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 Duff, Armin
- dc.contributor.author Cameirão, Mónica
- dc.contributor.author Bermúdez i Badia, 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.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.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.doi http://dx.doi.org/10.1152/jn.00762.2018
- dc.identifier.issn 0022-3077
- dc.identifier.uri http://hdl.handle.net/10230/43600
- dc.language.iso eng
- dc.publisher American Physiological Society
- dc.relation.ispartof Journal of Neurophysiology. 2019 Jul 1;122(1):350-7
- 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 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.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri https://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Motor recovery
- dc.subject.keyword Neuroplasticity
- dc.subject.keyword Neurorehabilitation
- dc.subject.keyword Stroke recovery
- dc.subject.keyword Virtual reality
- dc.title A critical time window for recovery extends beyond one-year post-stroke
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion