Document Detail


Impact of intensity of practice after stroke: issues for consideration.
MedLine Citation:
PMID:  16777769     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The present debate paper addresses four relevant issues related to the impact of intensity of practice after stroke. First, the best way to define intensity of practice is discussed. Second, the paper describes the evidence that exists for a dose-response relationship in stroke rehabilitation. Third, the relevance of an appropriate patient selection for a meaningful intensive practice is explored. Finally, the paper raises the question of what it is that patients actually learn when they improve their functional skills. Search strategy. For this purpose articles from MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, PEDro, DARE and PiCarta and references presented in relevant publications were examined.
DISCUSSION AND CONCLUSION: Although, there is strong evidence that early augmented exercise therapy time (expressed as time dedicated to practice) may enhance functional recovery, there is a discrepancy between the evidence for the benefits of intensive practice, on the one hand, and, the implementation of intensive rehabilitation treatment programmes in the current healthcare system on the other. Further emphasis should be given on a better understanding of the time-dependency of prognostic factors that determine the effectiveness of intensive practice in patients with stroke. In addition, a better understanding is needed of the neurophysiological and biomechanical mechanisms that underlie compensation-related learning of functional tasks after stroke.
Authors:
Gert Kwakkel
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Disability and rehabilitation     Volume:  28     ISSN:  0963-8288     ISO Abbreviation:  Disabil Rehabil     Publication Date:    2006 Jul 15-30
Date Detail:
Created Date:  2006-06-16     Completed Date:  2006-11-09     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  9207179     Medline TA:  Disabil Rehabil     Country:  England    
Other Details:
Languages:  eng     Pagination:  823-30     Citation Subset:  IM    
Affiliation:
De Hoogstraat Center of Excellence for Rehabilitation, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, and VU University Medical Center, Amsterdam, The Netherlands. g.kwakkel@vumc.nl
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Exercise Therapy / methods*
Humans
Motor Activity / physiology
Physical Therapy Modalities / classification*,  economics
Prognosis
Randomized Controlled Trials as Topic
Recovery of Function / physiology*
Rehabilitation / methods*
Stroke / rehabilitation*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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