Revealing an extended critical window of recovery post-stroke

Rubio Ballester, B.; Duff, A.; Maier, M.; Cameirao, M.; Bermudez, S.; Duarte, E.; Cuxart, A.; Rodriguez, S.; Verschure, P. F. M. J.

doi:10.1101/458745

bioRxiv · 10.1101/458745

Revealing an extended critical window of recovery post-stroke

Rubio Ballester, B.·Duff, A.·Maier, M.·Cameirao, M.·Bermudez, S.·Duarte, E.·Cuxart, A.·Rodriguez, S.·Verschure, P. F. M. J.

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Abstract

The impact of rehabilitation on post-stroke motor recovery and its dependency on the patients chronicity remain unclear. The existence and regularity of a, so called, proportional recovery rule across a range of functional deficits and therapies supports the notion that functional interventions have little or no impact beyond spontaneous recovery rates in a critical window of recovery which lasts from 3 to 6 months post-stroke. In this meta-analysis, we apply a bootstrap analysis method to assess the overall impact of a specific VR-based rehabilitation protocol for the upper extremities on a homogeneous sample of 219 individuals with hemiparesis at various stages post stroke. Our analysis uncovers a precise gradient of sensitivity to treatment that expands more than one year beyond the limits of the so-called critical window of recovery. These findings redefine the limits of the so-called critical window of recovery and suggest that stroke-derived plasticity mechanisms do facilitate functional recovery even at the chronic and late chronic stage.

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Rubio Ballester, B., Duff, A., Maier, M., Cameirao, M., Bermudez, S., Duarte, E., Cuxart, A., Rodriguez, S., Verschure, P. F. M. J.. 2018-10-31. Revealing an extended critical window of recovery post-stroke. https://doi.org/10.1101/458745

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