Early Rehabilitation After Stroke: a Narrative Review

  • Elisheva R. ColemanEmail author
  • Rohitha Moudgal
  • Kathryn Lang
  • Hyacinth I. Hyacinth
  • Oluwole O. Awosika
  • Brett M. Kissela
  • Wuwei Feng
Cardiovascular Disease and Stroke (S. Prabhakaran, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cardiovascular Disease and Stroke


Purpose of Review

Despite current rehabilitative strategies, stroke remains a leading cause of disability in the USA. There is a window of enhanced neuroplasticity early after stroke, during which the brain’s dynamic response to injury is heightened and rehabilitation might be particularly effective. This review summarizes the evidence of the existence of this plastic window, and the evidence regarding safety and efficacy of early rehabilitative strategies for several stroke domain-specific deficits.

Recent Findings

Overall, trials of rehabilitation in the first 2 weeks after stroke are scarce. In the realm of very early mobilization, one large and one small trial found potential harm from mobilizing patients within the first 24 h after stroke, and only one small trial found benefit in doing so. For the upper extremity, constraint-induced movement therapy appears to have benefit when started within 2 weeks of stroke. Evidence for non-invasive brain stimulation in the acute period remains scant and inconclusive. For aphasia, the evidence is mixed, but intensive early therapy might be of benefit for patients with severe aphasia. Mirror therapy begun early after stroke shows promise for the alleviation of neglect. Novel approaches to treating dysphagia early after stroke appear promising, but the high rate of spontaneous improvement makes their benefit difficult to gauge.


The optimal time to begin rehabilitation after a stroke remains unsettled, though the evidence is mounting that for at least some deficits, initiation of rehabilitative strategies within the first 2 weeks of stroke is beneficial. Commencing intensive therapy in the first 24 h may be harmful.


Stroke rehabilitation Early rehabilitation Stroke recovery Neuroplasticity Motor recovery Aphasia 


Compliance with Ethical Standards

Conflict of Interest

Drs. Coleman, Moudgal, Lang, Hyacinth, Awosika, and Feng have nothing to disclose.

Dr. Kissela was a consultant for Ipsen, received fees for adjudication of clinical trial events for AbbVie and Janssen and grants from the NIH/NINDS.

Human and Animal Rights

All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).


  1. 1.
    Krakauer JW, Carmichael ST, Corbett D, Wittenberg GF. Getting neurorehabilitation right—what can we learn from animal models? Neurorehabil Neural Repair. 2012;26(8):923–31. Scholar
  2. 2.
    Whishaw IQ, Alaverdashvili M, Kolb B. The problem of relating plasticity and skilled reaching after motor cortex stroke in the rat. Behav Brain Res. 2008;192(1):124–36. Scholar
  3. 3.
    Moon SK, Alaverdashvili M, Cross AR, Whishaw IQ. Both compensation and recovery of skilled reaching following small photothrombotic stroke to motor cortex in the rat. Exp Neurol. 2009;218(1):145–53. Scholar
  4. 4.
    Alaverdashvili M, Moon SK, Beckman CD, Virag A, Whishaw IQ. Acute but not chronic differences in skilled reaching for food following motor cortex devascularization vs. photothrombotic stroke in the rat. Neuroscience. 2008;157(2):297–308. Scholar
  5. 5.
    Stinear C, Ackerley S, Byblow W. Rehabilitation is initiated early after stroke, but most motor rehabilitation trials are not: a systematic review. Stroke. 2013;44(7):2039–45. Scholar
  6. 6.
    Dijkhuizen RM, Ren J, Mandeville JB, Wu O, Ozdag FM, Moskowitz MA, et al. Functional magnetic resonance imaging of reorganization in rat brain after stroke. Proc Natl Acad Sci U S A. 2001;98(22):12766–71. Scholar
  7. 7.
    Dijkhuizen RM, Singhal AB, Mandeville JB, Wu O, Halpern EF, Finklestein SP, et al. Correlation between brain reorganization, ischemic damage, and neurologic status after transient focal cerebral ischemia in rats: a functional magnetic resonance imaging study. J Neurosci. 2003;23(2):510–7.PubMedGoogle Scholar
  8. 8.
    Jablonka JA, Burnat K, Witte OW, Kossut M. Remapping of the somatosensory cortex after a photothrombotic stroke: dynamics of the compensatory reorganization. Neuroscience. 2010;165(1):90–100. Scholar
  9. 9.
    Marshall RS, Perera GM, Lazar RM, Krakauer JW, Constantine RC, DeLaPaz RL. Evolution of cortical activation during recovery from corticospinal tract infarction. Stroke. 2000;31(3):656–61. Scholar
  10. 10.
    Nelles G, Jentzen W, Bockisch A, Diener HC. Neural substrates of good and poor recovery after hemiplegic stroke: a serial pet study. J Neurol. 2011;258(12):2168–75. Scholar
  11. 11.
    Fujii Y, Nakada T. Cortical reorganization in patients with subcortical hemiparesis: neural mechanisms of functional recovery and prognostic implication. J Neurosurg. 2003;98(1):64–73. Scholar
  12. 12.
    Saur D, Lange R, Baumgaertner A, Schraknepper V, Willmes K, Rijntjes M, et al. Dynamics of language reorganization after stroke. Brain. 2006;129(Pt 6):1371–84. Scholar
  13. 13.
    Cramer SC. Repairing the human brain after stroke: I. Mechanisms of spontaneous recovery. Ann Neurol. 2008;63(3):272–87. Scholar
  14. 14.
    Jorgensen HS, Nakayama H, Raaschou HO, Vive-Larsen J, Stoier M, Olsen TS. Outcome and time course of recovery in stroke. Part II: time course of recovery. The Copenhagen stroke study. Arch Phys Med Rehabil. 1995;76(5):406–12.CrossRefPubMedGoogle Scholar
  15. 15.
    Stroemer RP, Kent TA, Hulsebosch CE. Neocortical neural sprouting, synaptogenesis, and behavioral recovery after neocortical infarction in rats. Stroke. 1995;26(11):2135–44. Scholar
  16. 16.
    Carmichael ST. Cellular and molecular mechanisms of neural repair after stroke: making waves. Ann Neurol. 2006;59(5):735–42. Scholar
  17. 17.
    Wei L, Erinjeri JP, Rovainen CM, Woolsey TA. Collateral growth and angiogenesis around cortical stroke. Stroke. 2001;32(9):2179–84. Scholar
  18. 18.
    Kojima T, Hirota Y, Ema M, Takahashi S, Miyoshi I, Okano H, et al. Subventricular zone-derived neural progenitor cells migrate along a blood vessel scaffold toward the post-stroke striatum. Stem Cells. 2010;28:545–54. Scholar
  19. 19.
    Ernfors P, Ibáñez CF, Ebendal T, Olson L, Persson H. Molecular cloning and neurotrophic activities of a protein with structural similarities to nerve growth factor: developmental and topographical expression in the brain. Proc Natl Acad Sci. 1990;87(14):5454–8.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Hohn A, Leibrock J, Bailey K, Barde Y-A. Identification and characterization of a novel member of the nerve growth factor/brain-derived neurotrophic factor family. Nature. 1990;344(6264):339–41.CrossRefPubMedGoogle Scholar
  21. 21.
    Schabitz W-R, Sommer C, Zoder W, Kiessling M, Schwaninger M, Schwab S, et al. Intravenous brain-derived neurotrophic factor reduces infarct size and counterregulates Bax and Bcl-2 expression after temporary focal cerebral ischemia editorial comment. Stroke. 2000;31(9):2212–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Kleim JA, Chan S, Pringle E, Schallert K, Procaccio V, Jimenez R, et al. BDNF val66met polymorphism is associated with modified experience-dependent plasticity in human motor cortex. Nat Neurosci. 2006;9(6):735–7. Scholar
  23. 23.
    Jiang Y, Wei N, Lu T, Zhu J, Xu G, Liu X. Intranasal brain-derived neurotrophic factor protects brain from ischemic insult via modulating local inflammation in rats. Neuroscience. 2011;172:398–405. Scholar
  24. 24.
    Schabitz W-R, Schwab S, Spranger M, Hacke W. Intraventricular brain-derived neurotrophic factor size after focal cerebral ischemia in rats. J Cereb Blood Flow Metab. 1997;17(5):500–6.CrossRefPubMedGoogle Scholar
  25. 25.
    Schabitz WR, Steigleder T, Cooper-Kuhn CM, Schwab S, Sommer C, Schneider A, et al. Intravenous brain-derived neurotrophic factor enhances poststroke sensorimotor recovery and stimulates neurogenesis. Stroke. 2007;38(7):2165–72. Scholar
  26. 26.
    Kim JM, Stewart R, Park MS, Kang HJ, Kim SW, Shin IS, et al. Associations of BDNF genotype and promoter methylation with acute and long-term stroke outcomes in an East Asian cohort. PLoS One. 2012;7(12):e51280. Scholar
  27. 27.
    Simon RP, Meller R, Zhou A, Henshall D. Can genes modify stroke outcome and by what mechanisms? Stroke. 2012;43(1):286–91. Scholar
  28. 28.
    Stapels M, Piper C, Yang T, Li M, Stowell C, Xiong ZG, et al. Polycomb group proteins as epigenetic mediators of neuroprotection in ischemic tolerance. Sci Signal. 2010;3(111):ra15. Scholar
  29. 29.
    Yasui DH, Peddada S, Bieda MC, Vallero RO, Hogart A, Nagarajan RP, et al. Integrated epigenomic analyses of neuronal MeCP2 reveal a role for long-range interaction with active genes. Proc Natl Acad Sci. 2007;104(49):19416–21. Scholar
  30. 30.
    Lusardi TA, Farr CD, Faulkner CL, Pignataro G, Yang T, Lan J, et al. Ischemic preconditioning regulates expression of microRNAs and a predicted target, MeCP2, in mouse cortex. J Cereb Blood Flow Metab. 2010;30(4):744–56. Scholar
  31. 31.
    Zhang P, Xianglei J, Hongbo Y, Zhang J, Xu C. Neuroprotection of early locomotor exercise poststroke: evidence from animal studies. Can J Neurol Sci. 2015;42(4):213–20. Scholar
  32. 32.
    Ke Z, Yip SP, Li L, Zheng X-X, Tong K-Y. The effects of voluntary, involuntary, and forced exercises on brain-derived neurotrophic factor and motor function recovery: a rat brain ischemia model. PLoS One. 2011;6(2):e16643. Scholar
  33. 33.
    Zhang P, Zhang Q, Pu H, Wu Y, Bai Y, Vosler PS, et al. Very early-initiated physical rehabilitation protects against ischemic brain injury. Front Biosci (Elite Ed). 2012;4:2476–89.Google Scholar
  34. 34.
    Yang Y-R, Wang R-Y, Wang PS-G. Early and late treadmill training after focal brain ischemia in rats. Neurosci Lett. 2003;339(2):91–4. Scholar
  35. 35.
    Zheng HQ, Zhang LY, Luo J, Li LL, Li M, Zhang Q, et al. Physical exercise promotes recovery of neurological function after ischemic stroke in rats. Int J Mol Sci. 2014;15(6):10974–88. Scholar
  36. 36.
    Biernaskie J. Efficacy of rehabilitative experience declines with time after focal ischemic brain injury. J Neurosci. 2004;24(5):1245–54. Scholar
  37. 37.
    Zhang A, Bai Y, Hu Y, Zhang F, Wu Y, Wang Y, et al. The effects of exercise intensity on p-NR2B expression in cerebral ischemic rats. Can J Neurol Sci. 2012;39(5):613–8.CrossRefPubMedGoogle Scholar
  38. 38.
    Zhang Y, Zhang P, Shen X, Tian S, Wu Y, Zhu Y, et al. Early exercise protects the blood-brain barrier from ischemic brain injury via the regulation of MMP-9 and occludin in rats. Int J Mol Sci. 2013;14(6):11096–112. Scholar
  39. 39.
    Lee M-H, Kim H, Kim S-S, Lee T-H, Lim B-V, Chang H-K, et al. Treadmill exercise suppresses ischemia-induced increment in apoptosis and cell proliferation in hippocampal dentate gyrus of gerbils. Life Sci. 2003;73(19):2455–65.CrossRefPubMedGoogle Scholar
  40. 40.
    Zhang L, Hu X, Luo J, Li L, Chen X, Huang R, et al. Physical exercise improves functional recovery through mitigation of autophagy, attenuation of apoptosis and enhancement of neurogenesis after MCAO in rats. BMC Neurosci. 2013;14(1):46. Scholar
  41. 41.
    Kim M-W, Bang M-S, Han T-R, Ko Y-J, Yoon B-W, Kim J-H, et al. Exercise increased BDNF and trkB in the contralateral hemisphere of the ischemic rat brain. Brain Res. 2005;1052(1):16–21. Scholar
  42. 42.
    Luo CX, Jiang J, Zhou QG, Zhu XJ, Wang W, Zhang ZJ, et al. Voluntary exercise-induced neurogenesis in the postischemic dentate gyrus is associated with spatial memory recovery from stroke. J Neurosci Res. 2007;85(8):1637–46. Scholar
  43. 43.
    Li F, Pendy JT, Ding JN, Peng C, Li X, Shen J, et al. Exercise rehabilitation immediately following ischemic stroke exacerbates inflammatory injury. Neurol Res. 2017;39(6):530–7. Scholar
  44. 44.
    Risedal A, Zeng R, Johansson BB. Early training may exacerbate brain damage after focal brain ischemia in the rat. J Cereb Blood Flow Metab. 1999;19(9):997–1003. Scholar
  45. 45.
    Komitova M, Zhao LR, Gidö G, Johansson BB, Eriksson P. Postischemic exercise attenuates whereas enriched environment has certain enhancing effects on lesion-induced subventricular zone activation in the adult rat. Eur J Neurosci. 2005;21(9):2397–405. Scholar
  46. 46.
    Kozlowski DA, James DC, Schallert T. Use-dependent exaggeration of neuronal injury after unilateral sensorimotor cortex lesions. J Neurosci. 1996;16(15):4776–86.PubMedGoogle Scholar
  47. 47.
    Group ATC. Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial. Lancet. 2015;386(9988):46–55. Scholar
  48. 48.
    Bernhardt J, Churilov L, Ellery F, Collier J, Chamberlain J, Langhorne P, et al. Prespecified dose-response analysis for a very early rehabilitation trial (AVERT). Neurology. 2016;86(23):2138–45. Scholar
  49. 49.
    Sundseth A, Thommessen B, Ronning OM. Outcome after mobilization within 24 hours of acute stroke: a randomized controlled trial. Stroke. 2012;43(9):2389–94. Scholar
  50. 50.
    Yelnik AP, Quintaine V, Andriantsifanetra C, Wannepain M, Reiner P, Marnef H, et al. AMOBES (Active Mobility Very Early After Stroke): a randomized controlled trial. Stroke. 2017;48(2):400–5. Scholar
  51. 51.
    Chippala P, Sharma R. Effect of very early mobilisation on functional status in patients with acute stroke: a single-blind, randomized controlled trail. Clin Rehabil. 2016;30(7):669–75. Scholar
  52. 52.
    Momosaki R, Yasunaga H, Kakuda W, Matsui H, Fushimi K, Abo M. Very early versus delayed rehabilitation for acute ischemic stroke patients with intravenous recombinant tissue plasminogen activator: a nationwide retrospective cohort study. Cerebrovasc Dis. 2016;42(1–2):41–8. Scholar
  53. 53.
    Rao N, Zielke D, Keller S, Burns M, Sharma A, Krieger R, et al. Pregait balance rehabilitation in acute stroke patients. Int J Rehabil Res. 2013;36(2):112–7. Scholar
  54. 54.
    Morreale M, Marchione P, Pili A, Lauta A, Castiglia SF, Spallone A, et al. Early versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: proprioceptive or cognitive approach? Eur J Phys Rehabil Med. 2016;52(1):81–9.PubMedGoogle Scholar
  55. 55.
    Kwakkel G, Winters C, Van Wegen EE, Nijland RH, Van Kuijk AA, Visser-Meily A, et al. Effects of unilateral upper limb training in two distinct prognostic groups early after stroke: the EXPLICIT-stroke randomized clinical trial. Neurorehabil Neural Repair. 2016;30(9):804–16.CrossRefPubMedGoogle Scholar
  56. 56.
    Yu C, Wang W, Zhang Y, Wang Y, Hou W, Liu S, et al. The effects of modified constraint-induced movement therapy in acute subcortical cerebral infarction. Front Hum Neurosci. 2017;11:265.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Hubbard IJ, Carey LM, Budd TW, Levi C, McElduff P, Hudson S, et al. A randomized controlled trial of the effect of early upper-limb training on stroke recovery and brain activation. Neurorehabil Neural Repair. 2015;29(8):703–13.CrossRefPubMedGoogle Scholar
  58. 58.
    Dromerick A, Lang C, Birkenmeier R, Wagner J, Miller J, Videen T, et al. Very early constraint-induced movement during stroke rehabilitation (VECTORS) a single-center RCT. Neurology. 2009;73(3):195–201.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Rossi C, Sallustio F, Di Legge S, Stanzione P, Koch G. Transcranial direct current stimulation of the affected hemisphere does not accelerate recovery of acute stroke patients. Eur J Neurol. 2013;20(1):202–4.CrossRefPubMedGoogle Scholar
  60. 60.
    Hesse S, Waldner A, Mehrholz J, Tomelleri C, Pohl M, Werner C. Combined transcranial direct current stimulation and robot-assisted arm training in subacute stroke patients: an exploratory, randomized multicenter trial. Neurorehabil Neural Repair. 2011;25(9):838–46. Scholar
  61. 61.
    Di Lazzaro V, Dileone M, Capone F, Pellegrino G, Ranieri F, Musumeci G, et al. Immediate and late modulation of interhemipheric imbalance with bilateral transcranial direct current stimulation in acute stroke. Brain Stimul. 2014;7(6):841–8.CrossRefPubMedGoogle Scholar
  62. 62.
    Sattler V, Acket B, Raposo N, Albucher J-F, Thalamas C, Loubinoux I, et al. Anodal tDCS combined with radial nerve stimulation promotes hand motor recovery in the acute phase after ischemic stroke. Neurorehabil Neural Repair. 2015;29(8):743–54.CrossRefPubMedGoogle Scholar
  63. 63.
    Li J, Zhang XW, Zuo ZT, Lu J, Meng CL, Fang HY, et al. Cerebral functional reorganization in ischemic stroke after repetitive transcranial magnetic stimulation: an fmri study. CNS Neurosci Ther. 2016;22(12):952–60.CrossRefPubMedGoogle Scholar
  64. 64.
    Chhatbar PY, Ramakrishnan V, Kautz S, George MS, Adams RJ, Feng W. Transcranial direct current stimulation post-stroke upper extremity motor recovery studies exhibit a dose-response relationship. Brain Stimul. 2016;9(1):16–26. Scholar
  65. 65.
    Chhatbar PY, Chen R, Deardorff R, Dellenbach B, Kautz SA, George MS, et al. Safety and tolerability of transcranial direct current stimulation to stroke patients—a phase I current escalation study. Brain Stimul. 2017;10(3):553–9. Scholar
  66. 66.
    Kuznetsov AN, Rybalko NV, Daminov VD, Luft AR. Early poststroke rehabilitation using a robotic tilt-table stepper and functional electrical stimulation. Stroke Res Treatm. 2013;2013:946056Google Scholar
  67. 67.
    Forrester LW, Roy A, Krywonis A, Kehs G, Krebs HI, Macko RF. Modular ankle robotics training in early subacute stroke: a randomized controlled pilot study. Neurorehabil Neural Repair. 2014;28(7):678–87.CrossRefPubMedPubMedCentralGoogle Scholar
  68. 68.
    Cruz VT, Bento V, Ruano L, Ribeiro DD, Fontao L, Mateus C et al. Motor task performance under vibratory feedback early poststroke: single center, randomized, cross-over, controlled clinical trial. Sci Rep.4:5670.
  69. 69.
    Nouwens F, de Lau LML, Visch-Brink EG, van de Sandt-Koenderman WME, Lingsma HF, Goosen S, et al. Efficacy of early cognitive-linguistic treatment for aphasia due to stroke: a randomised controlled trial (Rotterdam Aphasia Therapy Study-3). Eur Stroke J. 2017;2(2):126–36. Scholar
  70. 70.
    Godecke E, Hird K, Lalor EE, Rai T, Phillips MR. Very early poststroke aphasia therapy: a pilot randomized controlled efficacy trial: research. Int J Stroke. 2012;7(8):635–44. Scholar
  71. 71.
    Godecke E, Armstrong EA, Rai T, Middleton S, Ciccone N, Whitworth A et al. A randomized controlled trial of very early rehabilitation in speech after stroke. Int J Stroke: Off J Int Stroke Soc. 11(5):586–92.
  72. 72.
    Ciccone N, West D, Cream A, Cartwright J, Rai T, Granger A, et al. Constraint-induced aphasia therapy (CIAT): a randomised controlled trial in very early stroke rehabilitation. Aphasiology. 2016;30(5):566–84. Scholar
  73. 73.
    Godecke E, Ciccone NA, Granger AS, Rai T, West D, Cream A, et al. A comparison of aphasia therapy outcomes before and after a Very Early Rehabilitation programme following stroke: outcomes in early aphasia rehabilitation in stroke. Int J Lang Commun Disord. 2014;49(2):149–61. Scholar
  74. 74.
    Mattioli F, Ambrosi C, Mascaro L, Scarpazza C, Pasquali P, Frugoni M, et al. Early aphasia rehabilitation is associated with functional reactivation of the left inferior frontal gyrus: a pilot study. Stroke. 2014;45(2):545–52. Scholar
  75. 75.
    Conklyn D, Novak E, Boissy A, Bethoux F, Chemali K. The effects of modified melodic intonation therapy on nonfluent aphasia: a pilot study. J Speech Lang Hear Res. 2012;55(5):1463–71. Scholar
  76. 76.
    Ianes P, Varalta V, Gandolfi M, Picelli A, Corno M, Di Matteo A, et al. Stimulating visual exploration of the neglected space in the early stage of stroke by hemifield eye-patching: a randomized controlled trial in patients with right brain damage. Eur J Phys Rehabil Med. 2012;48(2):189–96.PubMedGoogle Scholar
  77. 77.
    Machner B, Konemund I, Sprenger A, von der Gablentz J, Helmchen C. Randomized controlled trial on hemifield eye patching and optokinetic stimulation in acute spatial neglect. Stroke. 2014;45(8):2465–8. Scholar
  78. 78.
    Rengachary J, He BJ, Shulman GL, Corbetta M. A behavioral analysis of spatial neglect and its recovery after stroke. Front Hum Neurosci. 2011;5:29. Scholar
  79. 79.
    Pandian JD, Arora R, Kaur P, Sharma D, Vishwambaran DK, Arima H. Mirror therapy in unilateral neglect after stroke (MUST trial): a randomized controlled trial. Neurology. 2014;83(11):1012–7. Scholar
  80. 80.
    Lee KW, Kim SB, Lee JH, Lee SJ, Ri JW, Park JG. The effect of early neuromuscular electrical stimulation therapy in acute/subacute ischemic stroke patients with dysphagia. Ann Rehabil Med. 2014;38(2):153–9. Scholar
  81. 81.
    Du J, Yang F, Liu L, Hu J, Cai B, Liu W, et al. Repetitive transcranial magnetic stimulation for rehabilitation of poststroke dysphagia: a randomized, double-blind clinical trial. Clin Neurophysiol. 2016;127(3):1907–13. Scholar
  82. 82.
    Bakhtiyari J, Sarraf P, Nakhostin-Ansari N, Tafakhori A, Logemann J, Faghihzadeh S, et al. Effects of early intervention of swallowing therapy on recovery from dysphagia following stroke. Iran J Neurol. 2015;14(3):119–24.PubMedPubMedCentralGoogle Scholar
  83. 83.
    Lynch E, Hillier S, Cadilhac D. When should physical rehabilitation commence after stroke: a systematic review. Int J Stroke: Off J Int Stroke Soc. 2014;9(4):468–78. Scholar
  84. 84.
    de Jong-Hagelstein M, van de Sandt-Koenderman WM, Prins ND, Dippel DW, Koudstaal PJ, Visch-Brink EG. Efficacy of early cognitive-linguistic treatment and communicative treatment in aphasia after stroke: a randomised controlled trial (RATS-2). J Neurol Neurosurg Psychiatry. 2011;82(4):399–404. Scholar
  85. 85.
    Johnston KC, Connors AF Jr, Wagner DP, Knaus WA, Wang X, Haley EC Jr. A predictive risk model for outcomes of ischemic stroke. Stroke. 2000;31(2):448–55.CrossRefPubMedGoogle Scholar
  86. 86.
    Kissela B, Lindsell CJ, Kleindorfer D, Alwell K, Moomaw CJ, Woo D, et al. Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race. Stroke. 2009;40(2):530–6. Scholar
  87. 87.
    Baird AE, Dambrosia J, Janket S, Eichbaum Q, Chaves C, Silver B, et al. A three-item scale for the early prediction of stroke recovery. Lancet. 2001;357(9274):2095–9.CrossRefPubMedGoogle Scholar
  88. 88.
    Alexander LD, Pettersen JA, Hopyan JJ, Sahlas DJ, Black SE. Long-term prediction of functional outcome after stroke using the Alberta Stroke Program Early Computed Tomography Score in the subacute stage. J Stroke Cerebrovasc Dis. 2012;21(8):737–44. Scholar
  89. 89.
    Bernhardt J, Hayward KS, Kwakkel G, Ward NS, Wolf SL, Borschmann K, et al. Agreed definitions and a shared vision for new standards in stroke recovery research: the Stroke Recovery and Rehabilitation Roundtable taskforce. Int J Stroke: Off J Int Stroke Soc. 2017;12(5):444–50. Scholar
  90. 90.
    Wu J, Srinivasan R, Burke Quinlan E, Solodkin A, Small SL, Cramer SC. Utility of EEG measures of brain function in patients with acute stroke. J Neurophysiol. 2016;115(5):2399–405. Scholar
  91. 91.
    Nicolo P, Rizk S, Magnin C, Pietro MD, Schnider A, Guggisberg AG. Coherent neural oscillations predict future motor and language improvement after stroke. Brain. 2015;138(Pt 10):3048–60. Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Elisheva R. Coleman
    • 1
    Email author
  • Rohitha Moudgal
    • 2
  • Kathryn Lang
    • 3
  • Hyacinth I. Hyacinth
    • 4
  • Oluwole O. Awosika
    • 1
  • Brett M. Kissela
    • 1
  • Wuwei Feng
    • 5
  1. 1.Department of Neurology and Rehabilitation MedicineUniversity of Cincinnati Gardner Neuroscience InstituteCincinnatiUSA
  2. 2.University of Cincinnati College of MedicineCincinnatiUSA
  3. 3.Department of Rehabilitation ServicesUniversity of CincinnatiCincinnatiUSA
  4. 4.Aflac Cancer and Blood Disorder Center of Children’s Healthcare of Atlanta and Emory University Department of PediatricsAtlantaUSA
  5. 5.Department of NeurologyMedical University of South CarolinaCharlestonUSA

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