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Stroke is a leading cause of adult mortality and morbidity worldwide. The incidence of stroke is falling in developed countries, while on the rise in developing countries.1 Pakistan is a low middle-income country with an underdeveloped health care system whose major focus is on the management of communicable diseases.2 Epidemiological data on stroke in Pakistan is limited, based mostly on small samples reported from hospital data.3
Due to the combined efforts of the Pakistan Society of Neurology, Pakistan Stroke Society and the Faculty of Neurology at the College of Physicians and Surgeons of Pakistan (CPSP), the number of neurologists and stroke medicine physicians in the country has increased in the last decade.4 Diagnosis, acute evaluation and management of stroke has also improved. Areas of noted progress include early recognition of signs and symptoms of stroke, timely evacuation to a hospital, early neurology consult, availability of brain imaging (Computed Tomographic scan and Magnetic Resonance Imaging) and access to treatments including tissue plasminogen activator and endovascular procedures.4 At present, this is available only in major cities and hospitals. Despite such improvements in acute stroke management, functional outcomes and community reintegration for stroke patients in Pakistan is generally inadequate, due largely in part to the lack of multi-disciplinary stroke rehabilitation services. We aim to describe the current status of stroke rehabilitation services in Pakistan and discuss the main challenges and barriers towards providing multi-disciplinary stroke rehabilitation. Recommendations to overcome these challenges are also provided.
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