Priority 14 Stroke Rehabilitation and Long-term Care

UNCERTAINTY:Is there a fixed time period after which stroke survivors make no measurable improvement with an intervention; if improvements can continue, what type and intensity of treatment is effective at a later stage? (JLA PSP Priority 14)
Overall ranking	14
JLA question ID	0106/14b
Explanatory note	It is a common misconception that recovery of impairments can only occur in the first few months to one year after stroke. Although the speed at which impairments are recovered is quicker earlier after stroke and there is more significant variation in recovery between individuals longer after stroke, it’s important that there is more evidence on rehabilitation interventions at a later stage in order to support stroke survivors to make the best possible recovery.
Evidence	No evidence identified
Health Research Classification System category	Stroke

Extra information provided by this PSP
Original uncertainty examples	What are the longer-term functional outcomes of stroke (e. g. over one year post-discharge), and how do these differ between those who had access to post-acute rehabilitation and those who did not? ~ Who is suitable for rehabilitation? ~ How can it be determined who will benefit most from on-going rehabilitation? ~ Will we ever be able to determine when no further improvement is likely therefore formal therapy not essential but maintenance therapy may be needed?
Submitted by	Stroke Survivor x 28, Carer x 4, Health/social care professional x 27, Not stated x 2

Extra information provided by this PSP

Original uncertainty examples

What are the longer-term functional outcomes of stroke (e. g. over one year post-discharge), and how do these differ between those who had access to post-acute rehabilitation and those who did not? ~ Who is suitable for rehabilitation? ~ How can it be determined who will benefit most from on-going rehabilitation? ~ Will we ever be able to determine when no further improvement is likely therefore formal therapy not essential but maintenance therapy may be needed?

Submitted by

Stroke Survivor x 28, Carer x 4, Health/social care professional x 27, Not stated x 2

PSP information
PSP unique ID	0106
PSP name	Stroke Rehabilitation and Long-term Care
Total number of uncertainties identified by this PSP.	93 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	19/20th April 2021