Advances in Neuro-Rehabilitation for Stroke - A Statement from the German Competence Network Stroke

Comprehensive structures for neurorehabilitation including stroke rehabilitation were established in Germany during the past few decades. A graded system of neurorehabilitation patient categories from most severely affected patients, e.g., vegative state patients, to ambulatory patients with neurorehabilitation needs is mirrored in a healthcare system with both (i) neurorehabilitation units with acute care status and (ii) neurorehabilitation facilities in primary rehabilitation centres. These two sequential health-care system segments are linked to two social security domains, i.e., (i) health insurance and (ii) pension insurance. The service interface between the two segments needs to be regulated and is commented on in this position paper. Knowledge in basic and clinical neuroscience as well as neurorehabilitation research activities has increased steadily during the past few decades. There is a growing demand for knowledge management from the bench to the bed-side. Therefore, the position paper suggests various activities that could promote the application of the best evidence in clinical practice: systematic teaching of neurorehabilitation at medical schools and schools for applied medical sciences, rotations in neurorehabilitation during residency programmes, development of evidence-based practice guidelines and neurorehabilitation newsletters with summaries of information about recently published clinical trials.