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A critical time window for recovery extends beyond one-year post-stroke

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dc.contributor.author Rubio Ballester, Belén
dc.contributor.author Maier Martina
dc.contributor.author Maier, Martina
dc.contributor.author Duff, Amin
dc.contributor.author Cameirão, Mónica
dc.contributor.author Bermúdez, Sergi
dc.contributor.author Duarte Oller, Esther
dc.contributor.author Cuxart, Ampar
dc.contributor.author Rodriguez, Susana
dc.contributor.author San Segundo Mozo, Rosa María
dc.contributor.author Verschure, Paul F. M. J.
dc.date.accessioned 2020-02-14T08:24:58Z
dc.date.available 2020-02-14T08:24:58Z
dc.date.issued 2019
dc.identifier.citation Ballester BR, Maier M, Duff A, Cameirão M, Bermúdez S, Duarte E. et al. A critical time window for recovery extends beyond one-year post-stroke. J Neurophysiol. 2019 Jul 1;122(1):350-7. DOI: 10.1152/jn.00762.2018
dc.identifier.issn 0022-3077
dc.identifier.uri http://hdl.handle.net/10230/43600
dc.description.abstract 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.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher American Physiological Society
dc.rights Copyright © 2019 the American Physiological Society. Licensed under Creative Commons Attribution CC-BY 4.0: https://creativecommons.org/licenses/by/4.0/deed.en_US © the American Physiological Society.
dc.rights.uri https://creativecommons.org/licenses/by/4.0/
dc.title A critical time window for recovery extends beyond one-year post-stroke
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1152/jn.00762.2018
dc.subject.keyword Motor recovery
dc.subject.keyword Neuroplasticity
dc.subject.keyword Neurorehabilitation
dc.subject.keyword Stroke recovery
dc.subject.keyword Virtual reality
dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/641321
dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/TIN2013-44200REC
dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/341196
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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