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Letter
The dose and intensity matter for chronic stroke
  1. Deborah Solomonow-Avnon,
  2. Firas Mawase
  1. Faculty of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
  1. Correspondence to Dr Firas Mawase, Faculty of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel; mawasef{at}bm.technion.ac.il

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Stroke is one of the most common causes of physical disability worldwide, and the majority of patients experience impairment of movement. Each year, approximately five million new people are left permanently disabled by stroke. Long-term reduction of impairment and restoring of function are of critical challenges. To date, the general consensus remains that current levels of rehabilitative training in chronic stroke result in minimal improvement, and are ineffective at enhancing recovery from motor impairment beyond what is achieved in the acute poststroke stage (eg, from spontaneous biological recovery). Furthermore, this recovery of functional and motor outcomes has even been shown to gradually deteriorate from the level of recovery achieved at 6 months poststroke to that at 2 months by 5 years poststroke,1 leaving stroke victims to suffer the remaining handicaps. In addition, it is argued that improvement following task-specific training in stroke does not necessarily stem from improvement in general movement quality. Recent study by Ward et al, 20192 addressed these questions and provided compelling evidence that intensive and high-dose behavioural training in the chronic poststroke stage could lead to clinically …

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