P Langhorne

..Although the existing evidence is limited by poor trial designs, some treatments do show promise for improving motor recovery, particularly those that have focused on high-intensity and repetitive task-specific practice...

..Services have been developed that offer patients early discharge from hospital with rehabilitation at home (early supported discharge [ESD]). We have assessed the effects and costs of such services...

..However, there are concerns that the benefits seen in clinical trials may not be replicated in routine practice. We carried out a systematic review of observational studies of stroke unit implementation...

..Stroke patients are usually admitted to hospital for their acute care and rehabilitation. Services to help acute stroke patients avoid admission to hospital ('hospital-at-home') have now been developed...

..Our aim was to develop and evaluate the implementation of a complex, multidimensional oral health care (OHC) intervention for people in stroke rehabilitation settings which would inform the development of a randomised controlled trial...

..Nonselective NSAIDs are frequently prescribed, and so further investigation into the risk of AMI is warranted because the potential for harm can be substantial...

..This prospective, multicenter study was performed to determine the frequency of symptomatic complications up to 30 months after stroke using prespecified definitions of complications...

..It is not known if mobile stroke teams can achieve the good results seen in trials of geographically discrete stroke wards (stroke units)...

..In conclusion, an illustrative case report is set out, indicating a typical patient pathway in an early supported discharge service...

..However, it is unclear what impact this complex intervention actually has in routine practice. A comprehensive national dataset was used to study the impact of stroke unit implementation...

..CONCLUSION: Stroke rehabilitation needs to establish and apply a solid evidence-base even though the challenges are formidable...

..The effectiveness of organized inpatient (stroke unit) care has been demonstrated in systematic reviews of clinical trials. However, the key components of stroke unit care are poorly understood...

..We conducted a systematic review to evaluate the effectiveness of such services...

..To evaluate the relative cost-effectiveness of universal and selective VTE history-based screening for thrombophilia compared with no screening in the three high-risk patient groups...

..We aimed to assess the effects of therapy-based rehabilitation services targeted at stroke patients resident in the community within 1 year of stroke onset or discharge from hospital...

..The severity of clinical stroke is a major contributor to these poor outcomes; baseline characteristics, however, do not fully explain outcome differences...

..Results are compared with a model using only the stratified covariate data available, where each stratum is treated as a separate trial, and a model using fully aggregated data, where no covariate data are used...

..Urinary tract infection (UTI) is a recognized complication of stroke. We aimed to determine the incidence of UTI after acute stroke, the risk factors associated with this complication, and its association with outcome...

..Providing informal care has been linked with poor health but has not previously been studied across a whole population. We aimed to study the association between informal care provision and self-reported poor health...

..The aim of this study was to identify predictors of early stroke progression using two independent patient cohorts...

..To determine the perceived barriers to evidence-based practice by health professionals working within the field of stroke rehabilitation...

..There is also a lack of controlled trials of antithrombotic intervention to prevent pregnancy complications. Thus, at present, universal screening for thrombophilia in pregnancy cannot be justified clinically...

..To perform a systematic review of exercise trials post stroke...

..The LADIS (LeukoAraiosis and DISability) Study primarily aims to assess ARWMCs as a determinant of global functional decline in the elderly population...

..Finally, some key challenges have been identified for stroke units in improving rehabilitation outcomes over the next decade and for healthcare planners in investing adequately in organized stroke services...

..Obtaining this information prospectively requires significant resources. We wished to assess the reliability of estimating the Scandinavian Stroke Scale (SSS) score retrospectively from routine hospital admission records...

..To determine whether there is a difference in global dependency and functional independence in patients with stroke associated with different approaches to physiotherapy treatment...

..Pneumonia is a major cause of morbidity and mortality after stroke. We aimed to determine key characteristics that would allow prediction of those patients who are at highest risk for poststroke pneumonia...

..To determine whether occupational therapy focused specifically on personal activities of daily living improves recovery for patients after stroke...

..Early neurological deterioration after ischaemic stroke (stroke in progression) is reported to be common and associated with poor outcome or death. The causes of progressing stroke are, however, uncertain...

..We hypothesized that activation of the coagulation system is an important contributor in some cases of deterioration. We aimed to characterize alterations in circulating hemostatic markers in patients with progressing stroke...

..Four outcome measures of carer stress and coping at one year post-stroke were identified: carer general health, anxiety, depression and perception of stress...

..However, CGA does not reduce long-term mortality. This evidence should inform future service developments...

..However, the burden of caring for stroke survivors usually rests with family members who have neither chosen nor volunteered for the role of 'carer'...

..Homocysteine is an independent risk factor for vascular disease and is associated with dementia in older people. Potential mechanisms include altered endothelial and hemostatic function...

..We wished to confirm these findings using commercially available assays and to provide data to allow the design of intervention studies...

..To present a systematic review of studies that addresses the effects of intensity of augmented exercise therapy time (AETT) on activities of daily living (ADL), walking, and dexterity in patients with stroke...

..The recommendations are endorsed by the 3 European societies which are represented in the European Stroke Initiative: the European Stroke Council, the European Neurological Society and the European Federation of Neurological Societies...

..However, further studies are required to establish with greater confidence the associations of these, and other, thrombophilias with venous thromboembolism among hormone users...

..Impairment-based therapy and a wide variety of compensatory management strategies are undertaken by speech and language therapists with this patient population...

....

..We studied the natural course of white matter hyperintensities (WMH) and lacunes, the main MRI representatives of small vessel disease, over time and evaluated possible predictors for their development...

..However, the most suitable method for measuring WMH progression has not been established yet. We compared the reliability and sensitivity of cross-sectional and longitudinal visual scales with volumetry for measuring WMH progression...

..However, it is unclear how this is achieved. We tested whether stroke unit care could reduce deaths by preventing complications...

..Selective thrombophilia screening based on previous personal and/or family history of venous thromboembolism was more cost-effective than universal screening in all the patient groups evaluated...