http://journals.sagepub.com/doi/full/10.1177/1545968317732680?
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Lara A. Boyd, PhD1
, Kathryn S. Hayward, PhD2
, Nick S. Ward, MD3
,
1Department of Physical Therapy & the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
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2Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
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3Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
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Cathy M. Stinear, PhD4
, Charlotte Rosso, MD, PhD5
, Rebecca J Fisher, PhD6
, Alexandre R. Carter7
, Alex P. Leff, PhD8
, David A. Copland, PhD9
, Leeanne M. Carey, PhD10
, Leonardo G. Cohen, MD11
, D. Michele Basso, EdD, PT12
, Jane M. Maguire, PhD13
, Steven C. Cramer, PhD14
...
4Department of Medicine and Centre for Brain Research, University of Auckland, Auckland, New Zealand
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5Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, France; AP-HP, Stroke Unit, Pitié-Salpêtrière Hospital, France
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6Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
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7Department of Neurology, Washington University in Saint Louis, St Louis, MO, USA
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8Department of Brain Repair and Rehabilitation, Institute of Neurology & Institute of Cognitive Neuroscience, University College London, Queens Square, London, UK
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9School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia; and University of Queensland Centre for Clinical Research, Brisbane, Australia
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10School of Allied Health, College of Science, Health and Engineering, La Trobe, University, Bundoora, Australia; and Neurorehabilitation and Recovery, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
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11Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
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12School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
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13Faculty of Health, University of Technology Sydney, Ultimo, Sydney, Australia
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14University of California, Irvine, CA, USA; Depts. Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, Irvine, CA, USA
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Article Information
Volume: 31 issue: 10-11, page(s): 864-876
Article first published online: December 12, 2017; Issue published: October 1, 2017
https://doi.org/10.1177/1545968317732680
Lara A. Boyd, PhD1, Kathryn S. Hayward, PhD2, Nick S. Ward, MD3, Cathy M. Stinear, PhD4, Charlotte Rosso, MD, PhD5, Rebecca J Fisher, PhD6, Alexandre R. Carter7, Alex P. Leff, PhD8, David A. Copland, PhD9, Leeanne M. Carey, PhD10, Leonardo G. Cohen, MD11, D. Michele Basso, EdD, PT12, Jane M. Maguire, PhD13, Steven C. Cramer, PhD14
1Department of Physical Therapy & the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
2Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
3Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
4Department of Medicine and Centre for Brain Research, University of Auckland, Auckland, New Zealand
5Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, France; AP-HP, Stroke Unit, Pitié-Salpêtrière Hospital, France
6Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
7Department of Neurology, Washington University in Saint Louis, St Louis, MO, USA
8Department of Brain Repair and Rehabilitation, Institute of Neurology & Institute of Cognitive Neuroscience, University College London, Queens Square, London, UK
9School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, Australia; and University of Queensland Centre for Clinical Research, Brisbane, Australia
10School of Allied Health, College of Science, Health and Engineering, La Trobe, University, Bundoora, Australia; and Neurorehabilitation and Recovery, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
11Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
12School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
13Faculty of Health, University of Technology Sydney, Ultimo, Sydney, Australia
14University of California, Irvine, CA, USA; Depts. Neurology, Anatomy & Neurobiology, and Physical Medicine & Rehabilitation, Irvine, CA, USA
Corresponding Author: boyd@ubc. ca
*This article was first published in International Journal of Stroke 2017, Volume 12, Issue 5, pages 480–493. To request permission to re-use any part of this article, please contact SAGE Publishing: https://uk.sagepub.com/en-gb/eur/journals-permissions.
Lara A. Boyd, PhD, University of British Columbia, 212, 2177 Wesbrook Mall, Vancouver, BC V6T 1Z4, Canada. Email: lara.Abstract
Section:
The most difficult clinical questions in stroke rehabilitation are “What is this patient’s potential for recovery?”(WRONG, WRONG, WRONG; It is how to get 100% recovered) and “What is the best rehabilitation strategy for this person, given her/his clinical profile?” Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy(the focus is simple, 100% recovery), and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not(Stop cherry picking participants for research, everyone deserves 100% recovery). Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process. The goal of the present paper is to provide a consensus statement regarding the current state of the evidence for stroke recovery biomarkers. Biomarkers of motor, somatosensory, cognitive and language domains across the recovery timeline post-stroke are considered; with focus on brain structure and function, and exclusion of blood markers and genetics. We provide evidence for biomarkers that are considered ready to be included in clinical trials, as well as others that are promising but not ready and so represent a developmental priority. We conclude with an example that illustrates the utility of biomarkers in recovery and rehabilitation research, demonstrating how the inclusion of a biomarker may enhance future clinical trials. In this way, we propose a way forward for when and where we can include biomarkers to advance the efficacy of the practice of, and research into, rehabilitation and recovery after stroke.
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