Stroke can have a devastating impact on the lives of people, their families and carers. Morbidity from stroke is the single largest cause of complex impairments and limitations on activity. Mood disturbance, cognitive difficulties, vision problems and fatigue are particular issues that exacerbate other problems and impede overall recovery.
Although stroke is one of the biggest causes of death in the UK, most people survive a first stroke. Thanks to improvements in stroke care and new, acute treatments, the overall survival rate from first stroke has improved over the past 10 years. This has led to increases in the number of people in the community who need comprehensive post-stroke care and rehabilitation.
The previous NICE guideline on stroke rehabilitation was first published in 2013. Since then, there have been changes in the way stroke services have developed and a number of studies looking into the benefits of stroke rehabilitation. Modern stroke care starts immediately after the onset of stroke symptoms. Most acute care is delivered within stroke units as part of organised stroke services. Post-acute care can be delivered in secondary or primary care, often by teams working across different NHS trusts or other organisations.
Within such services, specialist multidisciplinary teams of appropriately skilled professionals work together to deliver goal-directed rehabilitation with the aim of helping people to relearn any skills they may have lost, improve their quality of life and enable them to live as independently as possible.