UK Stroke Forum 2025 | Addressing cognitive impairment in stroke survivors during the rehabilitation process

So cognitive impairment is really common after a stroke. Most stroke survivors struggle with memory and thinking difficulties and the issue here is that in rehabilitation it actually affects their engagement with therapy. So how well they interact with therapists and how well they adhere to a rehabilitation program. So what’s really important is that we need to address this in the rehabilitation setting because stroke survivors, those first few weeks after a stroke, it’s very important to get themselves back on track. And the issue is if they’re not engaging or adhering to a rehabilitation program, they can end up with worse rehabilitation outcomes. So my talk delves into the fact that we need to address cognition, manage cognition by naming a lead, so most of the time in rehabilitation units we don’t have psychology support here in the UK, or very little, so we need to upskill the therapy team, including occupational, physio, and speech and language therapists, to properly address cognition and rehabilitation by adapting their therapy sessions, making tasks more manageable, breaking them down, just overall engaging a stroke survivor with these impairments a bit more. All in all, we need to be more inclusive in our research because most of the, at least motor rehabilitation strategies or interventions, are recommended, actually exclude cognitively impaired stroke survivors, and it’s important that we include who therapists are seeing day in, day out, just so it’s more reflective of the clinical reality that cognitive impairment is very prominent and we need to properly address it, or at least know how to tailor our interventions towards them. So definitely, in the future, let’s be more inclusive, or at least more transparent about who we’re including. In neuropsychology practice, there are lots of cognitive rehabilitation strategies, such as using a metacognitive strategy like goal-plan-do-check, or goal management training, where you break down steps to make a task more manageable, or errorless learning, so before they can make a mistake, you tell them what to do, and these are all cognitive strategies which neuropsychologists use, but what we could do is bring these into a toolkit for therapists to use, so across the multi-disciplinary team in rehabilitation, and so enabling them to be more confident in using these cognitive strategies and not fully relying on neuropsychology.

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