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Chapter 23 - Evidence-based Motor Rehabilitation after Stroke

from Part VI - Stroke Rehabilitation and Recovery

Published online by Cambridge University Press:  15 December 2020

Jeffrey L. Saver
Affiliation:
David Geffen School of Medicine, University of Ca
Graeme J. Hankey
Affiliation:
University of Western Australia, Perth
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Summary

Worldwide, stroke is a most common disabling disorder that requires rehabilitation services if curative and preventive treatments fail. There is growing evidence that intensive rehabilitation offered by a multidisciplinary team is effective to improve outcome in terms of independent daily living and health–related quality of life. This conclusion is based on systematic reviews and recent pragmatic phase III and IV trials. Although intensity of practice is an important part of effective stroke care, very early mobilization should be restricted and applied in small doses within 24 hours post-stroke. Systematic review shows that evidence-based therapies for the upper limb are constraint–induced movement therapy and upper limb robotics, whereas interventions that could be beneficial to gait include fitness training and high-intensive, task-specific training. A number of novel therapies, such as combining exercise therapy with transcranial direct current stimulation, repetitive transcranial magnetic stimulation or pharmacological interventions, and virtual reality are under way. However, the evidence for most of these therapies is still unclear and in its infancy.

Type
Chapter
Information
Stroke Prevention and Treatment
An Evidence-based Approach
, pp. 485 - 500
Publisher: Cambridge University Press
Print publication year: 2020

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