Recent Advances in Stroke Recovery and Rehabilitation

Wuwei Feng, MD, MS; Samir R. Belagaje, MD

Disclosures

Semin Neurol. 2013;33(5):498-506. 

In This Article

Abstract and Introduction

Abstract

Stroke is the fourth leading cause of death in the United States, but remains a leading cause of disability. As more stroke victims survive with advanced acute care, effective strategies and interventions are required to optimize poststroke outcomes. In recent years, knowledge with respect to stroke recovery has expanded greatly through completion of preclinical and clinical trials. Emerging technology may provide further treatment options beyond the standard therapy and practices. In this article, the authors review recent advances in stroke recovery and rehabilitation, including the major determinants of poststroke recovery, challenges in translational stroke recovery research, and several emerging rehabilitation modalities such as noninvasive brain stimulation, brain–computer interface, biotherapeutics, and pharmacologic agents. Potential future directions in research are also addressed.

Introduction

Stroke is the fourth leading cause of death and a leading cause of long-term disability in the United States.[1,2] The economic burden of stroke is huge. As of 1990, the average lifetime cost of caring for one stroke patient was estimated at $103,576,[3] including care costs for all phases (acute treatment, rehabilitation, ambulatory, and nursing home).

With improvement in acute stroke care and the establishment of stroke centers nationwide, more stroke victims survive, but with varying degrees of disability.[4,5] The common deficits associated with stroke are motor impairment (including limb spasticity), sensory impairment, language impairment (aphasia and/or dysarthria), dysphagia, cognitive impairment, visual impairment, and poststroke depression. Motor impairment is the most common physical deficit. Although the demand for effective and accessible rehabilitation therapies has tremendously increased over time, only a limited set of effective neurorehabilitative modalities are currently available while a few promising therapeutic options are still in research stages.[6,7]

In this article, we will review recent advances in stroke recovery and rehabilitation. We will provide (1) a summary of the major determinants of poststroke recovery, (2) a discussion of the challenging issues in translational stroke recovery research, (3) a review of several promising rehabilitation modalities; and (4) and overview of future research directions.

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