Rehabilitation of patients with stroke: summary of SIGN guidance

Stroke is the third most common cause of death and the most frequent cause of severe adult disability in Scotland.1 Despite considerable advances in organised stroke care over recent years, improvements are still needed,2 because patients have been reported to spend up to 50% of their time in bed3 and only 20% of their time in treatment.4 Since publication of the previous Scottish Intercollegiate Guidelines Network (SIGN) guideline on rehabilitation after stroke (SIGN 64), several small studies have shown the effectiveness of new therapeutic techniques and technologies.5 This guideline supersedes the earlier guideline and summarises the most recent recommendations from SIGN on rehabilitation after stroke.6 It also complements SIGN guidelines 119 and 108 on other aspects of the management of stroke.7 8 SIGN recommendations are based on systematic reviews of best available evidence. The strength of the evidence is graded as A, B, C, or D (figure⇓), but the grading does not reflect the clinical importance of the recommendations. Recommended best practice (“good practice points”), based on the clinical experience of the guideline development group, is also indicated (as GPP). Explanation of SIGN grades of recommendations ### Arranging appropriate care