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November 1, 2006

Stroke Recovery—Moving in an EXCITE-ing Direction

Author Affiliations

Affiliations: Department of General Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany (Dr Luft); Division of Brain Injury Outcomes, Department of Neurology, Johns Hopkins University (Drs Luft and Hanley), Department of Neurology (Dr Luft) and Department of Medicine, Division of Gerontology (Dr Hanley), University of Maryland School of Medicine, and Department of Veterans Affairs, Baltimore VA Medical Center Geriatric Research, Education and Clinical Center (Drs Luft and Hanley), Baltimore, Md.

JAMA. 2006;296(17):2141-2143. doi:10.1001/jama.296.17.2141

Stroke produces well-known motor and cognitive impairment and high levels of disability. Currently used stroke rehabilitation treatments generally are based on empirical approaches rather than scientifically validated therapies.1-3 A wide variety of poorly standardized and unevaluated traditional treatments aim to recondition spinal or muscular targets to prevent4 or accommodate5 impaired motor control. The results of the EXCITE (Extremity Constraint Induced Therapy Evaluation) trial reported by Wolf and colleagues6 in this issue of JAMA contribute to a new understanding of how to approach disability in stroke survivors. A careful look at this trial and its background opens new directions for clinical care, stroke recovery, rehabilitation care delivery, and research. Such new directions are of utmost importance for stroke survivors who hope to reacquire abilities lost after ischemic brain injury.

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