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Carolee Winstein

The last decade has witnessed an increase in the number of moderate to large-scale nonpharmacologic stroke recovery trials. While a majority, having tested the superiority of a particular evidence-based intervention, returned negative findings, the rehabilitation research community has gained an important perspective for future efforts. We offer our interpretation first, on why most of the past decade’s trials failed in the sense of not supporting the primary superiority hypothesis, and, second, we provide our perspective on how to solve this problem and thereby inform the next generation of neurorehabilitation clinical trials. The first large-scale randomized controlled trial (RCT) ever conducted in neurorehabilitation was the Extremity Constraint Induced Movement Therapy Evaluation (EXCITE) trial. The majority of stroke recovery trials that followed were based on a prevailing, but as yet immature science of brain-behavior mechanisms for recovery and limited practical know-how about how to select the most meaningful outcomes. The research community had been seduced by a set of preclinical studies, ignited by the 1990’s revolution in neuroscience and an oversimplified premise that high doses of task-oriented training was the most important ingredient to foster recovery. Here, we highlight recent qualitative and quantitative evidence, both mechanistic and theory-driven, that integrates crucial social and personal factors to inform a more mature science better suited for the next generation of recovery-supportive rehabilitation clinical trials.

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Xiaoke Chen, Xinzheng Sun, Di Gao, Dan Qiu, and Hui He

). Concise review: Endothelial progenitor cells in regenerative medicine: Applications and challenges . STEM CELLS Translational Medicine, 5 ( 4 ), 530 – 538 . https://doi.org/10.5966/sctm.2015-0227 10.5966/sctm.2015-0227 De Biase , C. , De Rosa , R. , Luciano , R. , De Luca , S. , Capuano , E

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Hangue Park, Alexander N. Klishko, Kyunggeune Oh, Celina Zhang, Gina Grenga, Kinsey R. Herrin, John F. Dalton IV, Robert S. Kistenberg, Michel A. Lemay, Mark Pitkin, Stephen P. DeWeerth, and Boris I. Prilutsky

, S. , Capogrosso , M. , Petrini , F.M. , Bonizzato , M. , Rigosa , J. , Di Pino , G. , . . . Micera , S. ( 2014 ). Restoring natural sensory feedback in real-time bidirectional hand prostheses . Science Translational Medicine, 6 ( 222 ), 222ra219 . https://doi.org/10

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Kelley Strohacker and Cory T. Beaumont

013e31821b94c8 Riley , W.T. , Glasgow , R.E. , Etheredge , L. , & Abernethy , A.P. ( 2013 ). Rapid, responsive, relevant (R3) research: A call for a rapid learning health research enterprise . Clinical and Translational Medicine, 2 ( 1 ), 10 . PubMed ID: 23663660 doi:10

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Shona L. Halson, Louise M. Burke, and Jeni Pearce

vivo and in vitro . Science Translational Medicine, 7 ( 305 ), 305ra146 . PubMed ID: 26378246 doi:10.1126/scitranslmed.aac5125 10.1126/scitranslmed.aac5125 Castell , L.M. , Nieman , D.C. , Bermon , S. , & Peeling , P. ( 2019 ). Exercise-induced illness and inflammation: Can immunonutrition

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Dana M. Lis, Daniel Kings, and D. Enette Larson-Meyer

Translational Medicine, 14 ( 1 ), 290 . PubMed ID: 27737674 doi:10.1186/s12967-016-1044-0 10.1186/s12967-016-1044-0 Morton , J. , Stellingwerff , T. , & Burke , L.M. ( 2018 ). Periodised nutrition for training adaptation . International Journal of Sport Nutrition and Exercise Metabolism . Manuscript

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Jennifer L. Walton-Fisette and Theresa A. Walton-Fisette

seeing medicine as science or art, she offers a “developing, untidy, methodological pluralism” (p. 225) that includes evidence-based medicine, consensus, translational medicine, and narrative medicine. Narrative medicine is one potential method that seeks to offer medical knowledge that accounts for

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Neda Nasrollahi, Jordan Quensell, and Liana Machado

.2466/pms.1994.79.1.191 10.2466/pms.1994.79.1.191 Qiu , C. , Johansson , G. , Zhu , F. , Kivipelto , M. , & Winblad , B. ( 2019 ). Prevention of cognitive decline in old age—Varying effects of interventions in different populations . Annals of Translational Medicine, 68 . https

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André Filipe Paulino da Silva Bento, Luis Carrasco Páez, and Armando Manuel de Mendonça Raimundo

expenditure and respiratory ratio in non-dieting individuals . Journal of Translational Medicine, 10 ( 1 ), 237 . PubMed ID: 23176325 doi:10.1186/1479-5876-10-237 Racil , G. , Ben Ounis , O. , Hammouda , O. , Kallel , A. , Zouhal , H. , Chamari , K. , & Amri , M. ( 2013 ). Effects of high