A critical time window for recovery extends beyond one-year post-stroke
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.13/3078 |
Resumo: | The impact of rehabilitation on post-stroke motor recovery and its dependency on the patient's chronicity remain unclear. The field has widely accepted the notion of a proportional recovery rule with a "critical window for recovery" within the first 3-6 mo poststroke. This hypothesis justifies the general cessation of physical therapy at chronic stages. However, the limits of this critical window have, so far, been poorly defined. In this analysis, we address this question, and we further explore the temporal structure of motor recovery using individual patient data from a homogeneous sample of 219 individuals with mild to moderate upper-limb hemiparesis. We observed that improvement in body function and structure was possible even at late chronic stages. A bootstrapping analysis revealed a gradient of enhanced sensitivity to treatment that extended beyond 12 mo poststroke. Clinical guidelines for rehabilitation should be revised in the context of this temporal structure. NEW & NOTEWORTHY Previous studies in humans suggest that there is a 3- to 6-mo "critical window" of heightened neuroplasticity poststroke. We analyze the temporal structure of recovery in patients with hemiparesis and uncover a precise gradient of enhanced sensitivity to treatment that expands far beyond the limits of the so-called critical window. These findings highlight the need for providing therapy to patients at the chronic and late chronic stages. |
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A critical time window for recovery extends beyond one-year post-strokeAgedMiddle agedMovementNeuronal oplasticityParesisStroke rehabilitationRecovery of functionNervous system pathophysiology.Faculdade de Ciências Exatas e da EngenhariaThe impact of rehabilitation on post-stroke motor recovery and its dependency on the patient's chronicity remain unclear. The field has widely accepted the notion of a proportional recovery rule with a "critical window for recovery" within the first 3-6 mo poststroke. This hypothesis justifies the general cessation of physical therapy at chronic stages. However, the limits of this critical window have, so far, been poorly defined. In this analysis, we address this question, and we further explore the temporal structure of motor recovery using individual patient data from a homogeneous sample of 219 individuals with mild to moderate upper-limb hemiparesis. We observed that improvement in body function and structure was possible even at late chronic stages. A bootstrapping analysis revealed a gradient of enhanced sensitivity to treatment that extended beyond 12 mo poststroke. Clinical guidelines for rehabilitation should be revised in the context of this temporal structure. NEW & NOTEWORTHY Previous studies in humans suggest that there is a 3- to 6-mo "critical window" of heightened neuroplasticity poststroke. We analyze the temporal structure of recovery in patients with hemiparesis and uncover a precise gradient of enhanced sensitivity to treatment that expands far beyond the limits of the so-called critical window. These findings highlight the need for providing therapy to patients at the chronic and late chronic stages.American Physiological SocietyDigitUMaBallester, Belén RubioMaier, MartinaDuff, ArminCameirão, MónicaBermúdez i Badia, SergiDuarte, EstherCuxart, AmparRodríguez, SusanaSan Segundo Mozo, Rosa MaríaVerschure, Paul F. M. J.2021-01-19T14:53:45Z20192019-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.13/3078engBallester, B. R., Maier, M., Duff, A., Cameirão, M., Bermúdez, S., Duarte, E., ... & Verschure, P. F. (2019). A critical time window for recovery extends beyond one-year post-stroke. Journal of neurophysiology, 122(1), 350-357.10.1152/jn.00762.2018info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-26T03:38:43Zoai:digituma.uma.pt:10400.13/3078Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:05:55.757477Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
A critical time window for recovery extends beyond one-year post-stroke |
title |
A critical time window for recovery extends beyond one-year post-stroke |
spellingShingle |
A critical time window for recovery extends beyond one-year post-stroke Ballester, Belén Rubio Aged Middle aged Movement Neuronal oplasticity Paresis Stroke rehabilitation Recovery of function Nervous system pathophysiology . Faculdade de Ciências Exatas e da Engenharia |
title_short |
A critical time window for recovery extends beyond one-year post-stroke |
title_full |
A critical time window for recovery extends beyond one-year post-stroke |
title_fullStr |
A critical time window for recovery extends beyond one-year post-stroke |
title_full_unstemmed |
A critical time window for recovery extends beyond one-year post-stroke |
title_sort |
A critical time window for recovery extends beyond one-year post-stroke |
author |
Ballester, Belén Rubio |
author_facet |
Ballester, Belén Rubio Maier, Martina Duff, Armin Cameirão, Mónica Bermúdez i Badia, Sergi Duarte, Esther Cuxart, Ampar Rodríguez, Susana San Segundo Mozo, Rosa María Verschure, Paul F. M. J. |
author_role |
author |
author2 |
Maier, Martina Duff, Armin Cameirão, Mónica Bermúdez i Badia, Sergi Duarte, Esther Cuxart, Ampar Rodríguez, Susana San Segundo Mozo, Rosa María Verschure, Paul F. M. J. |
author2_role |
author author author author author author author author author |
dc.contributor.none.fl_str_mv |
DigitUMa |
dc.contributor.author.fl_str_mv |
Ballester, Belén Rubio Maier, Martina Duff, Armin Cameirão, Mónica Bermúdez i Badia, Sergi Duarte, Esther Cuxart, Ampar Rodríguez, Susana San Segundo Mozo, Rosa María Verschure, Paul F. M. J. |
dc.subject.por.fl_str_mv |
Aged Middle aged Movement Neuronal oplasticity Paresis Stroke rehabilitation Recovery of function Nervous system pathophysiology . Faculdade de Ciências Exatas e da Engenharia |
topic |
Aged Middle aged Movement Neuronal oplasticity Paresis Stroke rehabilitation Recovery of function Nervous system pathophysiology . Faculdade de Ciências Exatas e da Engenharia |
description |
The impact of rehabilitation on post-stroke motor recovery and its dependency on the patient's chronicity remain unclear. The field has widely accepted the notion of a proportional recovery rule with a "critical window for recovery" within the first 3-6 mo poststroke. This hypothesis justifies the general cessation of physical therapy at chronic stages. However, the limits of this critical window have, so far, been poorly defined. In this analysis, we address this question, and we further explore the temporal structure of motor recovery using individual patient data from a homogeneous sample of 219 individuals with mild to moderate upper-limb hemiparesis. We observed that improvement in body function and structure was possible even at late chronic stages. A bootstrapping analysis revealed a gradient of enhanced sensitivity to treatment that extended beyond 12 mo poststroke. Clinical guidelines for rehabilitation should be revised in the context of this temporal structure. NEW & NOTEWORTHY Previous studies in humans suggest that there is a 3- to 6-mo "critical window" of heightened neuroplasticity poststroke. We analyze the temporal structure of recovery in patients with hemiparesis and uncover a precise gradient of enhanced sensitivity to treatment that expands far beyond the limits of the so-called critical window. These findings highlight the need for providing therapy to patients at the chronic and late chronic stages. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019 2019-01-01T00:00:00Z 2021-01-19T14:53:45Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.13/3078 |
url |
http://hdl.handle.net/10400.13/3078 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Ballester, B. R., Maier, M., Duff, A., Cameirão, M., Bermúdez, S., Duarte, E., ... & Verschure, P. F. (2019). A critical time window for recovery extends beyond one-year post-stroke. Journal of neurophysiology, 122(1), 350-357. 10.1152/jn.00762.2018 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
American Physiological Society |
publisher.none.fl_str_mv |
American Physiological Society |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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