Stroke rehabilitation: strategies to enhance motor recovery. Review uri icon

Overview

abstract

  • Recent evidence indicates that the brain can remodel after stroke, primarily through synaptogenesis. Task-specific and repetitive exercise appear to be key factors in promoting synaptogenesis and are central elements in rehabilitation of motor weakness following stroke. Expert medical management ensures a patient is well enough to participate in rehabilitation with minimal distractions due to pain or depression. Contraint-induced motor therapy and body-weight-supported ambulation are forms of exercise that "force use" of an impaired upper extremity. Technologies now in common use include robotics, functional electrical stimulation, and, to a lesser degree, transcranial magnetic stimulation and virtual reality. The data on pharmacological interventions are mixed but encouraging; it is hoped such treatments will directly stimulate brain tissue to recovery. Mitigation of factors preventing movement, such as spasticity, might also play a role. Research evaluating these motor recovery strategies finds them generally good at the movement level but somewhat less robust when looking at functional performance. It remains unclear whether inconsistent evidence for functional improvement is a matter of poor treatment efficacy or insensitive outcome measures.

publication date

  • January 1, 2009

Research

keywords

  • Motor Skills
  • Stroke Rehabilitation

Identity

Scopus Document Identifier

  • 67650716758

Digital Object Identifier (DOI)

  • 10.1146/annurev.med.60.042707.104248

PubMed ID

  • 18928333

Additional Document Info

volume

  • 60