The DOI matches its Crossref record; 58 of the 58 references it cites were found in a registry or an index.
Impact of intensity of practice after stroke: Issues for consideration
Abstract
PURPOSE: The present debate paper addresses four relevant issues related to the impact of intensity of practice after stroke. First, the best way to define intensity of practice is discussed. Second, the paper describes the evidence that exists for a dose-response relationship in stroke rehabilitation. Third, the relevance of an appropriate patient selection for a meaningful intensive practice is explored. Finally, the paper raises the question of what it is that patients actually learn when they improve their functional skills. Search strategy. For this purpose articles from MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, PEDro, DARE and PiCarta and references presented in relevant publications were examined. DISCUSSION AND CONCLUSION: Although, there is strong evidence that early augmented exercise therapy time (expressed as time dedicated to practice) may enhance functional recovery, there is a discrepancy between the evidence for the benefits of intensive practice, on the one hand, and, the implementation of intensive rehabilitation treatment programmes in the current healthcare system on the other. Further emphasis should be given on a better understanding of the time-dependency of prognostic factors that determine the effectiveness of intensive practice in patients with stroke. In addition, a better understanding is needed of the neurophysiological and biomechanical mechanisms that underlie compensation-related learning of functional tasks after stroke.
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“Definitions for therapy intensity vary, but to date the focus has been on amount (minutes) rather than frequency (repetitions of a task, or sessions per day).16”
From Prespecified dose-response analysis for A Very Early Rehabilitation Trial (AVERT) (2016) · cites this paper as [16]
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Cites
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Probability of Regaining Dexterity in the Flaccid Upper Limb
Kwakkel, G., Kollen, B. J., van der Grond, J., & Prevo, A. J. H. (2003) · Stroke · doi:10.1161/01.str.0000087172.16305.cd · Cited by 1,409
Self-citationEffects of Augmented Exercise Therapy Time After Stroke: A Meta-Analysis
Kwakkel, G., van Peppen, R., Wagenaar, R. C., Wood Dauphinee, S., Richards, C., Ashburn, A., Miller, K., Lincoln, N., Partridge, C., Wellwood, I., et al. (2004) · Stroke · doi:10.1161/01.str.0000143153.76460.7d · Cited by 1,081
Self-citationCompensatory strategies for reaching in stroke
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The impact of physical therapy on functional outcomes after stroke: what's the evidence?
Van Peppen, R. P., Kwakkel, G., Wood-Dauphinee, S., Hendriks, H. J., Van der Wees, P. J., & Dekker, J. (2004) · Clinical Rehabilitation · doi:10.1191/0269215504cr843oa · Cited by 942
Self-citationIntensity of leg and arm training after primary middle-cerebral-artery stroke: a randomised trial
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Understanding the pattern of functional recovery after stroke: Facts and theories
Kwakkel, G., Kollen, B., & Lindeman, E. (2004) · Restorative Neurology and Neuroscience · doi:10.3233/rnn-2004-00282 · Cited by 727
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Cited by
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Items 401–417 of 417
Demartino, A. M., Ilha, J., Faria, J. G., Swarowsky, A., & Michaelsen, S. M. (2025) · European Journal of Physiotherapy · doi:10.1080/21679169.2025.2562038
Fall risk factors and exercise in Parkinson's disease
Allen, N. E. (2010) · The Sydney eScholarship Repository (The University of Sydney)
Kontinuitet i behandlingen og rehabilitering av pasienter med alvorlig traumatisk hjerneskade
Nilsen, H. W. (2012) · NORA - Norwegian Open Research Archives
Stockley, R., & Christian, D. L. (2022) · Figshare · doi:10.6084/m9.figshare.20069993
Nam, C., Zhang, B., Chow, T., Ye, F., Huang, Y., Guo, Z., Li, W., Rong, W., Hu, X., & Poon, W. (2021) · Figshare · doi:10.6084/m9.figshare.16625357
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Stockley, R., & Christian, D. L. (2022) · Figshare · doi:10.6084/m9.figshare.20069990
Rida, F., Feng, Y.-L., Zhou, Y., Tan, B.-T., Zhang, A., & Yu, L.-H. (2026) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.1177/10538127251412515
(2026) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2026.02.021
Moumeni, I. N., & Mapoure, Y. N. (2026) · Kinésithérapie la Revue · doi:10.1016/j.kine.2026.01.017
Emerging Technologies in Neurological Rehabilitation
Malik, A. N. (2026) · SpringerBriefs in modern perspectives on disability research. · doi:10.1007/978-981-92-1343-6_2
Dynamics-Based Collaborative Control for an Exoskeleton-Walker System via Deterministic Learning
He, W., Zhang, X., Yang, Q., Zou, C., Zhang, F., Cheng, H., & Wang, C. (2026) · IEEE Transactions on Automation Science and Engineering · doi:10.1109/tase.2026.3713580
Neural Repair Therapies After Stroke: II. Principles for Clinical Trials
Lin, D. J., & Cramer, S. C. (2026) · Stroke · doi:10.1161/strokeaha.126.056133
Treatment of transient ischemic attack and stroke
Pendlebury, S. T., Giles, M. F., & Rothwell, P. M. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511575815.019
Issues in Clinical Trial Design in Stem Cell Trials After Stroke
Cramer, S. C. (2015) · Springer eBooks · doi:10.1007/978-3-319-15063-5_18
Technology of neurorehabilitation: outcome measurement and diagnostic technology
Selzer, M. E., Clarke, S., Cohen, L. G., Kwakkel, G., & Miller, R. H. (2014) · Cambridge University Press eBooks · doi:10.1017/cbo9780511995590.003
Self-citation
Metadata
- Authors
- Kwakkel, G.
- Affiliations
- University Medical Center Utrecht (NL)
- Corresponding author
- Kwakkel, Gert
- ORCID
- Kwakkel, Gert
- Venue
- Disability and Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2006-01
- Volume
- 28
- Issue
- 13-14
- Pages
- 823-830
- ISSN
- 0963-8288 (ISSN-L)
- 1464-5165
- OpenAlex
- W2135838445
- Cited by
- 417
- References
- 58
- Citations by year
- 2026: 10 · 2025: 5 · 2024: 11 · 2023: 28 · 2022: 29 · 2021: 21 · 2020: 17 · 2019: 23 · 2018: 24 · 2017: 14 · 2016: 24 · 2015: 30 · 2014: 37 · 2013: 19 · 2012: 21
- FWCI
- 3.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Disability and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- ZonMw
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Keywords
- stroke rehabilitation, intensive rehabilitation, dose-response relationship, patient selection, functional recovery, neurophysiological mechanisms, biomechanical mechanisms
- MeSH terms
- Stroke Rehabilitation, Activities of Daily Living, Exercise Therapy, Humans, Motor Activity, Prognosis, Rehabilitation, Randomized Controlled Trials as Topic, Treatment Outcome, Recovery of Function, Physical Therapy Modalities
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