Saturday, February 23, 2019

Should We Care About Early Post-Stroke Rehabilitation? Not Yet, but Soon

Ask your doctor;  What is the path forward to 100% recovery?

Should We Care About Early Post-Stroke Rehabilitation? Not Yet, but Soon


  • Steven R. ZeilerEmail author
  1. 1.Department of NeurologyJohns HopkinsBaltimoreUSA
Neurorehabilitation and Recovery (J Krakauer and T Kitago, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Neurorehabilitation and Recovery

Abstract

Purpose of Review

Studies in humans and animal models show that most recovery from impairment occurs in the first 1–3 months after stroke as a result of both spontaneous recovery as well as increased responsiveness to enriched environments and training. Improvement from impairment is attributable to a short-lived “sensitive period” of post-stroke plasticity defined by unique genetic, physiological, and structural events. Unfortunately, rehabilitative interventions in humans have not been able to exploit this sensitive period similar to that seen in animal models. Here, we review these data and suggest a path forward.

Recent Findings

Pre-clinical data reveal underlying mechanisms that define the post-stroke sensitive period. These data are then discussed in the context of the spontaneous post-stroke recovery described in humans.

Summary

Future work will need to capitalize on unique interactions between the sensitive period, spontaneous recovery, and novel types of rehabilitative interventions.

Keywords

Stroke Motor recovery Enriched environment Sensitive period Neurological rehabilitation Spontaneous recovery 


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