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Long-term rehabilitation after stroke: where do we go from here?

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  21 July 2010

NA Aziz
NA Aziz*
Affiliation:
Department of Family Medicine, University Kebangsaan Malaysia Medical Centre, Cheras Kuala Lumpur, Malaysia
*
Address for correspondence: Dr Noor Azah Aziz, Associate Professor in Family Medicine/Stroke Rehabilitation, Department of Family Medicine, Medical Faculty University Kebangsaan Malaysia Medical Centre (UKM MC), Cheras Kuala Lumpur, 53000Malaysia. Email: [email protected]; [email protected]
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Summary

Current guidelines in stroke management are divided on the issue of providing further rehabilitation to stroke patients who have had stroke six months ago and longer. Whilst consensus considers that long-term rehabilitation is neither practical nor beneficial, rehabilitation remains vital in the complex management of longer-term stroke care, as it provides continuity from the formal rehabilitation intervention in the hospital setting. Longer-term rehabilitation is principally a community-based intervention, as it aims to assist the survivors to become more independent through social and leisure-based interventions. Available evidence is limited, with available studies heterogeneous and small in sample size. This review aims to look into the existing evidence, and discusses the feasibility and challenges in providing longer-term rehabilitation to stroke survivors.

Keywords

strokerehabilitationrecoverycommunity
Type
Intermediate care & rehabilitation
Information
Reviews in Clinical Gerontology , Volume 20 , Issue 3 , August 2010 , pp. 239 - 245
Copyright
Copyright © Cambridge University Press 2010

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References

1Sudlow, CL, Warlow, P. Comparable studies of the incidence of stroke and its pathological types: results from international collaboration. International Stroke Incidence Collaboration. Stroke 2009; 28: 491–99.CrossRefGoogle Scholar
2McKay, J, Mensah, GA. The Atlas of Heart Disease and Stroke. World Health Organization (WHO). Geneva: WHO Publications, 2004.Google Scholar
3Sarti, C, Rasteny, LD, Cepaitis, Z, Tuomilehto, J. International trends in mortality from stroke, 1968–1994. Stroke 2000; 31: 1588–1601.CrossRefGoogle Scholar
4Wilkinson, PR, Wolfe, CDA, Warburton, FG, Howard, RS, Ross-Russel, R, Rudd, AG, Beech, RR. A long-term follow-up of stroke patients. Stroke 1997; 28: 507–12.CrossRefGoogle ScholarPubMed
5Patel, MD, Tilling, K, Lawrence, E, Rudd, AG, Wolfe, CDA, McKevitt, C. Relationships between long-term stroke disability, handicap and health related quality of life. Age Ageing 2006; 35: 273–79.CrossRefGoogle ScholarPubMed
6Intercollegiate Stroke Working Party. National Clinical Guidelines for Stroke, 3rd edn. London: Royal College of Physicians, 2008.Google Scholar
7National Stroke Foundation. Clinical Guidelines for Stroke Rehabilitation and Recovery. Canberra: Australian Government National Health and Medical Research Council, 2005 (available at www.nhmrc.gov.au/publications).Google Scholar
8Duncan, PW, Zorowitz, R, Bates, B, Choi, JY, Glasberg, JJ, Graham, GD, Katz, RC, Lamberty, K, Reker, D. Management of adult stroke rehabilitation care: A clinical practice guideline. Stroke 2005; 36: e100–143.CrossRefGoogle Scholar
9Skilbeck, CE, Wade, DT, Hewer, RL, Wood, VA. Recovery after stroke. J Neurol Neurosurg Psychiat 1983; 46: 5–8.CrossRefGoogle ScholarPubMed
10Partridge, CJ, Johnston, M, Edwards, S. Recovery from physical disability after stroke: normal patterns as a basis for evaluation. Lancet 1987; i: 373–75.CrossRefGoogle Scholar
11Jongersen, HS, Nakayama, H, Padersen, PM, Raaschan, HO, Vive-Larsen, J, Stoler, M, Olsen, TS. Outcome and time-course of recovery in stroke. Part II: Time course of recovery. The Copenhagen Study. Archiv Physical Med Rehabil 1995; 76: 406–12.Google Scholar
12Dobkin, BH. Strategies for stroke rehabilitation. Lancet Neurol 2004; 3: 528–36.CrossRefGoogle ScholarPubMed
13Ebrahim, S, Harwood, R. Stroke: epidemiology, evidence and clinical practice. Oxford: Oxford University Press, 1999.Google Scholar
14Gravenson, GC, Gray, CS, French, JM, James, OFW. Long-term outcome for patients and carers following hospital admission for stroke. Age Ageing 1991; 20: 337–44.Google Scholar
15Indredavik, B, Slordhal, SA, Bakke, F, Rokseth, R, Haheim, LL. Stroke unit treatments. Long-term effects. Stroke 1997; 28: 1861–66.CrossRefGoogle ScholarPubMed
16Drummond, AER, Pearson, B, Lincoln, NB, Pearman, P. Ten year follow-up of a randomized controlled trial of care in a stroke rehabilitation unit. Br Med J 2005; 331: 491–92.CrossRefGoogle Scholar
17Lincoln, NB, Husbands, S, Trescoll, C, Drummond, AER, Gladman, JRF, Berman, P. Five-years follow-up of a randomized controlled-trial of stroke rehabilitation unit. Br Med J 2000; 320: 549.CrossRefGoogle Scholar
18World Health Organization (WHO). Cerebrovascular disorders: a clinical and research classification. Geneva: WHO, 1978, 43.Google Scholar
19Scotland Intercollegiate Guidelines Network (SIGN). National Clinical Guidelines for Management of Patients with Stroke (64). Scotland: SIGN, 2002.Google Scholar
20Gladman, JRF. Improving long-term rehabilitation. Br Med Bull 2000; 56: 495–500.CrossRefGoogle ScholarPubMed
21Wade, DT, Jong, BA. Recent advances in rehabilitation. Br Med J 2000; 320: 1385–88.CrossRefGoogle ScholarPubMed
22Outpatient Service Trialists. Therapy-based rehabilitation services for stroke patients at home. Cochrane Database Syst Rev 2002, issue 2.Google Scholar
23Aziz, NA, Bee, JLB, Phillips, M, Gladman, JRF, Legg, L, Walker, M. Therapy-based rehabilitation intervention for patients living at home more than one year after stroke. Cochrane Database Syst Rev 2008, issue 2.CrossRefGoogle Scholar
24Green, J, Forster, A, Boyle, S. Physiotherapy for patients with mobility problems, more than one year after stroke. Lancet 2002; 359: 199–203.CrossRefGoogle Scholar
25Wade, DT, Collen, FM, Robb, GF, Warlow, CP. Physiotherapy intervention late after stroke and mobility. Br Med J 2000; 320: 1385–88.CrossRefGoogle Scholar
26Drummond, A, Walker, M. A randomized controlled trial of leisure rehabilitation after stroke. Clin Rehabil 1995; 9: 283–90.CrossRefGoogle Scholar
27Logan, PA, Gladman, JR, Avery, A, Walker, MF, Dyas, J, Groom, L. Randomised controlled trial of an occupational therapy intervention to increase outdoor mobility after stroke. Br Med J 2004; 329: 1372–75.CrossRefGoogle ScholarPubMed
28Parker, CJ, Gladman, JRF, Drummond, AER, Dewey, AER, Lincoln, NB, Barer, BH et al. A multi-centre randomized controlled trial of leisure therapy and conventional occupational therapy after stroke. Clin Rehabil 2001; 15: 42–45.CrossRefGoogle Scholar
29Rodgers, H, Thomson, R. Functional status and long-term outcome of stroke. Br Med J 2008; 336: 337–38.CrossRefGoogle ScholarPubMed
30Young, J, Forster, A. Review of stroke rehabilitation. Br Med J 2007; 334: 86–90.CrossRefGoogle ScholarPubMed
31Aziz, NA, Raymond, AA. Managing further rehabilitation in longer-term stroke patients in the community: A new approach. Med Health 2008; 3: 1–6.Google Scholar
32Young, J, Murray, J, Forster, A. Review of longer-term problems after disabling stroke. Rev Clin Gerontol 2003; 13: 55–65.CrossRefGoogle Scholar
33Aziz, NA, Walker, MF, Phillips, M, Von Fragstein, MF, Gladman, JRF. Evaluation of functional problems affecting patients with long-term stroke in the community: a cross-sectional case-control survey. Cerebrovasc Dis 2009; 26 (suppl): 43.Google Scholar