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我们应该关注卒中后早期康复吗?现在还不用,但很快就需要了。

Should We Care About Early Post-Stroke Rehabilitation? Not Yet, but Soon.

机构信息

Department of Neurology, Johns Hopkins, Phipps 443 600 N. Wolfe Street, Baltimore, MD, 21287, USA.

出版信息

Curr Neurol Neurosci Rep. 2019 Feb 20;19(3):13. doi: 10.1007/s11910-019-0927-x.


DOI:10.1007/s11910-019-0927-x
PMID:30788609
Abstract

PURPOSE OF REVIEW: Studies in humans and animal models show that most recovery from impairment occurs in the first 1-3 months after stroke as a result of both spontaneous recovery as well as increased responsiveness to enriched environments and training. Improvement from impairment is attributable to a short-lived "sensitive period" of post-stroke plasticity defined by unique genetic, physiological, and structural events. Unfortunately, rehabilitative interventions in humans have not been able to exploit this sensitive period similar to that seen in animal models. Here, we review these data and suggest a path forward. RECENT FINDINGS: Pre-clinical data reveal underlying mechanisms that define the post-stroke sensitive period. These data are then discussed in the context of the spontaneous post-stroke recovery described in humans. Future work will need to capitalize on unique interactions between the sensitive period, spontaneous recovery, and novel types of rehabilitative interventions.

摘要

目的综述:人体和动物模型研究表明,由于自发性恢复以及对丰富环境和训练的反应性增加,大多数损伤后的恢复发生在中风后的 1-3 个月内。损伤后的改善归因于短暂的“敏感时期”,即中风后可塑性,其由独特的遗传、生理和结构事件定义。不幸的是,人类的康复干预措施无法像在动物模型中那样利用这段敏感时期。在这里,我们回顾这些数据并提出前进的道路。

最近的发现:临床前数据揭示了定义中风后敏感时期的潜在机制。然后,将这些数据置于人类描述的自发性中风后恢复的背景下进行讨论。未来的工作将需要利用敏感时期、自发性恢复和新型康复干预措施之间的独特相互作用。

相似文献

[1]
Should We Care About Early Post-Stroke Rehabilitation? Not Yet, but Soon.

Curr Neurol Neurosci Rep. 2019-2-20

[2]
The interaction between training and plasticity in the poststroke brain.

Curr Opin Neurol. 2013-12

[3]
Early Rehabilitation After Stroke: a Narrative Review.

Curr Atheroscler Rep. 2017-11-7

[4]
Interventions to Enhance Adaptive Plasticity after Stroke: From Mechanisms to Therapeutic Perspectives.

Neural Plast. 2016

[5]
Brain plasticity and rehabilitation in stroke patients.

J Nippon Med Sch. 2015

[6]
Lost in translation: rethinking approaches to stroke recovery.

Prog Brain Res. 2015

[7]
Cortical reorganization--effects of intensive therapy.

Restor Neurol Neurosci. 2004

[8]
Advanced Neurotechnologies for the Restoration of Motor Function.

Neuron. 2020-2-19

[9]
Current trends in stroke rehabilitation. A review with focus on brain plasticity.

Acta Neurol Scand. 2010-8-19

[10]
Neural network remodeling underlying motor map reorganization induced by rehabilitative training after ischemic stroke.

Neuroscience. 2016-12-17

引用本文的文献

[1]
Poststroke eHealth Technologies-Based Rehabilitation for Upper Limb Recovery: Systematic Review.

J Med Internet Res. 2025-3-4

[2]
Post-Stroke Recovery in Relation to Parvalbumin-Positive Interneurons and Perineuronal Nets.

Neurorehabil Neural Repair. 2025-4

[3]
The Role of Mirror Therapy in the Rehabilitation of the Upper Limb's Motor Deficits After Stroke: Narrative Review.

J Clin Med. 2024-12-20

[4]
Changes of health-related quality of life within 6 months after stroke by clinical and sociodemographic factors.

Sci Rep. 2025-1-2

[5]
Effect of intermittent theta burst stimulation on upper limb function in stroke patients: a systematic review and meta-analysis.

Front Neurol. 2024-10-11

[6]
What factors at discharge predict physical activity and walking outcomes 6 months after stroke? A systematic review.

Clin Rehabil. 2024-10

[7]
Developmental trajectory of care dependency in older stroke patients.

Front Neurol. 2024-5-20

[8]
A modified rehabilitation paradigm bilaterally increased rat extensor digitorum communis muscle size but did not improve forelimb function after stroke.

PLoS One. 2024

[9]
Cycling using functional electrical stimulation therapy to improve motor function and activity in post-stroke individuals in early subacute phase: a systematic review with meta-analysis.

Biomed Eng Online. 2024-1-2

[10]
Feasibility and outcomes of supplemental gait training by robotic and conventional means in acute stroke rehabilitation.

J Neuroeng Rehabil. 2023-10-4

本文引用的文献

[1]
Genome-wide transcriptome analysis using RNA-Seq reveals a large number of differentially expressed genes in a transient MCAO rat model.

BMC Genomics. 2018-9-5

[2]
Genome-Wide Expression Profiles for Ischemic Stroke: A Meta-Analysis.

J Stroke Cerebrovasc Dis. 2018-11

[3]
Is Environmental Enrichment Ready for Clinical Application in Human Post-stroke Rehabilitation?

Front Behav Neurosci. 2018-7-11

[4]
Temporal Gene Expression Profiles after Focal Cerebral Ischemia in Mice.

Aging Dis. 2018-4-1

[5]
CREB controls cortical circuit plasticity and functional recovery after stroke.

Nat Commun. 2018-6-8

[6]
Motor Improvement of Skilled Forelimb Use Induced by Treatment with Growth Hormone and Rehabilitation Is Dependent on the Onset of the Treatment after Cortical Ablation.

Neural Plast. 2018-3-20

[7]
Synergistic Effects of Enriched Environment and Task-Specific Reach Training on Poststroke Recovery of Motor Function.

Stroke. 2018-5-11

[8]
Ischemic Stroke Alters the Expression of the Transcribed Ultraconserved Regions of the Genome in Rat Brain.

Stroke. 2018-3-16

[9]
Predicting recovery in acute poststroke aphasia.

Ann Neurol. 2018-3-10

[10]
Does Stroke Rehabilitation Really Matter? Part B: An Algorithm for Prescribing an Effective Intensity of Rehabilitation.

Neurorehabil Neural Repair. 2018-1-15

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