European Stroke Organisation (ESO) guideline on motor rehabilitation
Motor rehabilitation aims to help people after stroke to gain optimal motor functioning, independence and quality of life. This European Stroke Organisation (ESO) guideline provides updated, evidence-based support for clinical practice in six agreed critical areas: dose for upper limb and gait therapy, high-intensity gait training, effect of therapy transfer package, group versus individual therapy and sit-to-stand training. The guideline was developed according to ESO standard operating procedures and Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Expert consensus statements are provided where a GRADE recommendation cannot be made due to insufficient evidence. For therapy dose, very low quality evidence supports a weak recommendation to provide an additional minimal dose of 20 h of repetitive upper limb practice to improve arm capacity. For gait, expert consensus suggests that an additional minimal dose of 20 h of walking practice could be beneficial for walking capacity. For high-intensity gait training, moderate quality evidence supports a strong recommendation for high-intensity gait training to improve walking endurance in people with chronic stroke and stable cardiovascular status, while low quality evidence supports a weak recommendation for improving walking speed. An expert consensus suggests using a transfer package when providing upper limb task-specific training to enhance transfer to daily life. For group therapy, a weak recommendation based on very low quality evidence suggests that task-specific group-based therapy is non-inferior to individual therapy for improving balance, gait speed and walking endurance. A weak recommendation based on moderate quality evidence suggests additional sit-to-stand training to improve balance.
Authors
- Apoorva M. Shankaranarayana (ORCID: https://orcid.org/0000-0003-0305-535X)
- Christina Kruuse (ORCID: https://orcid.org/0000-0002-4210-0523)
- Cathy M. Stinear (ORCID: https://orcid.org/0000-0002-9404-1959)
- Maria Munoz-Novoa (ORCID: https://orcid.org/0000-0002-6001-985X)
- Andreas R. Luft (ORCID: https://orcid.org/0000-0001-9865-7382)
- Anna Podlasek (ORCID: https://orcid.org/0000-0001-7297-7169)
- Margit Alt Murphy (ORCID: https://orcid.org/0000-0002-3192-7787)
- Sandra Lakičević
- P. Marqué (ORCID: https://orcid.org/0000-0001-7869-0708)
- Eva Swinnen (ORCID: https://orcid.org/0000-0002-3771-9479)
- Meret Branscheidt (ORCID: https://orcid.org/0000-0002-4008-6916)
- Gert Kwakkel (ORCID: https://orcid.org/0000-0002-4041-4043)
- Sarah Moore (ORCID: https://orcid.org/0000-0003-3158-4750)
- Lisa Shaw (ORCID: https://orcid.org/0000-0002-3435-9519)
- Stefan T. Engelter (ORCID: https://orcid.org/0000-0003-3855-6234)
- Andrea Turolla (ORCID: https://orcid.org/0000-0002-1609-8060)
- John M. Solomon (ORCID: https://orcid.org/0000-0002-0828-6977)
- Geert Verheyden (ORCID: https://orcid.org/0000-0003-3095-8175)
- Rosa Cabanas‐Valdés (ORCID: https://orcid.org/0000-0002-5255-2494)
- Sofia Lampropoulou (ORCID: https://orcid.org/0000-0002-2095-5184)
- Charlotte Heremans (ORCID: https://orcid.org/0009-0009-3449-2203)
Institutions
- Northwestern University (US)
- Allen Institute for Brain Science (US)
- Vrije Universiteit Brussel (BE)
- University of Auckland (NZ)
- Inserm (FR)
- Manipal Academy of Higher Education (IN)
- University of Patras (GR)
- University of Dundee (GB)
- Université Fédérale de Toulouse Midi-Pyrénées (FR)
- University of Basel (CH)
- University Clinical Hospital Mostar (BA)
- Sahlgrenska University Hospital (SE)
- European CanCer Organisation (BE)
- Copenhagen University Hospital (DK)
- Rigshospitalet (DK)
- Universitat Internacional de Catalunya (ES)
- Northumbria University (GB)
- ETH Zurich (CH)
- University Hospital of Zurich (CH)
- Amsterdam Neuroscience (NL)
- Felix Platter-Hospital (CH)
- Azienda USL di Bologna (IT)
- Hôpital Purpan (FR)
- European Stroke Organisation (CH)
- Amsterdam University Medical Centers (NL)
- Cereneo (CH)
- VIB-KU Leuven Center for Brain & Disease Research (BE)
- Newcastle University (GB)
- Vrije Universiteit Amsterdam (NL)
- University of Gothenburg (SE)
- University of Bologna (IT)
- KU Leuven (BE)
Publication Details
- Journal
- European Stroke Journal
- Published
- 2025-05-22
- DOI
- https://doi.org/10.1177/23969873251338142
- Citations
- 18
- Primary Topic
- Stroke Rehabilitation and Recovery
- Type
- article
- Field-Weighted Citation Impact
- 18.47
Funders
- European Stroke Organisation