When should upper limb function be trained after stroke? Evidence for and against early intervention.

Very little time is available for arm and hand training while patients are in hospital after stroke. Therapeutic strategies that use intensive practice in the early days and weeks after stroke may improve the recovery of upper limb function. This paper considers the physiology of the brain in acute stroke and evaluates the evidence for and against early intensive activity of the upper limb as an essential precursor to any decision to invest in increased activity.

[1]  T. Schallert,et al.  Use-dependent structural events in recovery of function. , 1997, Advances in neurology.

[2]  J. Riddoch Evaluation of Physiotherapy for People with Stroke , 1995 .

[3]  J Bamford,et al.  A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981-86. 1. Methodology, demography and incident cases of first-ever stroke. , 1988, Journal of neurology, neurosurgery, and psychiatry.

[4]  Theresa A. Jones,et al.  Overgrowth and pruning of dendrites in adult rats recovering from neocortical damage , 1992, Brain Research.

[5]  C. Weiller Recovery from Motor Stroke: Human Positron Emission Tomography Studies , 1995 .

[6]  T. Neumann-Haefelin,et al.  Increased long‐term potentiation in the surround of experimentally induced focal cortical infarction , 1998, Annals of neurology.

[7]  H. Hummelsheim,et al.  Transcranial magnetic stimulation and motor rehabilitation. , 1999, Electroencephalography and clinical neurophysiology. Supplement.

[8]  D. Graham,et al.  Quantitation of Photochemically Induced Focal Cerebral Ischemia in the Rat , 1988, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[9]  T. Schallert,et al.  Use-Dependent Exaggeration of Brain Injury: Is Glutamate Involved? , 1999, Experimental Neurology.

[10]  R. Schwartz,et al.  Blood pressure changes in acute cerebral infarction and hemorrhage. , 1997, Stroke.

[11]  K. Mauritz,et al.  Repetitive training of isolated movements improves the outcome of motor rehabilitation of the centrally paretic hand , 1995, Journal of the Neurological Sciences.

[12]  Ailie Turton,et al.  The Use of Home Therapy Programmes for Improving Recovery of the Upper Limb following Stroke , 1990 .

[13]  S. Slørdahl,et al.  Treatment in a combined acute and rehabilitation stroke unit: which aspects are most important? , 1999, Stroke.

[14]  R. J. Seitz,et al.  Thalamic metabolism and corticospinal tract integrity determine motor recovery in stroke , 1996, Annals of neurology.

[15]  C. Beaulieu,et al.  Longitudinal magnetic resonance imaging study of perfusion and diffusion in stroke: Evolution of lesion volume and correlation with clinical outcome , 1999, Annals of neurology.

[16]  R N Lemon,et al.  Contralateral and ipsilateral EMG responses to transcranial magnetic stimulation during recovery of arm and hand function after stroke. , 1996, Electroencephalography and clinical neurophysiology.

[17]  R L Hewer,et al.  Development of a neurological rehabilitation environment: an observational study , 1997, Clinical rehabilitation.

[18]  B. Dobkin Activity‐dependent learning contributes to motor recovery , 1998, Annals of neurology.

[19]  G. Schlaug,et al.  Enlargement of human cerebral ischemic lesion volumes measured by diffusion‐weighted magnetic resonance imaging , 1997, Annals of neurology.

[20]  J F Potter,et al.  Which parameters of beat-to-beat blood pressure and variability best predict early outcome after acute ischemic stroke? , 2000, Stroke.

[21]  M. Merzenich,et al.  Reorganization of neocortical representations after brain injury: a neurophysiological model of the bases of recovery from stroke. , 1987, Progress in brain research.

[22]  T. Bliss,et al.  Long‐lasting potentiation of synaptic transmission in the dentate area of the anaesthetized rabbit following stimulation of the perforant path , 1973, The Journal of physiology.

[23]  N B Lincoln,et al.  Comparison of rehabilitation practice on hospital wards for stroke patients. , 1996, Stroke.

[24]  M. Hallett,et al.  Rapid plasticity of human cortical movement representation induced by practice. , 1998, Journal of neurophysiology.

[25]  P. Glees,et al.  RECOVERY OF SKILLED MOTOR FUNCTIONS AFTER SMALL REPEATED LESIONS OF MOTOR CORTEX IN MACAQUE , 1950 .

[26]  J. Krakauer,et al.  Evolution of cortical activation during recovery from corticospinal tract infarction. , 2000, Stroke.

[27]  J. Liepert,et al.  Motor cortex plasticity during constraint-induced movement therapy in stroke patients , 1998, Neuroscience Letters.

[28]  K. Zilles,et al.  Neuronal Hyperexcitability and Reduction of GABAA-Receptor Expression in the Surround of Cerebral Photothrombosis , 1996, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[29]  T. Olsen,et al.  Recovery of upper extremity function in stroke patients: the Copenhagen Stroke Study. , 1994, Archives of physical medicine and rehabilitation.

[30]  T. Jones,et al.  Use-dependent growth of pyramidal neurons after neocortical damage , 1994, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[31]  M. Hallett,et al.  Modulation of muscle responses evoked by transcranial magnetic stimulation during the acquisition of new fine motor skills. , 1995, Journal of neurophysiology.

[32]  G. Hagemann,et al.  Electrophysiological changes in the surrounding brain tissue of photochemically induced cortical infarcts in the rat , 1993, Neuroscience Letters.

[33]  A. Prevo,et al.  The long-term outcome of arm function after stroke: results of a follow-up study. , 1999, Disability and rehabilitation.

[34]  H Asanuma,et al.  Neurobiological basis of motor learning in mammals. , 1997, Neuroreport.

[35]  Orthostatic tolerance training of stroke patients in general medical wards. An experimental study. , 1989 .

[36]  J. H. van der Lee,et al.  Forced use of the upper extremity in chronic stroke patients: results from a single-blind randomized clinical trial. , 1999, Stroke.

[37]  N B Lincoln,et al.  Effect of severity of arm impairment on response to additional physiotherapy early after stroke , 1999, Clinical rehabilitation.

[38]  H. Freund,et al.  The role of diaschisis in stroke recovery. , 1999, Stroke.

[39]  G. Hagemann,et al.  Electrophysiological transcortical diaschisis after cortical photothrombosis in rat brain. , 1996, Stroke.

[40]  N. Hogan,et al.  Robot training enhanced motor outcome in patients with stroke maintained over 3 years , 1999, Neurology.

[41]  J. Keyser,et al.  From stroke unit care to stroke care unit , 1999, Journal of the Neurological Sciences.

[42]  H. Flor,et al.  Plasticity in the motor system related to therapy-induced improvement of movement after stroke. , 1999, Neuroreport.

[43]  C. S. Gray,et al.  Cerebral and systemic pathophysiological responses to acute stroke. , 2000, Age and ageing.

[44]  G. Kwakkel,et al.  Intensity of leg and arm training after primary middle-cerebral-artery stroke: a randomised trial , 1999, The Lancet.

[45]  H. Hummelsheim,et al.  Influence of physiotherapeutic facilitation techniques on motor evoked potentials in centrally paretic hand extensor muscles. , 1995, Electroencephalography and clinical neurophysiology.

[46]  T. Matyas,et al.  Can simultaneous bilateral movement involve the undamaged hemisphere in reconstruction of neural networks damaged by stroke? , 2000, Disability and rehabilitation.

[47]  W. Pulsinelli,et al.  Pathophysiology of acute ischaemic stroke , 1992, The Lancet.

[48]  R. P. Stroemer,et al.  Neocortical neural sprouting, synaptogenesis, and behavioral recovery after neocortical infarction in rats. , 1995, Stroke.

[49]  Dwaine F. Emerich Clinical trials with neuroprotective drugs in acute ischaemic stroke: are we doing the right thing? , 1999 .

[50]  B. Rockstroh,et al.  Increased Cortical Representation of the Fingers of the Left Hand in String Players , 1995, Science.

[51]  R Langton-Hewer,et al.  The hemiplegic arm after stroke: measurement and recovery. , 1983, Journal of neurology, neurosurgery, and psychiatry.

[52]  Leslie G. Ungerleider,et al.  Functional MRI evidence for adult motor cortex plasticity during motor skill learning , 1995, Nature.

[53]  N. Miller,et al.  Technique to improve chronic motor deficit after stroke. , 1993, Archives of physical medicine and rehabilitation.

[54]  E. Taub,et al.  Effects of constraint-induced movement therapy on patients with chronic motor deficits after stroke: a replication. , 1999, Stroke.

[55]  H. Feys,et al.  Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke: a single-blind, randomized, controlled multicenter trial. , 1998, Stroke.

[56]  G. Thickbroom,et al.  Physiological studies of the corticomotor projection to the hand after subcortical stroke , 1999, Clinical Neurophysiology.

[57]  Fausto Viader,et al.  Spontaneous neurological recovery after stroke and the fate of the ischemic penumbra , 1996, Annals of neurology.

[58]  K. Zilles,et al.  Lesion-induced network plasticity in remote brain areas. , 1997, Trends in neurosciences.

[59]  R. Nudo,et al.  Reorganization of movement representations in primary motor cortex following focal ischemic infarcts in adult squirrel monkeys. , 1996, Journal of neurophysiology.

[60]  G. Sette,et al.  Acute ischemic strokes improving during the first 48 hours of onset: predictability, outcome, and possible mechanisms. A comparison with early deteriorating strokes. , 1997, Stroke.

[61]  C. H. Bailey,et al.  Morphological basis of long-term habituation and sensitization in Aplysia. , 1983, Science.

[62]  R. Nudo,et al.  Neural Substrates for the Effects of Rehabilitative Training on Motor Recovery After Ischemic Infarct , 1996, Science.

[63]  N B Lincoln,et al.  Randomized, controlled trial to evaluate increased intensity of physiotherapy treatment of arm function after stroke. , 1999, Stroke.

[64]  S. Warach,et al.  Magnetic Resonance Imaging of Acute Stroke , 1998, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[65]  J. French,et al.  Motor recovery following acute stroke. , 1990, Age and ageing.

[66]  M. Hallett,et al.  Cortical mechanisms of recovery of function after stroke. , 1998, NeuroRehabilitation.

[67]  H Ogata,et al.  Disuse muscle atrophy of lower limbs in hemiplegic patients. , 1997, Archives of physical medicine and rehabilitation.

[68]  A. Risedal,et al.  Early Training May Exacerbate Brain Damage after Focal Brain Ischemia in the Rat , 1999, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[69]  J. Whitall,et al.  Repetitive Bilateral Arm Training With Rhythmic Auditory Cueing Improves Motor Function in Chronic Hemiparetic Stroke , 2000, Stroke.

[70]  M. Creditor Hazards of Hospitalization of the Elderly , 1993, Annals of Internal Medicine.