Purpose: This text is written to provide the reader with a multidisciplinary and international perspective on the basic neuroscience and anatomy of stroke, the physiology of neural recovery after focal injury, and clinical rehabilitation interventions for stroke, based on randomized clinical trials. The intent is to provide a practical clinical guide to evidence-based stroke rehabilitation built on a foundation of basic neurophysiology and neuroscience.
Audience: The text has been written for academicians and clinicians involved in stroke rehabilitation. Contributors include basic scientists and clinicians from a variety of fields, including biomedical engineering, neurology, physical medicine and rehabilitation, psychology, neuroscience, physical therapy, occupational therapy, speech and language pathology, neuroradiology, optometry, orthotics, and rehabilitation nursing.
Organization/Structure: The text is organized into 8 sections with 47 chapters. Each chapter is written by recognized experts in their fields of study, is well organized, and includes introductions to the chapters, helpful figures, pictures, diagnostic imaging, tables, assessment tools, and summaries at the end of the chapter. Many chapters include patient, family, and clinician education resources.
Information: Section 1, the “Introduction,” includes 6 chapters which review the historical origins of stroke rehabilitation, epidemiology, pathophysiology, management and neuroimaging of acute stroke, and cerebral and infratentorial stroke syndromes. Section 2, “Neurophysiology of Stroke Recovery,” addresses the mechanisms and neurophysiology of recovery after stroke, functional imaging and stroke recovery, and the physiological basis of rehabilitation therapeutics in stroke. Section 3, “Neurologic Impairments and Their Treatment,” describes aphasia; apraxia of speech; dysarthria; right hemispheric neurobehavioral syndromes; memory; executive function; dementia; central poststroke pain; and visual, oculomotor, and vestibular deficits. Section 4, “Sensorimotor Impairments and Their Treatment,” covers patterns of locomotor recovery after stroke, task-oriented training to promote upper extremity recovery, neuromuscular electrical stimulation for motor restoration in hemiplegia, technological aids for motor recovery, walking recovery and rehabilitation after stroke, and recovery and rehabilitation of standing balance after stroke. Section 5, “Post-Stroke Complications and Their Treatment,” focuses on secondary prevention of ischemic stroke, prevention of deconditioning after stroke, medical complications, physiology and management of spasticity, shoulder pain and other musculoskeletal complications, depression and other neuropsychiatric complications, fatigue, sleep disturbances, malnutrition, and bladder and bowel management after stroke. Section 6, “Other Rehabilitation Therapeutics,” outlines orthotic management; alternative, complementary, and integrative medicine; seating; assistive technology; and equipment. Section 7, “Stroke Care Systems and Outcomes,” includes information on stroke-specific functional assessment instruments; predictive factors for recovery; stroke services: a global perspective; levels of rehabilitative care and patient triage; and rehabilitation of children, young adults, and older adults. The final section, Section 8, “Psychosocial and Community Reintegration,” focuses on ethical issues in the care of stroke survivors.
Summary: This comprehensive text is the first to include all aspects of stroke recovery and rehabilitation, with contributions from well-recognized experts in their disciplines. It is well-organized and written and includes the latest information and research in stroke. It is appropriate for all academicians and clinicians working with stroke survivors.
Anne McCarthy Jacobson, PT, DPT, MS
Clinical Assistant Professor
Graduate Programs in Physical Therapy
MGH Institute of Health Professions, Boston, Massachusetts
Clinical Expert Physical Therapist
Spaulding Rehabilitation Hospital, Boston, Massachusetts