European Stroke Organisation (ESO) guideline on motor rehabilitation

TY - JOUR

T1 - European Stroke Organisation (ESO) guideline on motor rehabilitation

AU - Alt Murphy, Margit

AU - Munoz-Novoa, Maria

AU - Heremans, Charlotte

AU - Branscheidt, Meret

AU - Cabanas-Valdés, Rosa

AU - Engelter, Stefan T.

AU - Kruuse, Christina

AU - Kwakkel, Gert

AU - Lakičević, Sandra

AU - Lampropoulou, Sofia

AU - Luft, Andreas R.

AU - Marque, Philippe

AU - Moore, Sarah A.

AU - Podlasek, Anna

AU - Shankaranarayana, Apoorva Malavalli

AU - Shaw, Lisa

AU - Solomon, John M.

AU - Stinear, Cathy

AU - Swinnen, Eva

AU - Turolla, Andrea

AU - Verheyden, Geert

N1 - Copyright: © European Stroke Organisation 2025.

PY - 2025/12

Y1 - 2025/12

N2 - 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.

AB - 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.

KW - dosage

KW - gait

KW - Guideline

KW - intensity

KW - lower limb

KW - motor rehabilitation

KW - stroke

KW - upper limb

KW - walking

UR - https://www.scopus.com/pages/publications/105008078662

U2 - 10.1177/23969873251338142

DO - 10.1177/23969873251338142

M3 - Article

C2 - 40401760

AN - SCOPUS:105008078662

SN - 2396-9873

VL - 10

SP - 1160

EP - 1188

JO - European Stroke Journal

JF - European Stroke Journal

IS - 4

ER -