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Author Notes:

Correspondence: colemaev@ucmail.uc.edu

Drs. Coleman, Moudgal, Lang, Hyacinth, Awosika, and Feng have nothing to disclose.

Dr. Kissela was a consultant for Ipsen, received fees for adjudication of clinical trial events for AbbVie and Janssen and

Subject:

Research Funding:

Dr. Kissela received grants from the NIH/NINDS.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Peripheral Vascular Disease
  • Cardiovascular System & Cardiology
  • Stroke rehabilitation
  • Early rehabilitation
  • Stroke recovery
  • Neuroplasticity
  • Motor recovery
  • Aphasia
  • RANDOMIZED CONTROLLED-TRIAL
  • DIRECT-CURRENT STIMULATION
  • FOCAL CEREBRAL-ISCHEMIA
  • TRANSCRANIAL MAGNETIC STIMULATION
  • REDUCES INFARCT SIZE
  • NERVE GROWTH-FACTOR
  • MOTOR CORTEX
  • DELAYED REHABILITATION
  • SUBACUTE STROKE
  • BRAIN ISCHEMIA

Early Rehabilitation After Stroke: a Narrative Review

Tools:

Journal Title:

Current Atherosclerosis Reports

Volume:

Volume 19, Number 12

Publisher:

, Pages 59-59

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Purpose of Review: Despite current rehabilitative strategies, stroke remains a leading cause of disability in the USA. There is a window of enhanced neuroplasticity early after stroke, during which the brain’s dynamic response to injury is heightened and rehabilitation might be particularly effective. This review summarizes the evidence of the existence of this plastic window, and the evidence regarding safety and efficacy of early rehabilitative strategies for several stroke domain-specific deficits. Recent Findings: Overall, trials of rehabilitation in the first 2 weeks after stroke are scarce. In the realm of very early mobilization, one large and one small trial found potential harm from mobilizing patients within the first 24 h after stroke, and only one small trial found benefit in doing so. For the upper extremity, constraint-induced movement therapy appears to have benefit when started within 2 weeks of stroke. Evidence for non-invasive brain stimulation in the acute period remains scant and inconclusive. For aphasia, the evidence is mixed, but intensive early therapy might be of benefit for patients with severe aphasia. Mirror therapy begun early after stroke shows promise for the alleviation of neglect. Novel approaches to treating dysphagia early after stroke appear promising, but the high rate of spontaneous improvement makes their benefit difficult to gauge. Summary: The optimal time to begin rehabilitation after a stroke remains unsettled, though the evidence is mounting that for at least some deficits, initiation of rehabilitative strategies within the first 2 weeks of stroke is beneficial. Commencing intensive therapy in the first 24 h may be harmful.

Copyright information:

© 2017, Springer Science+Business Media, LLC.

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