Training and stimulation in post stroke recovery brain reorganization.
In both animal and clinical studies, training or rehabilitation increases cortical representation with subsequent functional recovery, whereas a lack of rehabilitation or training decreases cortical representation and delays recovery. Animals exposed to enriched environments post stroke have improved functional outcomes compared with animals exposed to nonenriched environments. In humans, stroke units may be the closest approximation there is to an enriched environment. However, studies indicate that patients spend the majority of time being inactive and alone while on a stroke unit. Given the animal evidence (which emphasizes increased stimulation and increased activity), there is clearly an opportunity for improving the stroke rehabilitation experience to maximize post stroke recovery.
Teasell
Robert
R
Department of Physical Medicine and Rehabilitation, St. Joseph's Health Care and the University of Western Ontario, London, Ontario, Canada.
Bitensky
Jamie
J
Foley
Norine
N
Bayona
Nestor A
NA
D000818:Animals; D002540:Cerebral Cortex / Q000254:growth & development* / Q000502:physiology*; D004195:Disease Models, Animal; D004777:Environment; D006801:Humans; D010812:Physical Stimulation; D011379:Prognosis; D000071939:Stroke Rehabilitation