Editorial: Transitional and long-term continuous care & rehabilitation after stroke

Abstract

Editorial on the Research Topic Transitional and long-term continuous care & rehabilitation after strokeStroke incidence and prevalence are increasing, causing substantial socioeconomic burdens and loss of healthy life-years worldwide (1). Timely acute treatment, such as thrombolysis, is crucial to reduce mortality and disability; however, many stroke survivors have to live with disabilities after acute care (1-4). Therefore, continuous rehabilitation and long-term care to meet the needs of individual stroke survivors is mandatory.Establishing novel therapeutics to promote the recovery and management to avoid complications along with adequate rehabilitation in acute and subacute phases is important because the time window for recovery after stroke is limited (5). After adequate intensive rehabilitation, many stroke survivors and their caregivers lack a personalized long-term continuous care plan. Moreover, important information has often not been provided at the time of discharge from acute treatment. Because such need for long-term care is unmet in many cases, subjective and objective outcomes remain unfavorable (6). Therefore, adequate transitional and long-term care strategies and therapeutics to compensate or reduce the effect of impairments after stroke are required.The Research Topic "Transitional and Long-term Continuous Care & Rehabilitation After Stroke" included 14 manuscripts, ranging from a study protocol, case report and observational study to randomized controlled trials, a mini-review, systematic review, and meta-analysis. These timely contributions offer an interesting insight from acute rehabilitation to transitional and long-term care in patients with stroke.

Descriptive analysis of post-stroke patients in a neurological physical therapy unit

“…Depending on the phase of the disease, there are two main scopes of assistance in pwS ( 9): (1) the hospitalization phase or acute phase (from the onset of the symptoms to the hospital discharge), in which the treatment must be applied by a multidisciplinary team, including physical therapy (PT) (10); and (2) the subacute phase (3-6 months after the stroke), in which the PT treatment is essential to prevent complications and recover the patient's maximum functional capacity possible, to maximize his/her personal autonomy and his/her family and social reintegration (11). In this phase, PT can be performed as outpatient treatment (home care), in a hospital scope (12), and a mediumor long-stay center or hospice, depending on the clinical and/or social situation of the pwS. Hospital PT after suffering a stroke produces improvements in all patients, regardless of their age; however, age reversely predicts a good functional result (13) (the younger the patient, the better the results).…”

“…The role of PT in pwS must begin after an initial evaluation aimed at establishing a PT diagnosis from the results obtained in it. This diagnosis is based on the International Classification of Functioning, Disability, and Health (ICF), which considers deficiencies in bodily functions and structures, activity limitation, participation restriction, and existing contextual factors, both environmental and personal (12,16). This allows for establishing the prognosis and the treatment objectives and developing a PT intervention plan (17,18).…”