Stroke Rehabilitation and Motor Recovery.
Journal
Continuum (Minneapolis, Minn.)
ISSN: 1538-6899
Titre abrégé: Continuum (Minneap Minn)
Pays: United States
ID NLM: 9509333
Informations de publication
Date de publication:
01 04 2023
01 04 2023
Historique:
medline:
12
4
2023
entrez:
11
4
2023
pubmed:
12
4
2023
Statut:
ppublish
Résumé
Up to 50% of the nearly 800,000 patients who experience a new or recurrent stroke each year in the United States fail to achieve full independence afterward. More effective approaches to enhance motor recovery following stroke are needed. This article reviews the rehabilitative principles and strategies that can be used to maximize post-stroke recovery. Evidence dictates that mobilization should not begin prior to 24 hours following stroke, but detailed guidelines beyond this are lacking. Specific classes of potentially detrimental medications should be avoided in the early days poststroke. Patients with stroke who are unable to return home should be referred for evaluation to an inpatient rehabilitation facility. Research suggests that a substantial increase in both the dose and intensity of upper and lower extremity exercise is beneficial. A clinical trial supports vagus nerve stimulation as an adjunct to occupational therapy for motor recovery in the upper extremity. The data remain somewhat mixed as to whether robotics, transcranial magnetic stimulation, functional electrical stimulation, and transcranial direct current stimulation are better than dose-matched traditional exercise. No current drug therapy has been proven to augment exercise poststroke to enhance motor recovery. Neurologists will collaborate with rehabilitation professionals for several months following a patient's stroke. Many questions still remain about the ideal exercise regimen to maximize motor recovery in patients poststroke. The next several years will likely bring a host of new research studies exploring the latest strategies to enhance motor recovery using poststroke exercise.
Identifiants
pubmed: 37039412
doi: 10.1212/CON.0000000000001218
pii: 00132979-202304000-00014
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
605-627Informations de copyright
Copyright © 2023 American Academy of Neurology.
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