Oral Presentation Australian and New Zealand Stroke Organisation Conference 2026

An international initiative to advance stroke rehabilitation: development of the World Stroke Organisation Rehabilitation Certification program (139354)

Jessica Nolan 1 , Kwah Li Khim 2 , Dorcas Gandhi 3 , Jussara Baggio 4 , Shamala Thilarajah 2 , Marina Charalambous 5 , Emily A Stevens 6 , Fiona Rowe 7 , Marie-Louise Bird 8 , Nevine El Nahas 9 , Sanjana Gururaj 10 , Patricia Meier 11 , Sharon D Ignacio 12 , Norhayati Hussein 13 , Jeyaraj Pandian 3 , Rachel Stockley 14 , Julie Bernhardt 15 , Sheila Martins 16 , Gillian Mead 17 , Simaio Wu 18 , Thoshenthri Kandasamy 19 , Sean I Savitz 6 , Elizabeth A Lynch 20
  1. Curtin University, Perth
  2. Singapore General Hospital, Singapore
  3. Christian Medical College and Hospital, Ludhiana, India
  4. Federal University of Alagoas, Arapiraca, Brazil
  5. Cyprus University of Technology, Limassol, Cyprus
  6. UTHealth, Houston, USA
  7. University of Liverpool, Liverpool, UK
  8. Federation University, Churchill
  9. Ain Shams University, Cairo, Egypt
  10. Oxleas NHS Foundation Trust, London, UK
  11. Medical University of Innsbruck, Innsbruck, Austria
  12. University of Philippines, Manila, Philippines
  13. Cheras Rehabilitation Hospital, Kuala Lumpur, Malaysia
  14. University of Lancashire, Preston, UK
  15. Florey Institute of Neuroscience and Mental Health, Melbourne
  16. Hospital Moinhos de Vento, Porto Alegre, Brazil
  17. University of Edinburgh, Edinburgh, UK
  18. Sichuan University, Chengdu, China
  19. Riverland Mallee Coorong Local Health Network, Berri
  20. Flinders University, Bedford Park, SA, Australia

Introduction

Access to evidence-based rehabilitation after stroke is inconsistent and particularly limited in low-and-middle-income countries (LMICs). The World Stroke Organisation (WSO) Rehabilitation Implementation Committee was convened to develop an internationally applicable rehabilitation certification program to improve delivery of evidence-based stroke rehabilitation.

Methods

The WSO Rehabilitation Implementation Committee comprises 16 people from 11 countries (5 LMICs, 6 continents). High-quality stroke Clinical Practice Guidelines, systematic reviews and syntheses of guidelines, and International Stroke Recovery and Rehabilitation Alliance (ISRRA) Centres of Clinical Excellence criteria were reviewed. 

Patient-level recommendations were identified if they were strongly recommended in ≥2 guidelines or were harmful practices to avoid that are commonly performed in LMICs (per Committee experience). Service-level recommendations were generated through expert consensus, ISRRA Centres of Clinical Excellence criteria or derived from existing guidelines. An implementation manual was developed to support clinical implementation and to facilitate assessment for certification.

Criteria were piloted at 15 centres in 6 countries (4 continents) and subsequently refined. The program includes three tiers of certification (Minimal, Essential and Advanced) which were determined post-pilot through reviewing strength of evidence, pilot data and Committee discussions.  

Results

Fifty-five (9 service-level, 46 patient-level) recommendations were included. Patient-level indicators include amount and timing of rehabilitation, management of swallow, communication, mood and cognition, exercise and motor rehabilitation, information provision, discharge planning and support.

Conclusions

The WSO rehabilitation certification program incorporates evidence-based recommendations and evaluation processes that have been refined following pilot testing. The certification program is due to be launched in 2026.