Article

Novel molecular, cellular, and pharmacological therapies to stimulate repair of
sensorimotor circuits after stroke are entering clinical trials. Compared with
acute neuroprotection and thrombolysis studies, clinical trials for repair in
subacute and chronic hemiplegic participants have a different time course for
delivery of an intervention, different mechanisms of action within the milieu of
the injury, distinct relationships to the amount of physical activity and skills
practice of participants, and need to include more refined outcome measures. This
review examines the biological interaction of targeted rehabilitation with neural
repair strategies to optimize outcomes. We suggest practical guidelines for the
incorporation of inexpensive skills training and exercise at home. In addition,
we describe some novel outcome measurement tools, including wearable sensors, to
obtain the more detailed outcomes that may identify at least some minimal level
of success from cellular and regeneration interventions.
Thus, proceeding in the
shadow of acute stroke trial designs may unnecessarily limit the mechanisms of
action of new repair strategies, reduce their impact on participants, and risk
missing important behavioral outcomes.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS