[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-152618-en":3,"doc-seo-152618-105":30,"detail-sidebar-cat-0-en-105":92},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},152618,1099513958762,"Logic","https://ap-avatar.wpscdn.com/avatar/1000023916a998db790?x-image-process=image/resize,m_fixed,w_180,h_180&k=1784791008015729253",7,"Healthcare","Stroke Rehabilitation and Motor Recovery - Review Article","Up to 50% of the nearly 800,000 U.S. patients who experience a new or recurrent stroke fail to achieve full independence afterward, creating a need for more effective strategies to enhance post-stroke motor recovery. This review summarizes rehabilitative principles and approaches, addressing timing of mobilization, avoidance of early harmful medications, referral for inpatient rehabilitation, exercise dose and intensity, and evidence for vagus nerve stimulation as an adjunct to occupational therapy, while noting mixed data for device- and stimulation-based options and the lack of proven drug therapies.","Stroke Rehabilitation and Motor Recovery  \nBy Michael W. O’Dell, MD  \nABSTRACT  \nOBJECTIVE: Up to 50% of the nearly 800,000 patients who experience a new or recurrent stroke each year in the United States fail to achieve full independence afterward. More effective approaches to enhance motor recovery following stroke are needed. This article reviews therehabilitative principles and strategies that can be used to maximize post-stroke recovery.  \nLATEST DEVELOPMENTS: Evidence dictates that mobilization should not begin prior to 24 hours following stroke, but detailed guidelines beyond this are lacking. Specific classes of potentially detrimental medications should be avoided in the early days poststroke. Patients with stroke who are unable to return home should be referred for evaluation to an inpatient rehabilitation facility. Research suggests that a substantial increase in both the dose and intensity of upper and lower extremity exercise is beneficial. A clinical trial supports vagus nerve stimulation as an adjunct to occupational therapy for motor recovery in the upper extremity. The data remain somewhat mixed as to whether robotics, transcranial magnetic stimulation, functional electrical stimulation, and transcranial direct current stimulation are better than dose-matched traditional exercise. No current drug therapy has been proven to augment exercise poststroke to enhance motor recovery.  \nESSENTIAL POINTS: Neurologists will collaborate with rehabilitation professionals for several months following a patient’s stroke. Many questions still remain about the ideal exercise regimen to maximize motor recovery in patients poststroke. The next several years will likely bring a host of new research studies exploring the latest strategies to enhance motor recovery using poststroke exercise.  \nINTRODUCTION  \nI  \nn the first hours after a stroke, neurologists work with emergency medicine physicians, interventional radiologists, and neurosurgeons to minimize infarct size by converting ischemic penumbra to salvaged brain tissue.1 That salvaged tissue then translates into the preservation of limb movement, mobility, communication, cognition, and eventually independence. While  \nneurologic interventions often focus on how damaged brain tissue relates to symptoms, rehabilitation interventions often focus on how symptoms relate to performance or function. Among the numerous manifestations of stroke, motor recovery typically predominates rehabilitation discussions partly because  \nREVIEW ARTICLE  \n􀀁  \nCONTINUUM AUDIO INTERVIEW AVAILABLE ONLINE  \nCITE AS:  \nCONTINUUM (MIN NEA P M INN) 2023;29(2, CEREBROVASCULAR DISEASE):605–627.  \nAddress correspondence to Dr Michael W. O’ Dell, MD, NeuroRehabilitation Consultants–New York City, c/o Manhattan Medicine, 300 East 56th St, New York, NY 10021, [mio2005@med.cornell.edu](mio2005@med.cornell.edu).  \nRELATIONSHIP DISCLOSURE: Dr O’ Dell has received personal compensation in the range of $0 to $499 for serving as an officer or member of the board of directors for Franklin College of Indiana, and in the range of $500 to $4999 for serving on a scientific advisory or data safety monitoring board for Merz Pharmaceuticals, LLC.  \nUNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE:  \nDr O’Dell discusses several clinical trials involving the use of investigational drugs, none of which are US Food and Drug Administration (FDA) approved for use in people with stroke.  \n© 2023 American Academy of Neurology.  \nCONTINUUM JOURNAL . COM 605  \nCopyright © American Academy of Neurology. Unauthorized reproduction of this article is prohibited.  \nSTROKE REHABILITATION AND MOTOR RECOVERY  \nof its importance in physical independence but also because it is so obvious and observable.2,3 The distinction between motor recovery and functional recovery in stroke rehabilitation is critical.4  \nMotor recovery is the partial or complete improvement of an individual’s motor symptoms such as weakness, coordination, fine con","cbCaiciY5uKp8YPH","https://ap.wps.com/l/cbCaiciY5uKp8YPH","pdf",1509466,1,23,"English","en",105,"# Abstract\n## Objective\n## Latest Developments\n## Essential Points\n# Introduction\n## Motor recovery vs functional recovery\n# Conceptual Model of Stroke Rehabilitation","[{\"question\":\"Why is motor recovery emphasized in stroke rehabilitation discussions?\",\"answer\":\"Motor recovery is a central focus because it supports physical independence and is often observable in clinical care, making it a prominent rehabilitation target.\"},{\"question\":\"What mobilization timing guidance is reflected in the latest developments?\",\"answer\":\"Evidence indicates mobilization should not begin prior to 24 hours after a stroke, while more detailed poststroke guidelines remain limited.\"},{\"question\":\"Which adjunct intervention has clinical trial support for improving upper-extremity motor recovery?\",\"answer\":\"Vagus nerve stimulation is supported as an adjunct to occupational therapy for motor recovery in the upper extremity.\"}]","Stroke Rehabilitation and Motor Recovery - 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