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June 1989

Stroke Rehabilitation

Arch Neurol. 1989;46(6):703. doi:10.1001/archneur.1989.00520420125036

Few areas in neurology are in greater need of critical examination than stroke rehabilitation. A prevalence of 600 per 100 000 population1 makes stroke a leading cause of serious disability, and yet, Isaacs'2 lament has not been redressed: "Experts in stroke rehabilitation abound, but none of them has ever proven anything about rehabilitation to the satisfaction of anybody else." The main problem stems from the dearth of methodologically sound studies, a point on which all contributors to this controversy agree.

Reding and McDowell postulate a randomized study to assess the overall benefit of stroke rehabilitation programs, in which half the patients would receive rehabilitation and half would not, and in which the outcome measures would be (1) the final level of functional outcome, (2) the time required to reach the outcome goal, and (3) the number of patients discharged to home vs institutional care. They maintain that such

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