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1992.07.24 :  Panel on Stroke Rehabilitation

Contact: Bob Isquith (301)227-8370
July 24, 1992

     The U.S. Public Health Service today announced formation of
a 17-member panel of private-sector medical experts to develop
guidelines for rehabilitating patients who have suffered acute
strokes.
     The guidelines, which are sponsored by the Agency for Health
Care Policy and Research, are designed to assist health care
providers improve the quality and effectiveness of after-stroke
care.  The medical experts -- and the guidelines they develop --
will identify the treatment methods or medical interventions that
are most likely to benefit patients.
     HHS Assistant Secretary for Health James Mason, M.D., who is
the head of the Public Health Service, said, "Strokes, which
result from the formation of blood clots or from sudden
hemorrhages in the brain, are a major cause of disability and
death.
     "An estimated 500,000 Americans a year suffer strokes, and
nearly 148,000 die from them.  Many who survive strokes require
long-term care."
     The economic cost and social impact of stroke are also
enormous.  The financial loss to stroke survivors in the United
States has been estimated to be between $7.5 billion and $11.2
billion per year, including the cost of care and loss of
earnings.  
     AHCPR Administrator J. Jarrett Clinton, M.D., said, "However
impressive these figures are, they probably underestimate the
personal impact of stroke.  The loss of independence caused by
stroke -- due to impaired ability to move, or loss of speech or
vision -- represents the end of meaningful, useful life to many
patients."
     Members of the guideline panel were selected on the basis of
education, clinical experience and research related to stroke and
vascular disease -- conditions affecting blood vessels and the
circulatory system.  The panel represents a broad spectrum of
healthcare specialties, including medicine, nursing, psychology,
speech, occupational and physical therapy, as well as consumers.  
      The panel is co-chaired by Glen E. Gresham, M.D., professor
and chairman, department of rehabilitation medicine, State
University of New York at Buffalo, and director of rehabilitation
medicine/medical director, Erie County Medical Center, Buffalo,
N.Y.; and Pamela W. Duncan, P.T., Ph.D., associate professor,
Graduate Program in Physical Therapy and Senior Fellow, Center
for Aging and Human Development, Duke University, Durham, N.C.
       The panel members include:
     Harold P. Adams Jr., M.D., professor of neurology and
director, Division of Cerebrovascular Diseases, University of
Iowa Hospitals, Iowa City, Iowa (neurology); 

     Alan M. Adelman, M.D., M.S., Medical School associate
professor, University of Maryland, Baltimore, Md. (family
practice); 
     David N. Alexander, M.D., director, Stroke Rehabilitation
Service, Daniel Freeman Memorial Hospital, Inglewood, Calif.
(neurology); 

     Duane S. Bishop, M.D., associate professor, Brown
University, and director, rehabilitation psychiatry, Rhode Island
Hospital, Providence, R.I. (psychiatry); 

     Leonard Diller, Ph.D., professor, clinical rehabilitation
medicine, New York University Medical Center, Rusk Institute of
Rehabilitation Medicine, New York, N.Y. (psychology); 

     Nancy E. Donaldson, R.N., DNSc., associate director of
nursing and director, nursing research and education, University
of California, Irvine (consumer); 

     Carl V. Granger, M.D., professor of rehabilitation medicine
and director, Center for Functional Assessment Research, State
University of New York at Buffalo, Buffalo, N.Y. (psychiatry);

     Audry L. Holland, Ph.D., professor of speech pathology,
University of Arizona, Tucson, Ariz. (speech therapy); 

     Margaret Kelly-Hayes, Ed.D., R.N., C.R.R.N., research
coordinator and associate clinical professor of neurological
nursing, Boston University School of Medicine, Boston, Mass.
(rehabilitation nursing); 

     Larry R. Myers, M.D., Mansfield Professional Center,
Mansfield, Texas (family practice); 

     Fletcher H. McDowell, M.D., medical director and chief
executive officer, Burke Rehabilitation Hospital, associate dean
and professor of neurology and rehabilitation medicine, Cornell
University Medical College, New York, N.Y. (neurology); 

     Elliot J. Roth, M.D., director, Center for Stroke
Rehabilitation, Rehabilitation Institute of Chicago, associate
professor, department of physical medicine and rehabilitation,
Northwestern Medical School, Chicago, Ill. (psychiatry);

     Hilary C. Siebens, M.D., medical director, rehabilitation
research and assistant clinical professor, department of physical
medicine and rehabilitation, University of California, Los
Angeles, Calif. (neurology); 

     Gloria A. Tarwin, ACSW, LSW, director, Social Work
Department, Rehabilitation Institute of Chicago, Chicago, Ill.
(social work);

     Catherine Anne Trombly, Sc.D., professor of occupational
therapy, Boston University, Boston, Mass. (occupational therapy).

     The AHCPR-supported guidelines on post stroke rehabilitation
are being developed under a contract to the Center for Health
Economics Research of Waltham, Mass., a non-profit organization.
     The guidelines will be completed in 1993.  Extensive review
by other experts and a trial of the guidelines by clinicians will
be conducted before it is published.
     Three guidelines -- on the prevention and treatment of post-
operative pain, of bedsores and of urinary incontinence -- have
been published by AHCPR and a dozen are underway, not counting
the new one on stroke.

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