Announcing The Lancet Neurology Commission on Neurorehabilitation

 This already is a complete failure: they are looking at what currently exists; RATHER THAN CREATING 100% RECOVERY PROTOCOLS! My god, how fucking stupid can you be?

Announcing The Lancet Neurology Commission on Neurorehabilitation

Joseph Yaria^a Sebastian F. Winter^b Gregory Roth^c Volker Hömberg ^{d e} Thomas Platz^g Mayowa O. Owolabi ^{a f h}

aDepartment of Medicine, University College Hospital, Ibadan 200212, Nigeria

bMassachusetts General Hospital, Harvard Medical School, Boston, MA, USA

cUniversity of Washington, Seattle, WA, USA

dDepartment of Neurorehabilitation, SRH Gesundheitszentrum Bad Wimpfen, Bad Wimpfen, Germany

eWorld Federation for Neurorehabilitation, North Shields, UK

fCentre for Genomic and Precision Medicine, University of Ibadan, Nigeria

gNeurorehabilitation Research Group, Universitätsmedizin Greifswald, Greifswald, Germany

hBlossom Specialist Medical Center, Old Bodija, Ibadan, Nigeria

Your Editorial1 underscored the urgent need to address the global burden of neurological disorders through neurorehabilitation, which is one of the four pillars of the neurology quadrangle alongside surveillance, prevention, and acute care.2 The Editorial also introduced The Lancet Neurology Commission on Neurorehabilitation, which seeks to unify global efforts to develop evidence-based pragmatic solutions for improving functioning and quality of life of people living with neurological conditions worldwide. Neurological conditions are now the leading cause of disability-adjusted life years (DALYs) and deaths globally.2–4 In 2021, they accounted for 443 million DALYs and affected 3·4 billion individuals (43·1% of the global population),4 mostly in low-income and middle-income countries (LMICs).2–4 The conditions accounting for most DALYs are stroke, neonatal encephalopathy, migraine, dementias, neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, Parkinson's disease and other neurodegenerative disorders, traumatic brain and spinal cord injuries, and nervous system neoplasms.4 In 2020, neurological disorders cost Europe US$1·06 trillion, which was equivalent to the cost from heart diseases, cancer, and diabetes combined.2 Globally, stroke costs nearly $1 trillion annually5,6 and occurs at a younger age in LMICs than in high-income countries, resulting in massive economic losses.5,6 Our Commission aims to set evidence-based pragmatic solutions for neurorehabilitation to equitably improve functioning and quality of life worldwide and reduce economic losses. We will start by conducting a situational and gap analysis (appendix pp 5, 6), which will involve a systematic review of the current and projected epidemiological and economic burdens using resources from WHO and The Global Burden of Diseases, Injuries, and Risk Factors Study. In addition, we will evaluate the evidence for clinical decision making (including evidence-based practice recommendations); policies and initiatives; neuroscientific and biopsychosocial, cross-cultural, and epistemological frameworks; and emerging innovative solutions (eg, artificial intelligence and brain computer interfaces, regenerative medicine, and precision medicine). To ensure real gains in quality of life, the approach will be holistic and person-centred. We will conduct a survey of neurorehabilitation services, examining infrastructure, workforce, availability, access, and financial coverage. A mixed-methods approach will be used to explore barriers and facilitators to implementation across diverse health systems. Simultaneously, we will conduct a gap analysis of neurorehabilitation services and an economic evaluation of interventions. We will use resources from guidelines and other sources of published evidence. Guided by implementation science, we will prioritise affordable, scalable, cost-efficient, and sustainable therapies for the rehabilitation of common neurological disorders globally. Outputs will include prioritised interventions, outcome measures, road maps, key performance indicators, consensus statements, and dissemination plans for policy makers and health-care professionals. We plan to establish global, regional, and national implementation ecosystems that will include global institutions, such as WHO, the UN, the World Federation of Neurorehabilitation, the World Stroke Organisation, the World Federation of Neurology, and the International Spinal Cord Society, as well as other international and regional professional societies, patient organisations, and non-governmental organisations as implementation partners for improving multidisciplinary therapies, research, advocacy, and training. The Commission's dissemination plan will include context-specific approaches for delivering pragmatic solutions, professional education for health-care providers, and innovative outreach through digital platforms, other media platforms, and the entertainment industry. An economic analysis of the costs of neurological disorders will be presented to strengthen the case for investment in neurorehabilitation, with implications for more than 3·4 billion people globally. Ultimately, the Commission should outline strategic directions and research priorities to guide the advancement of neurorehabilitation over the coming decades. For more on The Lancet Neurology Commission on Neurorehabilitation see https://neurorehabilitationcommission.org/