Pharmacological Therapies to Enhance Motor Recovery and Walking After Stroke

Emerging Strategies

Wieslaw Oczkowski

Disclosures

Expert Rev Neurother. 2013;13(8):903-909. 

In This Article

Five-year View

Acute stroke became a treatable condition in 1995 after the introduction of thrombolysis. Patients are now admitted to stroke units and not general medical wards so as to receive the best practice care.[41] Both of these proven and highly effective interventions have changed acute stroke care, have mobilized the healthcare community and have improved the outcome for many patients. Stroke unit care applies to acute care and also to rehabilitation care. Clustering patients under the care of stroke specialists on stroke rehabilitation units fosters a milieu for observation, asking questions and clinical trials.

Major challenges remain in testing the complex and expensive process of rehabilitation. For example, which components of the complex process of rehabilitating walking are important, when should they start and how often should they be done? What about interventions to enhance recovery from the many other functional losses, such as coordination, speech, vision and memory, to name a few? Preliminary studies suggest that pharmacotherapy may also enhance recovery from other losses after stroke such as speech.[42]

The author suspects that in the very near future a drug will be shown in a properly designed study, to enhance recovery after stroke; most likely motor weakness and walking. This will be a major breakthrough, and like thrombolysis for acute ischemic stroke, and amantidine for severe traumatic brain injury, it will change post-stroke care forever. This breakthrough may be the driver that awakens the sleeping giant of stroke rehabilitation.

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