23 Rehabilitation of Severe Stroke

Severe strokes often result in multiple disabilities and constitute not only the most disabled group of stroke patients but also the greatest rehabilitation challenge. On a per-person basis, severe stroke patients incur the greatest costs to the healthcare system, primarily due to increased length of stay (LOS) in hospital and the frequent need for expensive long-term care or institutionalization (NavarreteNavarro et al. 2003). Research relating to the definition, classification, neuro-recovery and rehabilitation of severe strokes is provided in this review. Clinical evidence for various severe stroke rehabilitation models are discussed (including slow-stream, intensive care unit (ICU), and specialized interdisciplinary stroke rehabilitation). Ethical dialogue pertaining to severe stroke is also presented.