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Related Concept Videos

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Related Experiment Video

Updated: Apr 7, 2026

Author Spotlight: Rehabilitation of Stroke Patients With a Digital Occupational Training System
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Implementing and sustaining 6-month post-stroke reviews: a complexity-informed, context-sensitive programme theory

Rich Holmes1,2, Suzanne Ackerley2,3, Dawn Goodwin2

  • 1St Richard's Hospital, University Hospitals Sussex NHS Foundation Trust, Chichester, United Kingdom.

Frontiers in Stroke
|April 6, 2026
PubMed
Summary
This summary is machine-generated.

This study developed a complexity-informed theory for 6-month post-stroke reviews, offering actionable recommendations to improve care for stroke survivors. The theory guides optimal implementation and sustainability across various healthcare settings.

Keywords:
6-month post-stroke reviewcomplexity analysisfollow-up careimplementation sciencelife after strokeprogramme theorystroke rehabilitationsustainability

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Area of Science:

  • Rehabilitation Medicine
  • Health Services Research
  • Complexity Science

Background:

  • Stroke is a primary cause of long-term disability, necessitating effective follow-up care.
  • Six-month post-stroke reviews are guideline-recommended but lack optimal delivery guidance.
  • Limited understanding of optimal delivery hinders effective post-stroke rehabilitation and support.

Purpose of the Study:

  • To develop a complexity-informed, context-sensitive programme theory for the 6-month post-stroke review.
  • To clarify core components and generate actionable recommendations for implementation and sustainability.
  • To enhance the quality and equity of post-stroke follow-up care.

Main Methods:

  • A multiple case study in England utilized interviews, observations, and document analysis.
  • Programme theory and logic models were developed heuristically using context-mechanism-outcome configurations.
  • Iterative refinement involved expert feedback and validation from international stroke rehabilitation specialists.

Main Results:

  • Fourteen context-mechanism-outcome configurations informed 13 core components across four domains: Access & Inclusion, Identifying & Addressing Needs, Maintaining Quality, and System Integration.
  • A logic model illustrates how patient, provider, and service outcomes emerge from review-context interactions.
  • Actionable recommendations include flexible delivery, person-centered tailoring, service integration, and quality/equity enhancement strategies.

Conclusions:

  • This is the first complexity-informed, context-sensitive programme theory for 6-month post-stroke reviews.
  • The theory translates empirical findings into practical recommendations for clinicians and service planners.
  • It provides a foundation for international evaluation and adaptation of post-stroke services.