Evidence and Recommendations for Acute Stroke Rehabilitation from the Japan Stroke Society: Abridged Secondary Publication of the Japanese-language Version.

Objectives: In Japan, acute stroke rehabilitation has been expanding more steadily than previously with the nationwide establishment of primary stroke centers. However, Japan previously had no established guidelines for the rehabilitation. Consequently, rehabilitation programs and the provision systems for acute stroke varied among the facilities. To equalize and standardize acute stroke rehabilitation in Japan, it is necessary to develop clinical recommendations for rehabilitation. Therefore, the rehabilitation project team of the Japan Stroke Society aimed to develop the first recommendations for acute stroke rehabilitation in Japan.
Methods: The recommendations are based on the results of a survey on the current status of acute stroke rehabilitation at primary stroke centers in Japan, which was completed in 2022, and on a literature review conducted by the rehabilitation project team.
Results: The recommendations consist of 19 clinical questions regarding the following topics of acute stroke rehabilitation: (1) head elevation and mobilization training, (2) acute complications, (3) training time and frequency for acute stroke rehabilitation, (4) dysphagia in the acute phase, and (5) acute rehabilitation during pandemics of novel and re-emerging infections, particularly novel coronavirus disease 2019 (COVID-19). The team members agreed on all answers for these 19 clinical questions.
Conclusions: These recommendations suggest broad principles of rehabilitative intervention in the acute phase of stroke. In the near future, it is expected that the dissemination of these recommendations will result in an increase in the quality of acute stroke rehabilitation in Japan.
Competing Interests: CONFLICTS OF INTEREST: Dr. Koga has received honoraria and research funds from Daiichi Sankyo Co. Ltd. and scholarship donations from Boehringer Ingelheim outside the scope of the submitted work. Dr. Ohta has received honoraria from Stryker, Daiichi Sankyo Co. Ltd., Eisai Co. Ltd., AstraZeneca, and Idorsia, all outside the scope of the submitted work. Dr. Fujimoto has received honoraria from Takeda Pharmaceutical Co. Ltd., Otsuka Pharmaceutical Co. Ltd., Bayer Yakuhin Ltd., Pfizer Japan Inc., Daiichi Sankyo Co. Ltd., Eisai Co. Ltd., and Bristol-Myers Squibb Co. Ltd., all outside the scope of the submitted work. Dr. Itabashi has received honoraria from Bristol-Myers Squibb Co. Ltd. and Daiichi Sankyo Co. Ltd. outside the scope of the submitted work. Dr. Tajima has received research funds from Nachi-Katsuura City and the Ministry of Education, Culture, Sports, Science, and Technology outside the scope of the submitted work. Dr. Tajima is also a member of the endowed department funded by Shima Seiki MFG. Ltd., Shirahama Hamayuu Hospital, and Takarazuka University of Medical and Health Care. Dr. Ogasawara has received research funds from Nihon Medi-Physics Co. Ltd. outside the scope of the submitted work. The remaining authors declare that they have no commercial or financial relationships that could be understood as a potential conflict of interest.
(2024 The Japanese Association of Rehabilitation Medicine.)