Priority 2 Stroke Rehabilitation and Long-term Care

UNCERTAINTY: What is the best way to assess for, understand the impacts of and track progression in all areas of cognition – including using standardised measures - across the stroke pathway; what and how can interventions and services involving multidisciplinary teams and families be made accessible, and how can information on these problems be provided? (JLA PSP Priority 2)
Overall ranking 2
JLA question ID 0106/2b
Explanatory note

After a stroke, many patients can experience difficulties with thinking and memory. They may have problems with perception, problem-solving, planning, attention and, language. Such problems can affect people’s confidence and mood, independence and ability to recover from other impacts of their stroke. In some cases, these problems can impact a patients abilities to participate in decisions about their care.

At present, we do not know how best to detect, measure, and rehabilitate these problems. The majority of evidence reviews focus on rehabilitation interventions and conclude evidence is low quality. It is important that more research is carried out that will help us understand how to rehabilitate and support people affected by stroke with cognitive difficulties, of which detection and measurement is key.

Evidence

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013406/full - THIS IS A PROTOCOL
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002842.pub3/full
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002293.pub3/full

Health Research Classification System category Stroke
Extra information provided by this PSP
Original uncertainty examples Can a cognitive group improve function? ~ What is the most effective way to rehabilitate cognitive deficits? Including a focus on the safety and efficacy of discharge to assess models for people with cognitive deficits post stroke. ~ Is cognitive rehabilitation effective? ~ What aspects, duration and intensity of cognitive rehabilitation are effective? ~ What is effectiveness of cognitive rehabilitation remedial activities? ~ What is the impact of neuropsychology intervention on therapy engagement and outcomes?
Submitted by Stroke Survivor x 64,Carer x 18, Health/social care professional x 98, Research Recommendations x 21, Not stated x 7
PSP information
PSP unique ID 0106
PSP name Stroke Rehabilitation and Long-term Care
Total number of uncertainties identified by this PSP. 93 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 19/20th April 2021