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.
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.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
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. https://doi.org/10.1177/1545968312440745.
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. https://doi.org/10.1016/j.bbr.2007.12.026.
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. https://doi.org/10.1016/j.expneurol.2009.04.021.
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. https://doi.org/10.1016/j.neuroscience.2008.09.015.
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. https://doi.org/10.1161/STROKEAHA.113.000968.
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. https://doi.org/10.1073/pnas.231235598.
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.
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. https://doi.org/10.1016/j.neuroscience.2009.09.074.
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. https://doi.org/10.1161/01.STR.31.3.656.
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. https://doi.org/10.1007/s00415-011-6085-y.
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. https://doi.org/10.3171/jns.2003.98.1.0064.
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. https://doi.org/10.1093/brain/awl090.
Cramer SC. Repairing the human brain after stroke: I. Mechanisms of spontaneous recovery. Ann Neurol. 2008;63(3):272–87. https://doi.org/10.1002/ana.21393.
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.
Stroemer RP, Kent TA, Hulsebosch CE. Neocortical neural sprouting, synaptogenesis, and behavioral recovery after neocortical infarction in rats. Stroke. 1995;26(11):2135–44. https://doi.org/10.1161/01.STR.26.11.2135.
Carmichael ST. Cellular and molecular mechanisms of neural repair after stroke: making waves. Ann Neurol. 2006;59(5):735–42. https://doi.org/10.1002/ana.20845.
Wei L, Erinjeri JP, Rovainen CM, Woolsey TA. Collateral growth and angiogenesis around cortical stroke. Stroke. 2001;32(9):2179–84. https://doi.org/10.1161/hs0901.094282.
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. https://doi.org/10.1002/stem.306.
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.
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.
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.
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. https://doi.org/10.1038/nn1699.
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. https://doi.org/10.1016/j.neuroscience.2010.10.054.
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.
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. https://doi.org/10.1161/STROKEAHA.106.477331.
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. https://doi.org/10.1371/journal.pone.0051280.
Simon RP, Meller R, Zhou A, Henshall D. Can genes modify stroke outcome and by what mechanisms? Stroke. 2012;43(1):286–91. https://doi.org/10.1161/STROKEAHA.111.622225.
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. https://doi.org/10.1126/scisignal.2000502.
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. https://doi.org/10.1073/pnas.0707442104.
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. https://doi.org/10.1038/jcbfm.2009.253.
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. https://doi.org/10.1017/cjn.2015.39.
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. https://doi.org/10.1371/journal.pone.0016643.
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.
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. https://doi.org/10.1016/S0304-3940(03)00010-7.
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. https://doi.org/10.3390/ijms150610974.
Biernaskie J. Efficacy of rehabilitative experience declines with time after focal ischemic brain injury. J Neurosci. 2004;24(5):1245–54. https://doi.org/10.1523/JNEUROSCI.3834-03.2004.
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.
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. https://doi.org/10.3390/ijms140611096.
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.
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. https://doi.org/10.1186/1471-2202-14-46.
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. https://doi.org/10.1016/j.brainres.2005.05.070.
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. https://doi.org/10.1002/jnr.21317.
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. https://doi.org/10.1080/01616412.2017.1315882.
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. https://doi.org/10.1097/00004647-199909000-00007.
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. https://doi.org/10.1111/j.1460-9568.2005.04072.x.
Kozlowski DA, James DC, Schallert T. Use-dependent exaggeration of neuronal injury after unilateral sensorimotor cortex lesions. J Neurosci. 1996;16(15):4776–86.
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. https://doi.org/10.1016/S0140-6736(15)60690-0.
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. https://doi.org/10.1212/WNL.0000000000002459.
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. https://doi.org/10.1161/STROKEAHA.111.646687.
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. https://doi.org/10.1161/STROKEAHA.116.014803.
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. https://doi.org/10.1177/0269215515596054.
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. https://doi.org/10.1159/000444720.
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. https://doi.org/10.1097/MRR.0b013e328359a2fa.
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.
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.
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.
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.
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.
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.
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. https://doi.org/10.1177/1545968311413906.
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.
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.
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.
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. https://doi.org/10.1016/j.brs.2015.09.002.
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. https://doi.org/10.1016/j.brs.2017.02.007.
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;2013:946056
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.
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. https://doi.org/10.1038/srep05670.
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. https://doi.org/10.1177/2396987317698327.
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. https://doi.org/10.1111/j.1747-4949.2011.00631.x.
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. https://doi.org/10.1177/1747493016641116.
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. https://doi.org/10.1080/02687038.2015.1071480.
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. https://doi.org/10.1111/1460-6984.12074.
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. https://doi.org/10.1161/STROKEAHA.113.003192.
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. https://doi.org/10.1044/1092-4388(2012/11-0105).
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.
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. https://doi.org/10.1161/STROKEAHA.114.006059.
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. https://doi.org/10.3389/fnhum.2011.00029.
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. https://doi.org/10.1212/WNL.0000000000000773.
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. https://doi.org/10.5535/arm.2014.38.2.153.
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. https://doi.org/10.1016/j.clinph.2015.11.045.
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.
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. https://doi.org/10.1111/ijs.12262.
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. https://doi.org/10.1136/jnnp.2010.210559.
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.
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. https://doi.org/10.1161/STROKEAHA.108.521906.
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.
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. https://doi.org/10.1016/j.jstrokecerebrovasdis.2011.03.010.
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. https://doi.org/10.1177/1747493017711816.
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. https://doi.org/10.1152/jn.00978.2015.
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. https://doi.org/10.1093/brain/awv200.
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).
This article is part of the Topical Collection on Cardiovascular Disease and Stroke
Rights and permissions
About this article
Cite this article
Coleman, E.R., Moudgal, R., Lang, K. et al. Early Rehabilitation After Stroke: a Narrative Review. Curr Atheroscler Rep 19, 59 (2017). https://doi.org/10.1007/s11883-017-0686-6
- Stroke rehabilitation
- Early rehabilitation
- Stroke recovery
- Motor recovery