Stroke Recovery During the COVID-19 Pandemic: A Position Paper on Recommendations for Rehabilitation.

Healthcare delivery shifted and adapted with the coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome (SARS) coronavirus 2 (CoV-2). Stroke care was negatively impacted across the care continuum and may lead to poor community living outcomes in those who survived a stroke during the ongoing pandemic. For instance, delays in seeking care, changes in length of stays, and shifts in discharge patterns were observed during the pandemic. Those seeking care were younger and had more severe neurological effects from stroke. Increased strain was placed on caregivers and public health efforts and community-wide lockdowns, albeit necessary to reduce the spread of COVID-19, had detrimental effects on treatment and recommendations to support community living outcomes. The American Congress of Rehabilitation Medicine (ACRM) Stroke Interdisciplinary Special Interest Group (Stroke ISIG) Health and Wellness Task Force convened to (1) discuss international experiences in stroke care and rehabilitation and (2) review recently published literature on stroke care and outcomes during the pandemic. Based on the findings in the literature, the task force proposes recommendations and interdisciplinary approaches at the (1) institutional and societal level, (2) healthcare delivery level, and (3) individual/interpersonal level spanning across the care continuum and into the community.