When should upper limb function be trained after stroke? Evidence for and against early intervention

Very little time is available for arm and hand training while patients are in hospital after stroke. Therapeutic strategies that use intensive practice in the early days and weeks after stroke may improve the recovery of upper limb function. This paper considers the physiology of the brain in acute stroke and evaluates the evidence for and against early intensive activity of the upper limb as an essential precursor to any decision to invest in increased activity.