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Pinter: Stroke

Stroke, a leading cause of disability and rehabilitation, is a major part of patient care in almost all, so-called, developed countries worldwide.

Today, it is well established that early (and invasive) intervention in dedicated stroke units will result in a marked improvement of stroke-associated long-term problems, as well as overall prognosis. Therefore, the introduction of standardized pathways of care for the increasing number of patients has become a major task for every health care system in order to prevent losses of life as well increasing economic burden based on long-lasting or permanent neurological deficit following episodes of cerebral ischaemia.

Furthermore, although most interventions do not target a specific age there is evidence to promote rehabilitation in multidisciplinary stroke units or integrated care of a multidisciplinary team at home. Most research of stroke rehabilitation has been about the effect of interventions on recovery in different forms of impairment and disability. The most promising options for motor recovery include constraint-induced movement therapy and robotic-assisted strategies. Beneficial interventions to improve postural stability and gait include fitness training, high-intensity therapy and repetitive-task training. Repetitive-task training might also improve transfer functions.

In addition, occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice are under way to inform future practice.

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