Neurorehabilitation relies on core principles of neuroplasticity to activate and engage latent neural connections, promote detour circuits, and reverse impairments. Clinical interventions incorporating these principles have been shown to promote recovery and demote compensation. However, many clinicians struggle to find interventions centered on these principles in our nascent, rapidly growing body of literature. Not to mention the immense pressure from regulatory bodies and organizational balance sheets that further discourage time-intensive recovery-promoting interventions, incentivizing clinicians to prioritize practical constraints over sound clinical decision making. Modern neurorehabilitation practices that result from these pressures favor strategies that encourage compensation over those that promote recovery. To narrow the gap between the busy clinician and the cutting-edge motor recovery literature, we distilled 5 features found in early-phase clinical intervention studies—ones that value the more enduring biological recovery processes over the more immediate compensatory remedies. Filtering emerging literature through this lens and routinely integrating promising research into daily practice can break down practical barriers for effective clinical translation and ultimately promote durable long-term outcomes. This perspective is meant to serve a new generation of mechanistically minded and caring clinicians, students, activists, and research trainees, who are poised to not only advance rehabilitation science, but also erect evidence-based policy changes to accelerate recovery-based stroke care.

中文翻译：

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在早期临床干预研究中寻找的五个特征

神经康复依赖于神经可塑性的核心原则来激活和参与潜在的神经连接，促进迂回回路和逆转损伤。结合这些原则的临床干预已被证明可以促进康复和降低代偿。然而，许多临床医生努力在我们新生的、快速增长的文献中找到以这些原则为中心的干预措施。更不用说来自监管机构和组织资产负债表的巨大压力进一步阻碍了时间密集型恢复促进干预措施，激励临床医生优先考虑实际限制而不是合理的临床决策。由这些压力产生的现代神经康复实践更倾向于鼓励补偿的策略，而不是那些促进恢复的策略。为了缩小忙碌的临床医生与前沿的运动恢复文献之间的差距，我们提炼出在早期临床干预研究中发现的 5 个特征——这些特征更重视更持久的生物恢复过程，而不是更直接的代偿疗法。通过这个镜头筛选新兴文献，并将有前途的研究定期整合到日常实践中，可以打破有效临床转化的实际障碍，并最终促进持久的长期结果。这一观点旨在为新一代具有机械思维和关怀精神的临床医生、学生、活动家和研究实习生提供服务，他们不仅准备好推进康复科学，而且准备建立基于证据的政策变革，以加速基于康复的中风护理。