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Intensity of rehabilitation: some answers and more questions?

Academic Section of Geriatric Medicine, 3rd Floor, Centre Block, Royal Infirmary, Glasgow G4 0SF, UK

Correspondence to:
Correspondence to:
Dr P Langhorne;
p.langhorne@clinmed.gla.ac.uk

Keywords: stroke; rehabilitation

For many years rehabilitation researchers have pondered whether the observed recovery of patients from stroke occurs at the optimum natural recovery rate or may be further enhanced by rehabilitation interventions, in particular by increasing the intensity of rehabilitation input. A carefully conducted randomised trial by Kwakkel et al¹ indicated that increasing the intensity of physical training after middle cerebral artery stroke brought about improvements in the recovery during the first 6 months. When the additional training was focused on the upper limb improvements in dexterity were observed; when the lower limb was targeted walking ability and Barthel activities of daily living (ADL) scores improved. In their follow up paper (Kwakkel et al this issue pp 473–479)² they address the question of whether these benefits continue in the longer term. This follow up paper indicates that there were no significant differences between the treatment groups at one year after randomisation, . . . [Full text of this article]