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Purpose—The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults
recovering from stroke.
Methods—Writing group members were nominated by the committee chair on the basis of their previous work in relevant
topic areas and were approved by the American Heart Association (AHA) Stroke Council’s Scientific Statement
Oversight Committee and the AHA’s Manuscript Oversight Committee. The panel reviewed relevant articles on adults
using computerized searches of the medical literature through 2014. The evidence is organized within the context of the
AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA
methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA
internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee
review before consideration and approval by the AHA Science Advisory and Coordinating Committee.
Results—Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and
his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and
occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers,
and others. Communication and coordination among these team members are paramount in maximizing the effectiveness
and efficiency of rehabilitation and underlie this entire guideline. Without communication and coordination, isolated
efforts to rehabilitate the stroke survivor are unlikely to achieve their full potential.
Guidelines for Adult Stroke Rehabilitation and Recovery
A Guideline for Healthcare Professionals From the American Heart
Association/American Stroke Association
Endorsed by the American Academy of Physical Medicine and Rehabilitation and the
American Society of Neurorehabilitation
The American Academy of Neurology affirms the value of this guideline as an educational tool for
neurologists and the American Congress of Rehabilitation Medicine also affirms the educational value
of these guidelines for its members
Carolee J. Winstein, PhD, PT, Chair; Joel Stein, MD, Vice Chair;
Ross Arena, PhD, PT, FAHA; Barbara Bates, MD, MBA; Leora R. Cherney, PhD;
Steven C. Cramer, MD; Frank Deruyter, PhD; Janice J. Eng, PhD, BSc; Beth Fisher, PhD, PT;
Richard L. Harvey, MD; Catherine E. Lang, PhD, PT; Marilyn MacKay-Lyons, BSc, MScPT, PhD;
Kenneth J. Ottenbacher, PhD, OTR; Sue Pugh, MSN, RN, CNS-BC, CRRN, CNRN, FAHA;
Mathew J. Reeves, PhD, DVM, FAHA; Lorie G. Richards, PhD, OTR/L; William Stiers, PhD, ABPP (RP);
Richard D. Zorowitz, MD; on behalf of the American Heart Association Stroke Council, Council
on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on
Quality of Care and Outcomes Research
The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship
or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete
and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.
This guideline was approved by the American Heart Association Science Advisory and Coordinating Committee on January 4, 2016, and the American Heart
Association Executive Committee on February 23, 2016. A copy of the document is available at http://professional.heart.org/statements by using either “Search
for Guidelines & Statements” or the “Browse by Topic” area. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.
The American Heart Association requests that this document be cited as follows: Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC,
Deruyter F, Eng JJ, Fisher B, Harvey RL, Lang CE, MacKay-Lyons M, Ottenbacher KJ, Pugh S, Reeves MJ, Richards LG, Stiers W, Zorowitz RD; on
behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on
Quality of Care and Outcomes Research. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American
Heart Association/American Stroke Association. Stroke. 2016;47:XXX–XXX. DOI: 10.1161/STR.0000000000000098.
Expert peer review of AHA Scientific Statements is conducted by the AHA Office of Science Operations. For more on AHA statements and guidelines
development, visit http://professional.heart.org/statements. Select the “Guidelines & Statements” drop-down menu, then click “Publication Development.”
Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express
permission of the American Heart Association. Instructions for obtaining permission are located at http://www.heart.org/HEARTORG/General/Copyright-
Permission-Guidelines_UCM_300404_Article.jsp. A link to the “Copyright Permissions Request Form” appears on the right side of the page.
© 2016 American Heart Association, Inc.
Stroke is available at http://stroke.ahajournals.org DOI: 10.1161/STR.0000000000000098
AHA/ASA Guideline
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