Stroke patients should be offered three hours of needs-based rehabilitation per day

NICE has updated its guidance on stroke rehabilitation, and now recommends that stroke patients are offered at least three hours of needs-based rehabilitation at least five times per week.

This rehabilitation should cover a range of multidisciplinary therapy including physiotherapy, occupational therapy and speech and language therapy.

The original guidance, which was published in 2013, suggested stroke patients undertake rehabilitation exercises for just 45 minutes per day.

NICE healthcare professionals may find it challenging to deliver the guidance

Stroke is one of the biggest causes of death in the UK and is a leading cause of adult disability.

It is estimated that there are around 85,000 strokes every year in England and roughly one million stroke survivors, many of who are living with its long-term effects.

The updated guidance is based on up-to-date evidence which showed more intensive rehabilitation improved quality of life and activities of daily living.

The evidence reviewed by the independent committee (which was made up of professionals and people with lived experience) also suggests intensive rehab can help stroke patients recover faster and gain back independence more quickly.

However, practitioners are concerned there will be challenges around the feasibility of delivering this new guidance, particularly when it comes to increasing service capacity.

Professor Jonathan Benger, Chief Medical Officer at NICE, says the Committee recognises the challenges systems may face in delivering these recommendations, but it shouldn’t be underestimated how important it is for stroke patients to be given the opportunity to benefit from longer, more intense rehab sessions.

“By focusing on what matters most, we need to find ways to enable people who have had a stroke to access the level of rehabilitation that supports their recovery and meets their long-term needs and goals,” he said.

The importance of accessing person-centred support

The Stroke Association has “warmly welcomed” the new guidance, and says increasingly rehabilitation therapies will give stroke patients the “best chance of recovery.”

Dr Maeva May, associate director for policy and research at the Stroke Association said: “Research shows that frequent and more intense rehabilitation leads to better recovery following a stroke but many stroke survivors only receive a fraction of what this guideline recommends, leaving many without support and limiting their improvement post-stroke.

“Every stroke is different and so is every recovery, so it’s important that stroke survivors can access person-centred support for as long as they need it, so they can regain their independence and rebuild their lives after stroke.”