Article

AIM: To explore the use, meaning and value of the term "rehabilitation potential". METHOD: The authors of this commentary met to discuss concerns
relating to the pressure on health service staff created by reduced length of
stay in acute settings of those who have suffered a stroke and the need to
determine the potential of a patient for rehabilitation in order to inform
discharge arrangements.
Points raised at this meeting were shared with an email
group who over a 12-month period contributed to this paper. RESULTS: The group
agreed that: (a) Given that there is very limited evidence to guide judgements
regarding rehabilitation potential following stroke at an early stage the need
for rehabilitation needs to be reviewed on a regular basis over a long period and
that this needs to be reflected in clinical guidelines. (b) Rehabilitation needs
to be available in a broad range of care settings, in order that discharge from
hospital is not equated with a lack of rehabilitation potential. (c) Research
related to rehabilitation potential needs to be conducted. This should examine
influences of decision-making and the algorithms associated with recovery and
local policy on rehabilitation potential. (d) The economic benefits of
rehabilitation needs further exploration. (e) Assessment of rehabilitation
potential should be made more explicit and supported by appropriate evidence.
CONCLUSION: Whilst further research is required to assist in determining the
right time for people to benefit from formal rehabilitation this gives the
impression that one dose of rehabilitation at a specific time will meet all
needs. It is likely that a rehabilitation pathway identifying features required
in the early stages following stroke as well as that required over many years in
order to prevent readmission, maintain fitness and prevent secondary sequelae
such as depression and social isolation would be beneficial. Implications for
Rehabilitation The potential of a patient to benefit from rehabilitation may be
overlooked due to other pressures. Some patients following a stroke will
demonstrate potential to benefit from rehabilitation later than the majority and
this is not always easy to predict. Regular reassessment is required in order to
identify whether an individual will benefit from rehabilitation at a particular
time.

Langue : ANGLAIS