence of the European Teaching Course on Neurorehabilitation on the scene of educational events in Neurosciences highlighted the fact that only through concentrated efforts, the dissemination of knowledge, and encouragement of diverse perspectives, research, education, as well as clinical practice can be improved, and new standards for rehabilitation can be put forward.

The complete program and list of speakers can be accessed here.

7th Teaching Course on Neurorehabilitation

The 7th European Teaching Course on Neurorehabilitation, under the already-established name of “RoNeuro Brain Days”, was set on 30 June – 2 July 2017 on the shores of the Black Sea at Eforie Nord (Romania). In the introduction, Prof. Volker Homberg (Germany) and Prof. Dafin F. Mureșanu (Romania) discussed WFNR updates and educational programs. Following their presentation, the first sessions of the teaching course were introduced, covering the state of neurorehabilitation and motor therapies. Moreover, Session 3 showcased an interactive debate entitled “Should neurorehabilitation after stroke start in the immediate post-acute stage?” with the “pro” side being represented by Prof. Dafin Mureșanu (Romania) and the counter-narrative by Prof. Volker Hömberg (Germany). The later sessions highlighted insightful perspectives on rehabilitation of stroke in the elderly, treatment of delirium, modular concepts in neurorehabilitation, status epilepticus, and the neurobiology and impact of vascular cognitive impairment. The 4th Session was parallelled with another session covering presentations on the N-PEP research trial. The 2nd day began with inspiring presentations of respected international speakers on non-kinesis physical therapy interventions, the burden and quality of life in caregivers of MS persons, experimental autoimmune encephalomyelitis, and multidimensional strategies to improve TBI clinical research. Further on, Session 6 centred itself around TBI translational research, unresponsive wakefulness syndrome and minimally conscious state, and the management of dystonia, while the following Session introduced topics such as REM – Sleep behavior disorder in PD, restless leg syndrome, chronic inflammatory demyelinating polyradiculoneuropathy, and Ischemic preconditioning of the spinal cord. The topics of spasticity, patient safety and education, cerebral vein and dural sinus thrombosis, sensory/motor therapy in children with cerebral palsy, neurorehabilitation in neurooncology, and cognitive decline after stroke were then discussed. The day ended with a Special Session dedicated to STROKE MANAGEMENT, where speakers discussed antiplatelet therapy for secondary stroke prevention, NOACs for stroke prevention in atrial fibrillation, cryptogenic stroke and embolic stroke of undetermined source (ESUS), and finally, the importance of innovative registry studies.

The complete program and list of speakers can be accessed here

8th Teaching Course on Neurorehabilitation

In 2018, the European Teaching Course on Neurorehabilitation reached its 8th edition, occurring from 29 of June to 1st of July. Again, the shores of the Black Sea hosted an inspiring educational event. The first day began with a JOINT WFNR/EFNR PRESIDENTIAL SESSION, followed by a remembring of Anna Liese Christensen. Further on, multidisciplinary topics were introduced, including neurorehabilitation after stroke, proportional recovery, physical therapy, robotic therapy, pain in neurorehabilitation, clinical assessment instruments for neuromotor and cognitive-functional deficits post-TBI, clinical research within the framework of evidence-based medicine, ICU acquired weakness, rehabilitation in functional neurological disorders in children, gerontechnology for older stroke patients. Moreover, the subject of N-PEP was again showcased through presentations on the neuropharmacology of N-PEP type peptides in neurocognitive impairment, a combined assessment of the effects of N-Pep-12, The role of N-PEP peripheral magnetic stimulation in neurorehabilitation after surgery of developmental maxillofacial deformities and The impact of N-PEP peptides on cognitive functions after traumatic brain injuries. The first day ended with an EFNR PRESIDIUM MEETING. On the second day, June 30th, Session 4 showcased a wide array of topics related to stroke, from non-invasive brain stimulation, TMS-induced brain neuroplasticity, and aphasias, to imaging of acute stroke. Later on, Session 5 allowed for fresh perspectives on neurological rehabilitation of the elderly, the management of Parkinson’s disease, The peculiarities in neurorehabilitation of patients with MS, and clinical and electrophysiological approaches to neuromuscular junction disorders. In contrast, Session 6 introduced minimal conscious state, vascular epilepsy and autoimmune encephalomyelitis. Later on during the day, session 7 covered the role of arts in neurorehabilitation, targeted nutrition, complex monitoring and specific therapies in early rehabilitation and classification and clinical manifestations of ischemic circulatory disorders of the spinal cord; during Session 8, speakers discussed vascular remodelling in the neurovascular unit in tissue recovery to ischemic injury successful recovery after stroke and biological agents in pharmacology neurorehabilitation, and the roles of placebo and nocebo. Post-stroke neurorehabilitation, leadership in medicine, and rare neurologic diseases were approached. The event came to an end with the last session, covering multimodal approaches on a much more comprehensive range of topics, including women and stroke, the Romanian Stroke Registry, The registry of stroke care quality (RES-Q), the role of vascular imaging in stroke, stroke risk factors among stroke patients, and the role of national stroke registries. The 8th edition highlighted the developments in research and clinical practice in better understanding the brain and the process of neurorehabilitation and offered the audience an in-depth understanding of complex yet vital concepts in neuroscience.

The complete program and list of speakers can be accessed here.

9th Teaching Course on Neurorehabilitation

The year 2019 hosted the 9th edition of the Teaching Course on 6 – 7 July 2019, on the picturesque sceneries from Poiana Brasov, Romania. The 1st day hosted international speakers from Romania, Germany, and Austria, addressing, in the first session, barriers to neurorehabilitation, Virtual Reality (VR) therapies in motor learning for young populations, and the role of music in neurorehabilitation. Further on, in session 2, the speakers discussed robotic therapy, the role of enriched environments for severely affected patients, and the art of neurological examination. The second day of the teaching course covered sessions 3 to 6. In Session 3, the presentations focused on the diagnosis and management of hemiplegic shoulder pain, the role of biomarkers in post-stroke rehabilitation and its future, and pharmacological treatments. Later on, speakers approached topics such as tPA fibrinolysis, the role of modulation for the recovery of stroke, avoiding pitfalls of diagnostics for DOC, and treatment challenges in post-stroke cognitive impairment and dementia. For session 5, the topics discussed covered methodological challenges and advances in clinical research, rTMS therapy after stroke, new advances in gait rehabilitation in Parkinson’s disease, and early rehabilitation for disorders of consciousness, while for the last session of the day, speakers discussed post-stroke dysphagia, neurorehabilitation in older people, and leadership in medicine and management. Neurorehabilitation is a complex pursuit bringing together a wide set of sciences (neurology, psychiatry, computer science), applicative pursuits (engineering) and humanities (arts, psychology, sociology) to direct the efforts into not only managing symptoms and sequelae of the patients but rather improving their lives and future perspectives.

The complete program and  the list of speakers can be accessed here.

10th Teaching Course on Neurorehabilitation

The 10th EUROPEAN TEACHING COURSE on NEUROREHABILITATION took place on 4 – 5 SEPTEMBER in 2020 and was hosted as a Virtual Event due to the complications of the pandemic. The event began with an incursion into biomarkers in stroke rehabilitation, restoration versus compensation in motor rehabilitation, developments for TBI clinical research, and the role of the multimodal approach. In contrast, session 2 approached different topics, such as post-stroke cognitive impairment and dementia, avoiding pitfalls in diagnosing DOC, and the role of the visual system and neurocognitive function to support neurorehabilitation technic development. For the 3rd session, the inspiring international speakers covered the treatment of spasticity, gait rehabilitation, the insights of building a neurotrauma program and forming a multidisciplinary neurotrauma team, and post-stroke rehabilitation. Further on during the event, for the 4th session, speakers approached new avenues in stroke rehabilitation, the evaluation of morbidities in patients with severe brain injury, and motivational aspects in neurorehabilitation and neurorehabilitation in the times of SARS-COV-2. The second day of congress started with insightful presentations from the 4th and 5th sessions on general neurology, vertigo, and peripheral neuropathy. The 6th session discussed spot diagnosis in neurology, while for the 7th session, Romanian speakers approached local case presentations from participants, with each speaker highlighting 3 cases. For the last session, pain management, virtual reality in cognitive rehabilitation, and consciousness were discussed. Considering the difficult period of the COVID-19 pandemic and the challenges it brought upon the medical and especially research community, the dissemination of knowledge and common work towards reaching innovative solutions were needed more than ever. Even though the in-person interactions were limited, by adapting to the online environment and supporting the development of science and education in neurorehabilitation (as well as in other domains), the difficult times were overcome, and the  limitations of the situation pushed towards fostering creativity to find innovative solutions to go beyond difficulties and limitations.

The complete program and list of speakers for the 10th edition can be accessed here.

11th Teaching Course on Neurorehabilitation

The 11th and most recent edition of the European Teaching Course on Neurorehabilitation took place on 17-18 September 2021, again as a Virtual Event.  For the 1st session, high-level international speakers presented insights on impairment-oriented post-stroke rehabilitation, monomodal versus multimodal drugs for the recovery of the brain, electromagnetic field stimulation for recovery after stroke, and the multidimensional approach in TBI clinical research. Next on, the event showcased applications for non-invasive brain stimulation in rehabilitation, treatment challenges in post-stroke cognitive impairment and dementia, the treatment of disorders of consciousness after stroke, and impairment-oriented therapy. In contrast, during Session 3, speakers highlighted a new program of e-learning for clinical evaluation and prognostic of pathological awakening from a coma, the role of empathy in neurorehabilitation, and new evidence for neurorehabilitation, while Session 4 focused on vagus nerve stimulation and deep brain stimulation for motor recovery after stroke, the process of planning brain stimulation stroke motor recovery trial, and the future of stroke rehabilitation in 2030. The 2nd day, 18 September 2021, began with session 5, which offered an insight into the EAN-EFNR guidelines for neurorecovery after stroke, the role of games in neurorehabilitation, creativity and science, and noninvasive neuromodulation for post-stroke rehabilitation. Further on, Session 6 discussed clinical and radiology markers in multiple sclerosis, noninvasive brain stimulation, assessment and rehabilitation in spine/cord meningiomas, fatigue and exercises for patients with neurologic disabilities. Session 7 covered general neurology, vertigo, and case presentations on stroke. Later on, in Session 8, 3 speakers had individual presentations on how to make a spot diagnosis in Neurology.

The complete program and list of speakers can be accessed here.

The history of the European Teaching Course on Neurorehabilitation highlights the importance of adapting to difficult contexts, pursuing the development of science, combining strong scientific findings with creative approaches, and understanding neurorehabilitation from multimodal perspectives. In the years to come, we hope to host many more editions of the teaching course and expand our perspectives through academic products even more, as science and technology progress at a faster pace than ever, and new avenues are discovered every day.