Intensive motor rehabilitation best given two months after stroke onset, study finds
![New research has found that the optimal period for intensive rehabilitation of the upper limb(s) should begin 60 to 90 days after a stroke, as this is the period when adults are most responsive to rehabilitation and are more likely to restore function in the affected limb. The research conducted by US-based Georgetown University Medical Center and MedStar National Rehabilitation Network (NRH) clinicians also found that rehabilitation at six months or more after a stroke had no significant benefit compared to those receiving standard care. Nearly two-thirds of US patients unfortunately do not recover complete motor function post-stroke – in their hands and arms, for example; this impairment can severely limit everyday activities and cause unexplained anguish for the patient and carers. In their attempt to find ways to “make substantial improvements to arm and hand recovery” the clinicians enrolled over 70 stroke participants who received 20 extra hours of activity-focused motor skills therapy, starting at different times after stroke, in addition to their regularly prescribed therapies. This therapy began either at 30 days after their stroke, at 60 to 90 days post-stroke, or at six months or more post-stroke. [These results were compared to a control group that received only their prescribed rehabilitation therapies but no extra motor rehabilitation training.] The improvement in hand and arm function found thereafter was not only statistically significant, but large enough to be perceived as functionally meaningful by the patients themselves. “Our results suggest that more intensive motor rehabilitation should be provided to stroke patients at 60 to 90 days after stroke onset," said Dr. Elissa Newport, Director of the Center for Brain Plasticity and Recovery at Georgetown University Medical Center. "[…] a young developing brain shows great plasticity, compared to other times in life. Our results show that there may be a similar period of heightened plasticity for stroke patients at a specific time after their stroke." Through the study, the clinicians hope to establish a time window in which future research can combine therapy with brain stimulation or medications aimed at helping remaining healthy areas of the brain recover impaired functions or take over functions lost from the damage inflicted by a stroke. They further plan to design a larger clinical trial to determine the optimum dose of therapy to achieve the best effects during this time-sensitive window.](https://sp-ao.shortpixel.ai/client/to_auto,q_glossy,ret_img,w_250,h_190/https://www.healthcareasia.org/wp-content/uploads/2021/09/hands.jpg)
New research has found that the optimal period for intensive rehabilitation of the upper limb(s) should begin 60 to 90 days after a stroke, as this is the period when adults are most responsive to rehabilitation and are more likely to restore function in the affected limb.
The research conducted by US-based Georgetown University Medical Center and MedStar National Rehabilitation Network (NRH) clinicians also found that rehabilitation at six months or more after a stroke had no significant benefit compared to those receiving standard care.
Nearly two-thirds of US patients unfortunately do not recover complete motor function post-stroke – in their hands and arms, for example; this impairment can severely limit everyday activities and cause unexplained anguish for the patient and carers.
In their attempt to find ways to “make substantial improvements to arm and hand recovery” the clinicians enrolled over 70 stroke participants who received 20 extra hours of activity-focused motor skills therapy, starting at different times after stroke, in addition to their regularly prescribed therapies. This therapy began either at 30 days after their stroke, at 60 to 90 days post-stroke, or at six months or more post-stroke.
[These results were compared to a control group that received only their prescribed rehabilitation therapies but no extra motor rehabilitation training.]
The improvement in hand and arm function found thereafter was not only statistically significant, but large enough to be perceived as functionally meaningful by the patients themselves.
Read: New device for stroke rehab receives FDA approval
“Our results suggest that more intensive motor rehabilitation should be provided to stroke patients at 60 to 90 days after stroke onset,” said Dr. Elissa Newport, Director of the Center for Brain Plasticity and Recovery at Georgetown University Medical Center. “[…] a young developing brain shows great plasticity, compared to other times in life. Our results show that there may be a similar period of heightened plasticity for stroke patients at a specific time after their stroke.”
Through the study, the clinicians hope to establish a time window in which future research can combine therapy with brain stimulation or medications aimed at helping remaining healthy areas of the brain recover impaired functions or take over functions lost from the damage inflicted by a stroke. They further plan to design a larger clinical trial to determine the optimum dose of therapy to achieve the best effects during this time-sensitive window.
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