Does shorter rehabilitation limit potential recovery poststroke?

Abstract

Objective. To examine retrospectively the recovery of patients engaged in robotic research during a 6- to 7-week course of inpatient rehabilitation. Because timing of the interim evaluation at 31/2 weeks was comparable to the present length of inpatient stroke rehabilitation, the authors assessed whether significant gains in motor abilities occurred after the time when most stroke patients today are discharged home. Methods. Fifty-six inpatients with a single, unilateral stroke were randomly assigned to a robot therapy or robot exposure group. Therapists blinded to group assignment administered the Fugl-Meyer, Motor Status Score, and MRC motor power test. Results. Significant improvements in upper-limb motor abilities occurred throughout a period approximately twice the present length of stay in inpatient rehabilitation. However, in the latter half of this period, patients who received conventional therapy showed little improvement, whereas patients who received robot training plus conventional therapy continued to improve. Conclusion. Further opportunities for recovery after stroke are possible by extending intensive therapy beyond present inpatient rehabilitation stays.