Table 1

Summary of some of the available evidence supporting stroke rehabilitation

Evidence available	Level of intervention
Evidence available	Service level	Operator level	Treatment level
Several trials available/reasonably conclusive (reasonable statistical power to guide decision making)	Stroke rehabilitation units have better outcomes than general medical wards	Occupational therapy (OT) input is effective for patients not admitted to hospital	Task related training can re-educate impaired balance
	Early supported discharge services reduce disability and institutional care in selected patients	Exercise interventions can prevent falls	Postural biofeedback can re-educate impaired balance
	Multifactorial interventions can prevent falls	Therapy rehabilitation services provided within one year of stroke can prevent deterioration in stroke patients living at home	High specification foam mattresses can prevent pressure sores in high risk patients
	Multifactorial interventions can prevent falls		Air fluidised and low air loss beds improve the healing of pressures sores
Several trials available/inconclusive (inconsistent results or inadequate statistical power to confidently guide decision making)	Hospital at home (hospital avoidance) for acute stroke is less effective than stroke unit	OT input for stroke patients returning home from hospital	Moving platform training to re-educate impaired balance
	Day hospital or domiciliary input are of equivalent benefit	Optimal methods of information provision after stroke	Shoulder strapping for post-stroke shoulder pain
	Rehabilitation in a generic rehabilitation unit is better than a general ward	The impact of routine input from a stroke family support worker	Cognitive rehabilitation for spatial neglect after stroke
	Care pathways for stroke patients in hospital	The impact of speech and language therapy interventions for aphasia	Cognitive rehabilitation for attention deficits after stroke
		The impact of therapy rehabilitation services for stroke patients more than one year after stroke	Electrical stimulation for post-stroke shoulder pain
			Constraint induced movement therapy after stroke
Little or no information from clinical trials (insufficient evidence or data of inadequate quality)	Stroke rehabilitation in community hospitals	Early mobilisation in acute stroke	Neurophysiological physiotherapy approaches to re-educate impaired balance
	Rehabilitation in nursing homes	Pre-discharge OT home visits	Provision of walking aids to re-educate impaired balance
	“Nurse led” rehabilitation wards	Speech and language therapy interventions for dysarthria	Provision of lower limb orthoses for impaired balance
		Walking facilitated by therapist to re-educate impaired balance	Triamcinolone acetonide for post-stroke shoulder pain
			Cryotherapy for post-stroke shoulder pain
			Education of staff and carers on handling the hemiplegic arm
			Foam supports for preventing or relieving post-stroke shoulder pain
			Subscapularis motor point block for post-stroke shoulder pain
			Cognitive rehabilitation for memory deficits after stroke
			Piracetam as an adjunct for aphasia therapy after stroke
			Physical methods to prevent deep vein thrombosis and pulmonary embolism after stroke
			Different physiotherapy treatment approaches for recovery of lower limb function and postural control after stroke