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01-12-2017 | Cardiovascular Disease and Stroke (S. Prabhakaran, Section Editor)

Early Rehabilitation After Stroke: a Narrative Review

Authors: Elisheva R. Coleman, Rohitha Moudgal, Kathryn Lang, Hyacinth I. Hyacinth, Oluwole O. Awosika, Brett M. Kissela, Wuwei Feng

Published in: Current Atherosclerosis Reports | Issue 12/2017

Abstract

Purpose of Review

Despite current rehabilitative strategies, stroke remains a leading cause of disability in the USA. There is a window of enhanced neuroplasticity early after stroke, during which the brain’s dynamic response to injury is heightened and rehabilitation might be particularly effective. This review summarizes the evidence of the existence of this plastic window, and the evidence regarding safety and efficacy of early rehabilitative strategies for several stroke domain-specific deficits.

Recent Findings

Overall, trials of rehabilitation in the first 2 weeks after stroke are scarce. In the realm of very early mobilization, one large and one small trial found potential harm from mobilizing patients within the first 24 h after stroke, and only one small trial found benefit in doing so. For the upper extremity, constraint-induced movement therapy appears to have benefit when started within 2 weeks of stroke. Evidence for non-invasive brain stimulation in the acute period remains scant and inconclusive. For aphasia, the evidence is mixed, but intensive early therapy might be of benefit for patients with severe aphasia. Mirror therapy begun early after stroke shows promise for the alleviation of neglect. Novel approaches to treating dysphagia early after stroke appear promising, but the high rate of spontaneous improvement makes their benefit difficult to gauge.

Summary

The optimal time to begin rehabilitation after a stroke remains unsettled, though the evidence is mounting that for at least some deficits, initiation of rehabilitative strategies within the first 2 weeks of stroke is beneficial. Commencing intensive therapy in the first 24 h may be harmful.

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Title: Early Rehabilitation After Stroke: a Narrative Review
Authors: Elisheva R. Coleman
Rohitha Moudgal
Kathryn Lang
Hyacinth I. Hyacinth
Oluwole O. Awosika
Brett M. Kissela
Wuwei Feng
Publication date: 01-12-2017
Publisher: Springer US
Published in: Current Atherosclerosis Reports / Issue 12/2017
Print ISSN: 1523-3804
Electronic ISSN: 1534-6242
DOI: https://doi.org/10.1007/s11883-017-0686-6

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Keynote webinar | Spotlight on medication adherence

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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PCSK9 Mutations in Familial Hypercholesterolemia: from a Groundbreaking Discovery to Anti-PCSK9 Therapies

Organic Ion Transporters and Statin Drug Interactions

Review of Cardiometabolic Effects of Prescription Omega-3 Fatty Acids

Community Interventions to Increase Stroke Preparedness and Acute Stroke Treatment Rates

Novel Approaches for HDL-Directed Therapies

Emerging Associations Between Neutrophils, Atherosclerosis, and Psoriasis

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials