Investigation on a critical time window for gait training in stroke rehabilitation.

Animal models have shown that motor training is effective only if initiated early after stroke. This activity-induced recovery pattern temporally matches increased gene expression important for neuronal growth and plasticity in the post-stroke brain. It seems that the brain after damage induces a window of enhanced neuroplasticity during which greatest rehabilitation gains can be achieved. In human stroke care, earlier rehabilitation is associated with improved outcome, however it remains unknown whether a similar time window exists and how to take advantage in clinical practice.In the current research project, gait training will be initiated at a very early stage using a mobile, wearable exoskeleton allowing even acute patients to walk over-ground. A comparison of clinical outcome with a group receiving the same intervention at a later stage will allow to investigate on the factor timing. Moreover, an association between functional improvement and outcomes on neuro-motor recovery (neuro-imaging, Fugl-Meyer Assessment, biomechanical gait analysis) will be investigated. This will enlighten our understanding on when an intervention should be provided in order to affect the proportions of plastic re-organization. Further research on larger populations with a longer follow-up is needed to confirm preliminary results and finally implement these insights into therapeutic strategies and clinical practice. This approach can lead to substantial changes in how rehabilitative treatment is provided to neurological patients.

Keywords:EXPERIMENTAL STUDY, GAIT ANALYSIS, REHABILITATION TECHNOLOGY, STROKE

Disciplines:Biomechanics, Medical imaging and therapy, Neurosciences, Orthopaedics, Human movement and sports sciences, Rehabilitation sciences, Other paramedical sciences, Biological and physiological psychology, Cognitive science and intelligent systems, Developmental psychology and ageing