Critical Period After Stroke Study (CPASS): A phase II clinical trial testing an optimal time for motor recovery after stroke in humans.

Aged Case-Control Studies Female Follow-Up Studies Humans Male Middle Aged Motor Activity / physiology Prognosis Prospective Studies Recovery of Function Stroke / therapy Stroke Rehabilitation / methods
critical period neuronal plasticity stroke stroke rehabilitation time factors

Journal

Proceedings of the National Academy of Sciences of the United States of America
ISSN: 1091-6490
Titre abrégé: Proc Natl Acad Sci U S A
Pays: United States
ID NLM: 7505876

Informations de publication

Date de publication:
28 09 2021
Historique:
accepted: 23 07 2021
entrez: 21 9 2021
pubmed: 22 9 2021
medline: 8 10 2021
Statut: ppublish

Résumé

Restoration of human brain function after injury is a signal challenge for translational neuroscience. Rodent stroke recovery studies identify an optimal or sensitive period for intensive motor training after stroke: near-full recovery is attained if task-specific motor training occurs during this sensitive window. We extended these findings to adult humans with stroke in a randomized controlled trial applying the essential elements of rodent motor training paradigms to humans. Stroke patients were adaptively randomized to begin 20 extra hours of self-selected, task-specific motor therapy at ≤30 d (acute), 2 to 3 mo (subacute), or ≥6 mo (chronic) after stroke, compared with controls receiving standard motor rehabilitation. Upper extremity (UE) impairment assessed by the Action Research Arm Test (ARAT) was measured at up to five time points. The primary outcome measure was ARAT recovery over 1 y after stroke. By 1 y we found significantly increased UE motor function in the subacute group compared with controls (ARAT difference = +6.87 ± 2.63,

Identifiants

DOI: 10.1073/pnas.2026676118 PMID: 34544853 PMC: PMC8488696
pubmed: 34544853
pii: 2026676118
doi: 10.1073/pnas.2026676118
pmc: PMC8488696
pii:
doi:

Types de publication

Clinical Trial, Phase II Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : NIDCD NIH HHS
ID : R01 DC016902
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2 TR001432
Pays : United States
Organisme : NINDS NIH HHS
ID : U24 NS107222
Pays : United States
Organisme : NICHD NIH HHS
ID : K12 HD093427
Pays : United States
Organisme : NIDCD NIH HHS
ID : K18 DC014558
Pays : United States
Organisme : NIMH NIH HHS
ID : T32 MH019942
Pays : United States

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2021 the Author(s). Published by PNAS.

Déclaration de conflit d'intérêts

The authors declare no competing interest.

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Auteurs

Alexander W Dromerick (AW)

Research Division, MedStar National Rehabilitation Hospital, Washington, DC 20010.
Center for Brain Plasticity and Recovery, Departments of Rehabilitation Medicine and Neurology, Georgetown University Medical Center, Washington, DC 20057.

Shashwati Geed (S)

Research Division, MedStar National Rehabilitation Hospital, Washington, DC 20010.
Center for Brain Plasticity and Recovery, Departments of Rehabilitation Medicine and Neurology, Georgetown University Medical Center, Washington, DC 20057.

Jessica Barth (J)

Research Division, MedStar National Rehabilitation Hospital, Washington, DC 20010.
Program in Physical Therapy, Washington University in St. Louis, St. Louis, MO 63110.

Kathaleen Brady (K)

Research Division, MedStar National Rehabilitation Hospital, Washington, DC 20010.

Margot L Giannetti (ML)

Research Division, MedStar National Rehabilitation Hospital, Washington, DC 20010.

Abigail Mitchell (A)

Research Division, MedStar National Rehabilitation Hospital, Washington, DC 20010.

Matthew A Edwardson (MA)

Center for Brain Plasticity and Recovery, Departments of Rehabilitation Medicine and Neurology, Georgetown University Medical Center, Washington, DC 20057.

Ming T Tan (MT)

Center for Brain Plasticity and Recovery, Departments of Rehabilitation Medicine and Neurology, Georgetown University Medical Center, Washington, DC 20057.
Department of Biostatistics, Bioinformatics & Biomathematics, Georgetown University Medical Center, Washington, DC 20057.

Yizhao Zhou (Y)

Department of Biostatistics, Bioinformatics & Biomathematics, Georgetown University Medical Center, Washington, DC 20057.

Elissa L Newport (EL)

Center for Brain Plasticity and Recovery, Departments of Rehabilitation Medicine and Neurology, Georgetown University Medical Center, Washington, DC 20057; eln10@georgetown.edu.
ORCID: 0000-0002-2783-5062

Dorothy F Edwards (DF)

Department of Kinesiology, University of Wisconsin-Madison, Madison, WI 53706.
Department of Medicine, University of Wisconsin-Madison, Madison, WI 53706.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Critical Period After Stroke Study (CPASS): A...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études cas-témoins › Critical Period After Stroke Study (CPASS): A...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › Critical Period After Stroke Study (CPASS): A...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Critical Period After Stroke Study (CPASS): A...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Critical Period After Stroke Study (CPASS): A...
questionsmedicales.fr › Phénomènes physiologiques de l'appareil locomoteur et du système nerveux › Phénomènes physiologiques du système locomoteur › Mouvement › Activité motrice › Critical Period After Stroke Study (CPASS): A...
questionsmedicales.fr › Diagnostic › Pronostic › Critical Period After Stroke Study (CPASS): A...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Critical Period After Stroke Study (CPASS): A...
questionsmedicales.fr › Phénomènes biologiques › Récupération fonctionnelle › Critical Period After Stroke Study (CPASS): A...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Critical Period After Stroke Study (CPASS): A...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Réadaptation › Rééducation neurologique › Réadaptation après un accident vasculaire cérébral › Critical Period After Stroke Study (CPASS): A...