Dr. Janna Friedly, M.D., MPH

March 2022:

Lesion location may attenuate response to strategy training in acute stroke

This month I chose “ Lesion location may attenuate response to strategy training in acute stroke “ by Dr. Elizabeth Skidmore to highlight. This study examined data from two randomized clinical trials of strategy training for stroke rehabilitation to determine if patients with strokes affecting regions of the brain involved with goal-directed behavior are less amenable to strategy training. Research aimed at determining the effectiveness of specific components of rehabilitation interventions on specific subsets of patients is critical yet difficult to conduct. Studying one specific aspect of rehabilitation interventions on outcomes is challenging and this is in part why we lack evidence for many of the interventions commonly used in rehabilitation. This study found that stroke lesions in ventromedial regions of the brain attenuated patients’ responsiveness to strategy training (which involves identifying specific problems with everyday activities and helping patients develop tailored strategies to address these problems). These findings provide guidance on which patients are less likely to benefit from this specific rehabilitation intervention – allowing for more efficient delivery of tailored rehabilitation interventions post-stroke. Although this study should be replicated in larger studies that are multi-institutional, it is representative of the kind of research needed to advance rehabilitation care. I hope to see a lot more studies of rehabilitation interventions in different care settings and patient populations in PM&R!

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