Stroke patients who take part in a high-intensity, early-start rehabilitation program show greater recovery than those receiving low-intensity rehab, according to an analysis by researchers in London and Barcelona. Their results suggest that the standard of care for stroke patients offered by many healthcare systems should be reevaluated. 

Researchers compared the results of two independent rehabilitation studies involving a total of 455 stroke patients who had lost some motor function in their arms. In the first study, UCL’s Queen Square Upper Limb Neurorehabilitation program offered patients three weeks of six-hour-a-day therapy — approximately 90 hours in total. In the second study, the Institute for Bioengineering of Catalonia’s Rehabilitation Gaming System offered patients 20 to 30 minutes a day of therapy for between three and 12 weeks, or 7.5 hours to 30 hours in total.

After measuring each patient’s improvement rate per week relative to their respective recovery potential, results showed that the recovery of those who received six hours of therapy per day was significantly greater than those who received just 20 to 30 minutes. These findings also backed up previous studies showing that the advantages of rehabilitation decrease the later that therapy starts following a stroke. Despite this, researchers observed that the benefits of receiving high-intensity therapy were enough to overcome the detrimental effects of starting late.

Current healthcare guidelines in many parts of the world still dictate that rehabilitation should not begin too early after a stroke, that the duration of each individual session should be short, and that patients should be discharged early, the study authors noted. They also predicted that patients who received high-intensity therapy would have shown even greater improvements if the duration of their program had gone longer than their weeks. 

“Many protocols follow a three-to-six-month window of recovery, but we believe that it could actually be much longer than that — perhaps even years,” concluded study author Belén Rubio Ballester with IBEC.

Full findings are published in the Journal of Neurology, Neurosurgery & Psychiatry.