Summary

Stroke is the leading cause of disability in the adult worldwide. The most common neurological impairment following stroke is weakness or loss of sensibility of the extremities contralateral to the side of the brain lesion. Only about 40% of affected individuals regain full recovery; the remaining 60% have persistent neurological deficits that impact on their social functioning in private and community life. By now, much of our clinical and scientific interest is focused on stroke prevention and acute stroke therapy. In contrast, there is less effort in developing novel strategies for hand motor rehabilitation after stroke. This is surprising since about two-thirds of stroke survivors are left with permanent sensory or motor impairment. This chapter discusses the intrinsic capacity of the cortical motor system for reorganization and gives an overview of established and novel concepts for sensorimotor rehabilitation of the hand after stroke.

Introduction

Stroke is the leading cause of disability in the adult worldwide (Kolominsky-Rabas et al., 2001). The annual incidence of stroke is 100–300 per 100,000 (Broderick et al., 1998). The most common impairment following stroke is weakness of the limbs contralateral to the side of the brain lesion (Kelly-Hayes et al., 1998). Only about 40% of stroke survivors recover completely (Hankey et al., 2002) and among the remaining 60% permanent sensory and/or motor disability of the hand constitutes a major problem (Stein, 1998).