Acute-Phase Stroke Rehabilitation: Translating Mechanisms and Evidence Into Practice

Despite major advances in acute stroke care, rehabilitation in the first hours to days after stroke remains inconsistently delivered, with ongoing uncertainty around who benefits most, when to start, and what “dose” is safe and effective. This Research Topic aims to address these gaps by bringing together clinical, mechanistic, and health-systems research that can guide earlier, better-coordinated, and more personalized rehabilitation in the acute phase. We seek contributions that clarify how acute rehabilitation can be integrated into modern stroke pathways (including Stroke Unit care and reperfusion strategies), how timing and intensity can be optimized, and how patient stratification and biomarkers can support clinical decision-making. Ultimately, the goal is to accelerate translation of emerging evidence into practical, scalable acute-care rehabilitation models that improve recovery trajectories and long-term outcomes.Acute-phase stroke rehabilitation has undergone a marked transformation over the past decade. New evidence on early mobilization, the maturation of interdisciplinary Stroke Unit care, and innovation in neurorehabilitation technologies have reshaped when and how rehabilitation begins after stroke onset. In parallel, advances in neuroimaging and neurophysiology are improving our ability to measure early impairment, recovery potential, and treatment response. The wider adoption of endovascular treatment and progress in basic science are further changing the clinical landscape, creating both opportunities and new challenges for early rehabilitation delivery. Increasingly, research suggests that timely, coordinated interventions during the acute stage can meaningfully influence functional recovery, long-term disability, and quality of life—provided they are appropriately targeted and implemented within acute care systems.This Research Topic welcomes work that advances acute stroke rehabilitation practice and mechanisms, including studies focused on motor, cognitive, communication, swallowing, and psychosocial domains. Topics of interest include:- Optimization of timing, intensity, and content of early rehabilitation- Patient stratification (clinical profiles, biomarkers, imaging/neurophysiology-based phenotyping)- Integration of rehabilitation into acute stroke pathways (Stroke Unit workflows, post-reperfusion care, interdisciplinary models)- Translational studies linking neuroscience, recovery biology, and clinical outcomes- Implementation research addressing feasibility, fidelity, safety, and scalability in real-world servicesWe encourage methodological diversity, including clinical trials, observational and cohort studies, pragmatic/implementation designs, health-services research, and high-quality case series that provide novel insight into early rehabilitation after stroke. Topic editors: Syoichi Tashiro, Yuki Uchiyama Source: https://www.frontiersin.org/research-topics/78087/acute-phase-stroke-rehabilitation-translating-mechanisms-and-evidence-into-practice