2.13 Follow-up review and longer term support

The course of recovery after stroke in any individual may fall outside expected time frames. The consensus of the Guideline Development Group is that a comprehensive, structured needs reassessment should be undertaken at 6 months and annually thereafter, depending on the individual’s needs. This review should consider physical, psychological and social needs (including relationships and work, where applicable) related to adjusting to life after stroke. Whilst limited, there is evidence to suggest that for some people improvements in communication, arm function, walking, physical fitness and ADL can be achieved with interventions more than 6 months after stroke (Palmer & Enderby, 2007; Duncan et al, 2011; Ferrarello et al, 2011; Lohse et al, 2014; Veerbeek et al, 2014b; Ward et al, 2019). The provision and timing of appropriate, person-centred follow-up rehabilitation, holistic structured reviews and long-term support after stroke are discussed in more detail in Sections 5.27 Further rehabilitation, and 5.28 Social integration and participation. [2023]