Long-Term Stroke Recovery: New Study Shows Functional Gains Plateau After 6 Months

NeuroRehab Team
Tuesday, July 1st, 2025

Stroke recovery is often described as a race against time. The biggest improvements usually happen early — but a landmark European study shows that without the right strategies, functional gains can fade over time.

This multi-center study followed over 500 stroke survivors for five years, measuring how well they recovered motor skills and daily function. The results remind therapists, patients, and caregivers that recovery doesn’t stop at discharge.

📈 Key Findings: What Happens Over 5 Years?

• Most recovery happens fast: The largest improvements were in the first 2 months.
• Progress slows: Between 2 and 6 months, gains continued but more slowly.
• Long-term plateau: From 6 months to 5 years, scores declined slightly — returning close to 2-month levels.
• Severity & age matter: Older adults and those with severe strokes showed poorer recovery overall.
• Stroke type differences: Patients with hemorrhagic strokes recovered arm function a bit better than those with infarcts.

🧠 Why Does Recovery Plateau?

Early on, the brain naturally rewires damaged pathways. Therapy speeds this up. But after a few months, the brain’s spontaneous recovery slows down. Without targeted, high-repetition practice, people tend to use their stronger side and neglect the weak arm or leg. This “learned non-use” makes it harder to improve later.

🔑 Strategies to Sustain Gains

The good news? Research shows that smart planning can slow or prevent this decline. Therapists and families should think long-term:

• Use home exercise programs: Teach patients safe, goal-oriented tasks they can repeat daily.
• Try booster sessions: Periodic “tune-ups” with a therapist can refresh skills and motivation.
• Promote increased use: Treatments like constraint-induced movement therapy (CIMT) force the weak limb to work harder.
• Consider telerehab: Remote sessions help patients stick with exercises and feel supported.
• Stay realistic: Tailor goals to age, stroke severity, and what motivates the patient day-to-day.

⚡ Real-World Application

This long-term study confirms what seasoned therapists know: short bursts of therapy aren’t enough. For lasting recovery, patients need ongoing, evidence-based practice that keeps their brain and body engaged.

Helping stroke survivors reach new milestones — even years later — means combining early intensive therapy with long-term self-management and family education.

📚 Related Evidence and Resources

• 5-Year Functional Outcome After Stroke (PubMed)
• Full Article in Stroke Journal
• Motor Recovery Patterns (PMC)

✅ Bottom Line

Recovery plateaus are real, but not permanent roadblocks. With the right mix of high-repetition therapy, functional tasks, and patient engagement, people can hold onto and even build on early gains.