Deans' stroke musings: Quality of rehabilitation care in Portuguese stroke units: findings from 2017–2018 and 2023 national cross‑sectional surveys

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.

Thursday, April 2, 2026

Quality of rehabilitation care in Portuguese stroke units: findings from 2017–2018 and 2023 national cross‑sectional surveys

Since you're measuring 'care' NOT RECOVERY; you're COMPLETELY FUCKING INCOMPETENT AND DESERVE TO BE KEEL HAULED!

There are no excuses for such incompetent crapola! I'd have you all fired!

Quality of rehabilitation care in Portuguese stroke units: findings from 2017–2018 and 2023 national cross‑sectional surveys

oana Teles SarmentoDepartment of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Physical and Rehabilitation Medicine, Unidade Local de Saúde do Médio Ave, Vila Nova de Famalicão, Portugal
Ana AlvesPhysical and Rehabilitation Clinic of S. Nicolau, Porto, Portugal
Paulo Castro-ChavesRISE-Health, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Internal Medicine, Unidade Local de Saúde de São João, Porto, Portugal
Bárbara M. CruzDepartment of Physical and Rehabilitation Medicine, Centro Hospitalar Universitário Santo António, Porto, Portugal
Cristina JácomeRISE-Health, Faculty of Medicine, University of Porto, Porto, Portugal

DOI:

https://doi.org/10.2340/jrm.v58.44855

Keywords:

Guideline Adherence, Health Services Research;, Quality Indicators, Rehabilitation, Stroke

Abstract

Objective: To evaluate adherence to stroke rehabilitation guidelines in Portuguese stroke units from the physicians’ perspective and examine changes over 6 years.

Design: A national cross-sectional survey across 2 time periods (2017–2018 and 2023).

Methods: Stroke units recognized by the Portuguese Stroke Society were invited to participate: 27 in 2017–2018 and 35 in 2023. A structured questionnaire, aligned with national and international guidelines, assessed 5 domains: team composition, care coordination, early assessment and planning, dysfunction assessments, and post-discharge planning.

Results: Response rates were 93% (n = 25) and 80% (n = 28). Most units (> 75%) had a physiatrist, physiotherapist, speech therapist, rehabilitation nurse, and social worker; only 20% had the full recommended team. Weekly stroke unit meetings were stable (88–89%), while rehabilitation team meetings increased markedly between the 2 periods (20% vs 72%). Rehabilitation started earlier on weekdays (89% vs 79%) than at weekends (68% vs 57%). Dysphagia screening was common (96% vs 89%), but neurogenic bladder assessment was rare (< 8%). The Modified Rankin Scale and Barthel Index were consistently used. Post-discharge planning remained high (92% vs 89%), with improved coordination between teams (48% vs 89%).

Conclusion: Portuguese Stroke Units demonstrated moderate-to-high adherence to rehabilitation guidelines, with progress in teamwork communication and care coordination, although important gaps remain.

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