BACKGROUND: The proportional recovery rule suggests that current rehabilitation practices may have limited ability to influence stroke recovery. However, the appropriate intensity of rehabilitation needed to achieve recovery remains unknown. Similarities between rodent and human recovery biomarkers may allow determination of rehabilitation thresholds necessary to activate endogenous biological recovery processes. OBJECTIVE: We determined the relative influence that clinically relevant biomarkers of stroke recovery exert on functional outcome. These biomarkers were then used to generate an algorithm that prescribes individualized intensities of rehabilitation necessary for recovery of function. METHODS: A retrospective cohort of 593 male Sprague-Dawley rats was used to identify biomarkers that best predicted poststroke change in pellet retrieval in the Montoya staircase-reaching task using multiple linear regression. Prospective manipulation of these factors using endothelin-1-induced stroke (n = 49) was used to validate the model. RESULTS: Rehabilitation was necessary to reliably predict recovery across the continuum of stroke severity. As infarct volume and initial impairment increased, more intensive rehabilitation was required to engage recovery. In this model, we prescribed the specific dose of daily rehabilitation required for rats to achieve significant motor recovery using the biomarkers of initial poststroke impairment and infarct volume. CONCLUSIONS: Our algorithm demonstrates an individualized approach to stroke rehabilitation, wherein imaging and functional performance measures can be used to develop an optimized rehabilitation paradigm for rats, particularly those with severe impairments. Exploring this approach in human patients could lead to an increase in the proportion of individuals experiencing recovery of lost motor function poststroke.
BACKGROUND: The proportional recovery rule suggests that current rehabilitation practices may have limited ability to influence stroke recovery. However, the appropriate intensity of rehabilitation needed to achieve recovery remains unknown. Similarities between rodent and human recovery biomarkers may allow determination of rehabilitation thresholds necessary to activate endogenous biological recovery processes. OBJECTIVE: We determined the relative influence that clinically relevant biomarkers of stroke recovery exert on functional outcome. These biomarkers were then used to generate an algorithm that prescribes individualized intensities of rehabilitation necessary for recovery of function. METHODS: A retrospective cohort of 593 male Sprague-Dawley rats was used to identify biomarkers that best predicted poststroke change in pellet retrieval in the Montoya staircase-reaching task using multiple linear regression. Prospective manipulation of these factors using endothelin-1-induced stroke (n = 49) was used to validate the model. RESULTS: Rehabilitation was necessary to reliably predict recovery across the continuum of stroke severity. As infarct volume and initial impairment increased, more intensive rehabilitation was required to engage recovery. In this model, we prescribed the specific dose of daily rehabilitation required for rats to achieve significant motor recovery using the biomarkers of initial poststroke impairment and infarct volume. CONCLUSIONS: Our algorithm demonstrates an individualized approach to stroke rehabilitation, wherein imaging and functional performance measures can be used to develop an optimized rehabilitation paradigm for rats, particularly those with severe impairments. Exploring this approach in humanpatients could lead to an increase in the proportion of individuals experiencing recovery of lost motor function poststroke.
Authors: Matthew S Jeffers; Boris Touvykine; Allyson Ripley; Gillian Lahey; Anthony Carter; Numa Dancause; Dale Corbett Journal: J Neurosci Date: 2020-06-30 Impact factor: 6.167
Authors: Jennifer Wu; Lucy Dodakian; Jill See; Erin Burke Quinlan; Lisa Meng; Jeby Abraham; Ellen C Wong; Vu Le; Alison McKenzie; Steven C Cramer Journal: Neurorehabil Neural Repair Date: 2020-10-21 Impact factor: 3.919
Authors: Matthew W McDonald; Matthew S Jeffers; Lama Issa; Anthony Carter; Allyson Ripley; Lydia M Kuhl; Cameron Morse; Cesar H Comin; Bernard J Jasmin; Baptiste Lacoste; Dale Corbett Journal: Neurorehabil Neural Repair Date: 2021-04-07 Impact factor: 3.919
Authors: Gustavo Balbinot; Clarissa Pedrini Schuch; Matthew S Jeffers; Matthew W McDonald; Jessica M Livingston-Thomas; Dale Corbett Journal: Sci Rep Date: 2018-06-07 Impact factor: 4.379
Authors: Quentin Sanders; Vicky Chan; Renee Augsburger; Steven C Cramer; David J Reinkensmeyer; An H Do Journal: IEEE Trans Neural Syst Rehabil Eng Date: 2020-04-15 Impact factor: 4.528