other entities (RWI) can be found at https://professional. heart.org/-/media/phd-files/guidelines-and-statements/ policies-devolopment/aha-asa-disclosure-rwi-policy-5118. pdf?la=en.Beginning in 2017, numerous modifications to AHA/ ASA guidelines have been implemented to make guidelines shorter and enhance user-friendliness. Guidelines are written and presented in a modular knowledge chunk format; each chunk includes a table of recommendations, a brief synopsis, recommendation-specific supportive text, and, when appropriate, flow diagrams or additional tables. Hyperlinked references are provided to facilitate quick access and review. Other modifications to the guidelines include the addition of Knowledge Gaps and Future Research segments in some sections and a web guideline supplement (Online Data Supplement) for useful but noncritical tables and figures.

Kinematic analysis in this study identified a set of movement variables during a functional task that may serve as an objective assessment of upper-extremity motor performance in persons who can complete a task, such as reaching and drinking, after stroke.

BACKGROUNDPrevious studies have suggested that fluoxetine could improve neurological recovery after stroke. The EFFECTS trial was designed to test the hypothesis that administration of fluoxetine for 6 months after acute stroke would improve functional outcome. METHODSEFFECTS was an investigator-led, parallel group, randomised, placebo-controlled trial that enrolled non-depressed stroke patients aged 18 years or older between two and 15 days after stroke onset in 35 hospitals in Sweden. The patients had a clinical diagnosis of ischemic or intracerebral haemorrhage with persisting focal neurological deficits at inclusion. A webbased randomisation system which incorporated a minimisation algorithm was used to allocate participants to fluoxetine 20 mg once daily or matching placebo capsules for 6 months with a ratio of 1:1. Patients, care providers, investigators, and outcomes assessors were masked to the allocation. The primary outcome was functional status, measured with the modified Rankin Scale (mRS) at 6 months. Patients were analysed according to their treatment allocation. EFFECTS is registered with ClinicalTrials.gov, number NCT02683213. FINDINGS Recruitment started 20 Oct 2014 and ended 28 June 2019, when the planned 1500 patients were included (750 to fluoxetine and 750 to placebo). mRS data were available for 737/750 (98%) in the fluoxetine group and 742/750 (99%) in the placebo group. The primary outcome -distribution across mRS categories-was neutral (common odds ratio adjusted for minimisation variables 0•94 [95% CI 0•78 to 1•13], p=0•42). Fluoxetine reduced depression

Anxiety is common during the first year post-stroke. Since anxiety significantly influences quality of life and is a predictor for depression, it may be worth considering further routine screening post-stroke.

Clinical tests used during the first week after stroke onset can, to some extent, identify those patients at risk of falling during the first year after stroke.