Nothing in Chapter 7. Rehabilitation for subacute to chronic stroke; even remotely suggests any path to 100% recovery. So you are screwed along with your children and grandchildren. Until we start holding stroke persons feet to the fire nothing will improve.
Japan Stroke Society Guideline 2021 for the Treatment of Stroke
Abstract
The revised Japan Stroke Society Guidelines for the Treatment of Stroke were published in Japanese in July 2021. In this article, the extracted recommendation statements are published. The revision keeps pace with the great progress in stroke control based on the recently enacted Basic Act on Stroke and Cardiovascular Disease in Japan. The guideline covers the following areas: primary prevention, general acute management of stroke, ischemic stroke and transient ischemic attack, intracerebral hemorrhage, subarachnoid hemorrhage, asymptomatic cerebrovascular disease, other cerebrovascular disease, and rehabilitation.
Introduction
The Japan Stroke Society Guideline 2021 for the Treatment of Stroke is a totally revised version that is developed every 6 years, with two yearly updates in the intervening periods. The guidelines have been developed in conjunction with Japan Neurosurgical Society, the Japanese Society of Neurology, the Japanese Association of Rehabilitation Medicine, the Japanese Society of Neurological Therapeutics, the Japanese Society on Surgery for Cerebral Stroke, and the Japanese Society for Neuroendovascular Therapy. The guideline comprises 300 pages in Japanese. In this English version, recommendations of each topic are extracted and introduced. The guideline consists of seven chapters. Of these, the chapters for ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage are introduced in the main text and the other four chapters, as part of the full guideline, are presented in the supplemental material.
Method
The Committee for Stroke Guideline 2021, selected from the members of the Japan Stroke Society(Notice no survivors were involved so the conclusions presented are invalid.), developed the present guideline based on the literature searched for the guidelines up to the 2019 version (papers published up to December 2017) and additional papers published between January 2018 and December 2019. In the Committee, there was no distinction between those who reviewed the literature and those who wrote the recommendations.
Taking into consideration the level of evidence, the balance between “benefit” and “harm” of the intervention, the influence of patient values and other factors, and the cost of the intervention and medical resources, the Committee members determined the grade of recommendations (Table 1). The level of bodies of evidence for the recommendations was determined by the Committee members after integrating the evidence of the relevant references (Table 2). Detailed explanation is described in “Level of Evidence and Grade of Recommendation” in the full article in the supplemental material.
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Table 1. Classification of grade of recommendation by the Committee (2021).
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Table 2. Classification of level of evidence (LOE) of the recommendations by the Committee (2021).
Chapter 7. Rehabilitation for subacute to chronic stroke
(Refer the full article as the supplemental material)
Declaration of conflicting interests
The
author(s) declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Disclosures
All
the authors completed the declaration of their conflicts of Interest
(COIs) to the office of the Japan Stroke Society. COIs for all the
authors are below the maximum amount for the inauguration of committee
members of guidelines in the Japanese Association of Medical Sciences
COI Management Guideline.
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