Principles of neurorehabilitation in stroke recovery

Despite advances in the acute management of stroke, a large proportion of stroke patients are left with significant impairments. Over the coming decades the prevalence of stroke-related disability is expected to increase worldwide and this will impact greatly on families, healthcare systems and economies. Effective neurorehabilitation is a key factor in reducing disability after stroke. Various therapeutic interventions to target non-motor impairments after stroke such as cognitive rehabilitation have been studied in recent years. Moreover, many jointspecific robotic devices have been developed and some are already in use in many centers for motor impairment after stroke. They have the potential to deliver functional, reproducible, high-intensity therapy and if shown to be clinically (and cost) effective in large scale studies, they may be more widely used to assist therapists in rehabilitation programmes in future clinical practice. Besides, new therapeutic strategies, including brain stimulation, focus on reestablishing brain circuits through a large number of mechanisms to improve circuit plasticity and remodeling. Although there is evidence to suggest a potential future role for neurorehabilitation in stroke, there is much left to explore in this area.This review points out several important mechanisms of stroke injury and represents developing therapies based on neurorehabilitation aimed at upgrading clinical outcomes.

Keywords:

Neurorehabilitation , Stroke , Non-motor impairments , Motor impairments , Brain stimulation