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Título

The Importance of Sleep for Successful Neurorehabilitation after Stroke

Resumo

Introduction - Proper sleep has important clinical implications for the learning and re-learning of movements and activities of daily life for optimal stroke rehabilitation. Both sleep and rehabilitation are critical for many activities that may need to be learned or re-learned following stroke, and for functionality in everyday life. In this context, sleep is essential in neurorehabilitation practice as it supports neuroplasticity, memory, and learning.
Objective - We aimed to systematically review the literature to answer if sleep (including naps) matters as a contributing factor for neurorehabilitation in patients after stroke in adults.
Methods - A systematic review was performed on clinical trials investigating the influence of sleep on post-stroke neurorehabilitation. The PRISMA guidelines were followed. Seven investigations were included in this review. Data were extracted and assessed for quality and risk of bias. We looked at any neurorehabilitation setting, compared sleep versus no sleep in rehabilitation, and explored these factors in stroke patients versus healthy individuals.
Results - This systematic review found that published neurorehabilitation interventions included nighttime sleep and long naps (≥ 90mins after intervention) as the intervention improved motor consolidation in patients following stroke. Sleep should be encouraged in the treatment of stroke to maximize outcomes. After a stroke, sleep disorders of any kind (e.g., OSA, insomnia, circadian rhythm disorders) can negatively influence neuroplasticity recovery and physical rehabilitation.
Conclusion - The available data suggest that sleep should be considered in the treatment plan for successfully targeted physiotherapy to optimize cognitive and motor learning.
Sleep hygiene and therapies to improve sleep, both quality and quantity are imperative in stroke treatments as they modulate rehabilitation outcomes.

Palavras Chave

Stroke, Rehabilitation, sleep

Área

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