Rehabilitation and Recovery After Stroke

Many poststroke complications are preventable. There are few data comparing the efficacy of specific, standard physiotherapeutic approaches with each other or with the incidence of spontaneous recovery. More intensive physiotherapeutic approaches may be of benefit, but the available data are inconclusive. Innovative physiotherapeutic approaches, such as robot training and forced-use therapy, are promising but require further study. Certain classes of drugs affecting central neurotransmitters (eg, alpha(2)-adrenergic receptor agonists, alpha(1)-adrenergic receptor antagonists, haloperidol, phenytoin, phenobarbital, and benzodiazepines) may interfere with recovery and should be avoided if possible until definitive data become available. Pharmacotherapy to improve poststroke recovery remains experimental.