Approximately 730,000 first-ever strokes occur in the United States each year. Stroke is the third leading cause of death in the United States and in most Western countries. However, approximately 80-90% of patients survive their stroke, often with substantial motor dysfunction that compromises their ability to perform valued activities. Stroke is the most frequent cause of permanent disability in adults worldwide. Average survival following stroke is eight years in the United States. This calculates to a stroke survivor prevalence of 5.7 million persons.
A recent review of randomized controlled trials in treatment alternatives (in over 1,000 stroke patients), indicates that rehabilitation provides improvement in function, when compared to no treatment or control. Yet, superiority of one type of therapy over another could not be distinguished, and therefore the specific choice of therapy was difficult to justify over another type of treatment. Consequently, there are reservations in the medical community concerning the benefit of various types of therapy. So, although we have progressed from “do nothing” to “do something” is the solution to “do anything”?
Despite evidence suggesting that therapy may be useful in brain restoration and in the rehabilitation of patients with stroke, there is little information available describing the precise nature of interventions provided by therapists. Little evidence determines which patients with stroke should receive motor therapy, what elements those therapies should contain, or when they should be implemented. In addition, results are limited, and functional gains after stroke are often minimal. Thus, identifying interventions that can improve motor function remains a priority. This book will provide an overview of the current understanding of modern rehabilitation therapies and the effects on plasticity and recovery of motor function in stroke.
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