title: Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.
abstract: OBJECTIVE
  The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke.
  
  
  METHODS
  Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee.
  
  
  RESULTS
  Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness and efficiency of rehabilitation and underlie this entire guideline. Without communication and coordination, isolated efforts to rehabilitate the stroke survivor are unlikely to achieve their full potential.
  
  
  CONCLUSIONS
  As systems of care evolve in response to healthcare reform efforts, postacute care and rehabilitation are often considered a costly area of care to be trimmed but without recognition of their clinical impact and ability to reduce the risk of downstream medical morbidity resulting from immobility, depression, loss of autonomy, and reduced functional independence. The provision of comprehensive rehabilitation programs with adequate resources, dose, and duration is an essential aspect of stroke care and should be a priority in these redesign efforts. (Stroke.2016;47:e98-e169. DOI: 10.1161/STR.0000000000000098.).
authors.forename: Carolee J
authors.initials: CJ
authors.lastname: Winstein
authors.forename: Joel
authors.initials: J
authors.lastname: Stein
authors.forename: Ross
authors.initials: R
authors.lastname: Arena
authors.forename: Barbara
authors.initials: B
authors.lastname: Bates
authors.forename: Leora R
authors.initials: LR
authors.lastname: Cherney
authors.forename: Steven C
authors.initials: SC
authors.lastname: Cramer
authors.forename: Frank
authors.initials: F
authors.lastname: Deruyter
authors.forename: Janice J
authors.initials: JJ
authors.lastname: Eng
authors.forename: Beth
authors.initials: B
authors.lastname: Fisher
authors.forename: Richard L
authors.initials: RL
authors.lastname: Harvey
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Lang
authors.forename: Marilyn
authors.initials: M
authors.lastname: MacKay-Lyons
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Ottenbacher
authors.forename: Sue
authors.initials: S
authors.lastname: Pugh
authors.forename: Mathew J
authors.initials: MJ
authors.lastname: Reeves
authors.forename: Lorie G
authors.initials: LG
authors.lastname: Richards
authors.forename: William
authors.initials: W
authors.lastname: Stiers
authors.forename: Richard D
authors.initials: RD
authors.lastname: Zorowitz
mesh_terms: D000328:Adult; D000572:American Heart Association; D015897:Comorbidity; D006282:Health Personnel; D006801:Humans; D020127:Recovery of Function; D020521:Stroke / Q000150:complications / Q000628:therapy*; D000071939:Stroke Rehabilitation / Q000379:methods / Q000592:standards*; D014481:United States
keywords: AHA Scientific Statements; exercise; paresis; recovery of function; rehabilitation; stroke