Stroke Rehab

Stroke Rehab is a comprehensive clinical reference tool for healthcare professionals involved in stroke rehabilitation. Built for neurologists, stroke physicians, physiotherapists, occupational therapists, speech and language therapists, and specialist nurses.

Content is based on NICE NG236 (2023), the RCP National Clinical Guideline for Stroke (2023), ESO guidelines, and over 20 key randomised controlled trials including AVERT, EXCITE, LEAPS, FLAME, FOCUS, and the Cochrane ESD meta-analysis.

8 CLINICAL DOMAINS

1. Organisation and Early Assessment
MDT goal-setting within 72 hours, SMART goals, intensity targets, NIHSS, MoCA, Barthel Index, swallow screening, and continence assessment.

2. Motor Recovery and Physiotherapy
Constraint-induced movement therapy (CIMT), robot-assisted therapy, mirror therapy, mental practice, the 3-hour daily therapy target from RCP 2023, and the AVERT trial findings on early mobilisation.

3. Walking and Balance Rehabilitation
LEAPS trial evidence, treadmill and overground training, functional electrical stimulation (FES) for foot drop, ankle-foot orthosis, aerobic exercise, falls prevention, and functional walking speed targets.

4. Communication and Aphasia
Aphasia classification table, SALT intensity targets (45 min/day), constraint-induced aphasia therapy, augmentative and alternative communication (AAC), dysarthria management, and dysphagia assessment including IDDSI texture levels and PEG timing.

5. Cognition, Mood and Fatigue
Post-stroke cognitive impairment screening (MoCA), cognitive rehabilitation strategies, post-stroke depression (PHQ-9, HADS), emotionalism, anxiety, and a dedicated fatigue management section reflecting the new NICE NG236 2023 guidance.

6. ADL, Spasticity and Shoulder Pain
Occupational therapy and personal and instrumental ADL rehabilitation, stepped spasticity management (physiotherapy, oral agents, botulinum toxin per NICE TA491), intrathecal baclofen, and hemiplegic shoulder pain including NMES and FES recommendations.

7. Community Discharge and Early Supported Discharge (ESD)
ESD eligibility criteria based on the Cochrane ESD meta-analysis (2017), pre-discharge checklist, driving and DVLA guidance, return to work (new NICE NG236 2023 section), telerehabilitation, annual review, and carer support.

8. Assessment Scales and Outcome Measures
Complete reference for modified Rankin Scale (mRS 0-6