A Call to Arm Rehabilitation to End Neuro-Nihilism

Stroke is among the top three causes of disability in our species. Motor deficits are the most common problem after stroke and a major contributor to this disability. Activity-based training (e.g., physical therapy or occupational therapy) can improve behavioural outcomes, with meta-analysis suggesting that higher doses of activity-based therapy targeting the motor system improve behavioural outcomes after stroke.1 However, many patients do not receive high doses of rehabilitation therapy after stroke, for reasons that include economic factors, access, and a paucity of data to guide decision-making regarding therapy intensity.

In this context, Ward et al2 examined whether providing patients with a very large dose of rehabilitation therapy produces enduring gains in motor function, with critically important results. These authors …