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Stroke patients continue to miss out on neuro-rehab

Problems around access to therapy continue, but survivors of most severe strokes receive higher amount

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Many patients still do not receive the neuro-rehab they need after a stroke, despite its vital role in reducing long-term disability, new research has revealed. 

While the research from the United States finds that patients who had more severe strokes receive higher amounts of neuro-rehab, many others are missing out on potentially life-changing therapy. 

After three months, the study found that about a third of patients had not received physical therapy, almost half had not received occupational therapy, and over six in ten did not receive speech therapy.

Those who did receive rehabilitation therapy typically had six to eight sessions by three months after their stroke – and between 0 and 1.5 sessions for the rest of the year.

The study also found that where patients were discharged to from hospital was a key factor – those who went home received the lowest level of neuro-rehab. 

The lack of access to neuro-rehab has been a key factor in the ongoing growth of remote rehab, with at-home rehab options significantly rising in their use and gamification in particular showing its positive impact among stroke patients. 

Dr Steven Cramer of UCLA, lead author of the study, said it was positive that people were able to access greater amounts of therapy after severe stroke. 

“But in the bigger picture, the findings reinforce that too many patients are missing out on a golden opportunity to maximise recovery during a critical period following a stroke,” he said. 

“In the initial weeks after a stroke, the brain is ready to undergo maximum rewiring to get people back on their feet. 

“Rehab therapy helps maximise this recovery, with higher rehab therapy doses helping more, but what we found in this study is that most patients are getting rather small doses of rehab therapy.” 

Dr Cramer, a stroke neurologist and professor of neurology at the David Geffen School of Medicine at UCLA and the California Rehabilitation Institute, said is is important for future research to examine the feasibility of providing higher therapy doses to stroke patients.

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