Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, May 11, 2025

Bridging the gap: unique strategies to improve access and implementation of stroke rehabilitation in LMICs – a scoping review

 This is where our first world fucking failures of stroke associations need to create 100% recovery protocols so LMICs can emulate them. But that won't occur, our stroke medical leaders have NO leadership skills whatsoever!

Bridging the gap: unique strategies to improve access and implementation of stroke rehabilitation in LMICs – a scoping review


Dorcas B. C. Gandhi
ORCID Icon,
Rinita Mascarenhas
,
Sania Zarreen
,
Nistara S. Chawla
ORCID Icon,
Jeyaraj D. Pandian
,
Coralie English
ORCID Icon & show all
Received 06 Nov 2024, Accepted 15 Apr 2025, Published online: 07 May 2025

Abstract

Purpose

The demand for stroke rehabilitation is rising across Low- and Middle-Income Countries (LMICs). This review explores the determinants affecting access to and utilization of post-stroke physical rehabilitation in LMICs.

Material and Methods

A systematic literature search across multiple databases retrieved 463 articles, of which 35 studies included were from Asia, Africa, and South America met the inclusion criteria. During the review process, 2 additional relevant studies were identified and added. A descriptive synthesis was conducted to identify key determinants influencing rehabilitation access and use.

Results

Three major categories of determinants emerged: (1) Contextual factors, including traditional/spiritual beliefs, reliance on alternative medicine, gender disparities, poor awareness, and environmental barriers; (2) Personal factors, such as apathy toward rehabilitation, lack of clinical guidance, and psychological challenges (fatigue, depression, cognitive impairment); (3) Resource-related factors, including high out-of-pocket costs, low provider pay, insufficient infrastructure, inadequate health policies, limited professional training, and poor rehabilitation curricula. Recommendations focus on capacity building, service delivery, extended support, and treatment content.

Conclusion

LMICs face unique, context-specific challenges in stroke rehabilitation, requiring tailored solutions. Addressing these barriers necessitates region-specific strategies that align with health system structures, governmental policies, economic resources, professional education, and clinical practice guidance.

IMPLICATIONS FOR REHABILITATION

  • Rehabilitation providers are encouraged to adopt a clinical decision-making framework that is contextual, patient-centered, and sensitive to available resources.

  • Stroke rehabilitation teams should implement a standardized checklist at discharge and follow-ups.

  • Government and non-government organizations must work to overcome persistent barriers.

  • Policymakers should suppourt by investing in workforce training, strengthening infrastructure, and expanding community-based rehabilitation programs.

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