http://journals.sagepub.com/doi/abs/10.1177/1073858417737486
Abstract
More
than 1.5 million people suffer a stroke in Europe per year and more
than 70% of stroke survivors experience limited functional recovery of
their upper limb, resulting in diminished quality of life. Therefore,
interventions to address upper-limb impairment are a priority for stroke
survivors and clinicians. While a significant body of evidence supports
the use of conventional treatments, such as intensive motor training or
constraint-induced movement therapy, the limited and heterogeneous
improvements they allow are, for most patients, usually not sufficient
to return to full autonomy. Various innovative neurorehabilitation
strategies are emerging in order to enhance beneficial plasticity and
improve motor recovery. Among them, robotic technologies, brain-computer
interfaces, or noninvasive brain stimulation (NIBS) are showing
encouraging results. These innovative interventions, such as NIBS, will
only provide maximized effects, if the field moves away from the
“one-fits all” approach toward a “patient-tailored” approach. After
summarizing the most commonly used rehabilitation approaches, we will
focus on NIBS and highlight the factors that limit its widespread use in
clinical settings. Subsequently, we will propose potential biomarkers
that might help to stratify stroke patients in order to identify the
individualized optimal therapy. We will discuss future methodological
developments, which could open new avenues for poststroke
rehabilitation, toward more patient-tailored precision medicine
approaches and pathophysiologically motivated strategies.
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