class=E-Title2>4.3. Treatment of Anger after Stroke

Treatment of anger after stroke remains largely uninvestigated. Glancy and Knott [51] have broadly suggested medications for the treatment of anger. Meta-analyses have supported the use of psychological interventions to treat anger in adults, though none specific to those who have had a stroke. DeVecchio and O’Leary [52] concluded that for non-institutionalised adults CBT is useful for driving anger, anger suppression and trait anger. They recommend relaxation therapy for state anger.

4.4. Treatment of Behavioural Problems

The literature on interventions for behavioural problems after stroke is highly limited, however it is considered that behavioural management strategies involving functional analysis of the behaviour of concern may be effective [28]. As with other populations, the use of medications to manage challenging behavioural problems after stroke remains unproven.

4.5. Prevention of Emotional Problems after Stroke

There is no evidence of any benefit of anti-depressants in preventing the onset of depression after stroke [53]. However, there is some evidence to support the provision of psychological treatments [53]. Motivational interviewing and problem solving therapy appear to offer preventative effects in this regard after stroke. Other psychological interventions such as distress management, group support and music therapy have been provided, but the evidence is limited [28]. However, the provision of information to patients and carers, and planned follow ups do improve patients’ mood [54].

5. Cognitive Impairments after Stroke

Cognitive impairments affect about 80% of stroke patients [55,56]. They are more common in the acute phase but many problems persist over time. Cognitive impairments are important because they are associated with rehabilitation outcome [56-59]. Impairments occur in cognitive domains, including attention, memory, language, visuospatial abilities, executive functions and praxis. In addition, there may be loss of awareness of deficits (anosognosia). Further, some patients have a dementia after stroke, usually vascular, which produces a progressive decline in cognitive abilities over time.

6. Screening for Cognitive Impairments after Stroke

Cognitive screening measures are used for two purposes, one is to detect post-stroke dementia and the other is to determine the pattern of cognitive impairments following stroke. Brief screening measures, derived from those used for the detection of Alzheimer’s dementia have been shown to be poor at detecting post stroke dementia [28]. Some widely used measures, such as the Mini Mental State Examination-MMSE [60] do not perform any better than chance [61]. Others, such as the Montreal Cognitive Assessment-MOCATEST [62], include more tests of executive abilities, which tend to be the most frequently impaired in vascular dementias, and are more sensitive. However, there are few validation studies [63].

Screening measures have also been used to detect cognitive impairment after stroke. The application of screening batteries developed for people with dementia, such as the Middlesex Elderly Assessment of Mental State—MEAMS [64], have rarely been supported [65]. However, they were useful in a stepped screening model as they were more sensitive than the brief bedside measures. An alternative strategy to detect cognitive impairment after stroke seems to be to screen in specific cognitive domains. Tests have been identified to detect language impairment such as the Frenchay Aphasia Screening Test-FAST [66], and The Sheffield Screening Test for Acquired Language Disorders-SSTALD [67]. Visual inattention can be assessed using Star Cancellation [68] and visuospatial impairment using the Rey Figure Copy [69] and Ravens Matrices [70]. There are also valid tests for apraxia [71]. However, there is little evidence to support screening measures to detect impairments of memory and executive abilities after stroke. Screening measures should be used to identify people who need further evaluation as the challenge is to correctly identify those without cognitive problems rather than those with them. The suggestion is therefore that all patients are screened with a brief bedside screening during the acute phase. If there are concerns about whether patients have capacity, further evaluation may be needed [72]. Those with no detectable problems on these bedside screening measures should be further evaluated using more sensitive tests. Those who have no detectable problems on these may need further evaluation if they wish to return to cognitively demanding activities, such as work [73], and driving a car [74-76]. These patients will require a comprehensive or specialist neuropsychological assessment, usually once they have been discharged from hospital to the community. There is some evidence to suggest that cognitive assessment can reduce stress in carers [77].

7. Cognitive Rehabilitation

Cognitive rehabilitation is provided to reduce cognitive impairments after stroke and improve functional outcomes. Narrative reviews have suggested there is evidence to support the effectiveness of cognitive rehabilitation [78,79]. However, Cochrane reviews have identified a dearth of high quality studies. There is evidence that cognitive rehabilitation can reduce some cognitive impairments, such as visual inattention [80] after stroke but there is a lack of evidence for an effect on functional outcome. In addition, there is little evidence to support or refute the effectiveness of rehabilitation of memory [81], attention [82], or apraxia after stroke [83,84]. However, lack of evidence does not mean such procedures are ineffective, and there are ample single case experimental design studies to support the provision of cognitive rehabilitation. Therefore it is important that visual inattention is treated as part of a rehabilitation programme. Other cognitive problems will also need an individualised treatment plan, based on expert guidelines rather than strong research evidence.

8. Research Needs

Research is needed to identify better measures to screen for anxiety problems after stroke, in both those with and without communication/cognitive problems. The investigation for psychological means to both prevent and treat emotional problems after stroke is in its infancy, and much needs to be done. There are few randomised controlled trials of individual or group psychological interventions after stroke, despite the evidence of the effectiveness of these in the non-stroke population. The provision of information is one means of supporting mood. The nature, prevalence and best means for managing challenging behaviours after stroke should be documented.

Cognitive assessments need to be developed to identify people with impairment of memory and executive abilities after stroke. In particular screening measures need to be developed which are sensitive to vascular dementia. Cognitive rehabilitation programmes have been shown to improve outcomes in individual patients, but more evidence is needed to indicate the generalisability of these findings.

9. Acknowledgements

Andrew Bateman, Louise Clark, Sarah Gillham, and Allan House are all to be thanked for their helpful comments. This article is based on a paper commissioned by the NHS Stroke Improvement Programme, who financially supported open access publication.


  1. P. Scarborough, et al., “Stroke Statistics 2009,” University of Oxford, Oxford, 2009.
  2. C. Wolfe, T. Rudd and R. Beech, “Stroke Services and Research,” The Stroke Association, London, 1996.
  3. Department of Health, “National Stroke Strategy,” Department of Health, London, 2007.
  4. M. L. Hackett, C. Yapa, V. Parag and C. S. Anderson, “Frequency of Depression after Stroke: A Systematic Review of Observational Studies,” Stroke, Vol. 36, 2005, pp. 1330-1340. doi:10.1161/01.STR.0000165928.19135.35
  5. N. Herrmann, S. E. Black, J. Lawrence, C. Szekely and J. P. Szalai, “The Sunnybrook Stroke Study: A Prospective Study of Depressive Symptoms and Functional Outcome,” Stroke, Vol. 29, No. 3, 1998, pp. 618-624. doi:10.1161/01.STR.29.3.618
  6. A. House, P. Knapp, J. Bamford and A. Vail, “Mortality at 12 and 24 Months after Stroke May Be Associated with Depressive Symptoms at 1 Month,” Stroke, Vol. 32, No. 3, 2001, pp. 696-701. doi:10.1161/01.STR.32.3.696
  7. P. L. Morris, R. G. Robinson, P. Andrzejewski, J. Samuels and T. R. Price, “Association of Depression with 10- Year Poststroke Mortality,” The American Journal of Psychiatry, Vol. 150, No. 1, 1993, pp. 124-129.
  8. T. Pohjasvaara, R. Vataja, A. Leppävuori, M. Kaste and T. Erkinjuntti, “Depression Is an Independent Predictor of Poor Long-Term Functional Outcome Post-Stroke,” European Journal of Neurology, Vol. 8, No. 4, 2001, pp. 315-319. doi:10.1046/j.1468-1331.2001.00182.x
  9. J. L. Cummings, et al., “Defining and Diagnosing Involuntary Emotional Expression Disorder,” CNS Spectrums, Vol. 11, No. 6, 2006, pp. 1-7.
  10. T. Calvert, P. Knapp and A. House, “Psychological Associations with Emotionalism after Stroke,” Journal of Neurology, Neurosurgery, and Psychiatry, Vol. 65, No. 6, 1998, pp. 928-929. doi:10.1136/jnnp.65.6.928
  11. A. House, M. Dennis, A. Molyneux, C. Warlow and K. Hawton, “Emotionalism after Stroke,” BMJ, Vol. 298, No. 6679, 1989, pp. 991-994. doi:10.1136/bmj.298.6679.991
  12. A. Carota, A. O. Rossetti, T. Karapanayiotides and J. Bogousslavsky, “Catastrophic Reaction in Acute Stroke: A Reflex Behavior in Aphasic Patients,” Neurology, Vol. 57, No. 10, 2001, pp. 1902-1905.
  13. S. E. Starkstein, J. P. Fedoroff, T. R. Price, R. Leiguarda and R. G. Robinson, “Catastrophic Reaction after Cerebrovascular Lesions: Frequency, Correlates, and Validation of a Scale,” The Journal of Neuropsychiatry and Clinical Neurosciences, Vol. 5, No. 2, 1993, pp. 189-194.
  14. R. S. Marin, “Differential Diagnosis and Classification of Apathy,” The American Journal of Psychiatry, Vol. 147, No. 1, 1990, pp. 22-30.
  15. L. Caeiro, J. M. Ferro, C. O. Santos and M. L. Figueira, “Depression in Acute Stroke,” Journal of Psychiatry & Neuroscienc, Vol. 31, No. 6, 2006, pp. 377-383.
  16. P. Angelelli, et al., “Development of Neuropsychiatric Symptoms in Poststroke Patients: A Cross-Sectional Study,” Acta Psychiatrica Scandinavica, Vol. 110, No. 1, 2004, pp. 55-63. doi:10.1111/j.1600-0447.2004.00297.x
  17. M. Aström, “Generalized Anxiety Disorder in Stroke Patients. A 3-Year Longitudinal Study,” Stroke, Vol. 27, No. 2, 1996, pp. 270-275. doi:10.1161/01.STR.27.2.270
  18. L. De Wit, et al., “Motor and Functional Recovery after Stroke: A Comparison of 4 European Rehabilitation Centers,” Stroke, Vol. 38, No. 7, 2007, pp. 2101-2107. doi:10.1161/STROKEAHA.107.482869
  19. L. Bruggimann, J. M. Annoni, F. Staub, N. von Steinbüchel, M. Van der Linden and J. Bogousslavsky, “Chronic Posttraumatic Stress Symptoms after Nonsevere Stroke,” Neurology, Vol. 66, No. 4, 2006, pp. 513-516. doi:10.1212/01.wnl.0000194210.98757.49
  20. E. L. Field, P. Norman and J. Barton, “Cross-Sectional and Prospective Associations between Cognitive Appraisals and Posttraumatic Stress Disorder Symptoms Following Stroke,” Behaviour Research and Therapy, Vol. 46, 2008, pp. 62-70. doi:10.1016/j.brat.2007.10.006
  21. S. Sembi, N. Tarrier, P. O’Neill, A. Burns and B. Faragher, “Does Post-Traumatic Stress Disorder Occur after Stroke: A Preliminary Study,” International Journal of Geriatric Psychiatry, Vol. 13, No. 5, 1998, pp. 315-322. doi:10.1002/(SICI)1099-1166(199805)13:5<315::AID-GPS766>3.0.CO;2-P
  22. Y. Watanabe, “Fear of Falling among Stroke Survivors after Discharge from Inpatient Rehabilitation,” International Journal of Rehabilitation Research, Vol. 28, No. 2, 2005, pp. 149-152. doi:10.1097/00004356-200506000-00008
  23. B. Belgen, M. Beninato, P. E. Sullivan and K. Narielwalla, “The association of Balance Capacity and Falls Self-Efficacy with History of Falling in CommunityDwelling People with Chronic Stroke,” Archives of Physical Medicine and Rehabilitation, Vol. 87, No. 4, 2006, pp. 554-561. doi:10.1016/j.apmr.2005.12.027
  24. S. Aybek, et al., “Emotional Behavior in Acute Stroke: The Lausanne Emotion in Stroke study,” Cognitive and Behavioral Neurology, Vol. 18, No. 1, 2005, pp. 37-44. doi:10.1097/01.wnn.0000152226.13001.8a
  25. C. O. Santos, L. Caeiro, J. M. Ferro, R. Albuquerque and M. Luísa Figueira, “Anger, Hostility and Aggression in the First Days of Acute Stroke,” European Journal of Neurology, Vol. 13, No. 4, 2006, pp. 351-358. doi:10.1111/j.1468-1331.2006.01242.x
  26. J. S. Kim, S. Choi, S. U. Kwon and Y. S. Seo, “Inability to Control Anger or Aggression after Stroke,” Neurology, Vol. 58, No. 7, 2002, pp. 1106-1108.
  27. H. E. Bennett and N. B. Lincoln, “Potential Screening Measures for Depression and Anxiety after Stroke,” International Journal of Therapy and Rehabilitation, Vol. 13, No. 4, 2006, pp. 401-406.
  28. N. B. Lincoln, I. I. Kneebone, J. A. B. Macniven and R. C. Morris, “Psychological Management of Stroke,” John Wiley & Sons, Hoboken, 2012.
  29. M. L. Hackett, C. S. Anderson, A. O. House and J. Xia, “Interventions for Treating Depression after Stroke,” Stroke, Vol. 40, 2009, pp. e487-e488.
  30. J. C. Fournier, et al., “Antidepressant Drug Effects and Depression Severity: A Patient-Level Meta-Analysis,” The Journal of the American Medical Association, Vol. 303, No. 1, 2010, pp. 47-53. doi:10.1001/jama.2009.1943
  31. I. Kirsch, B. J. Deacon, T. B. Huedo-Medina, A. Scoboria, T. J. Moore and B. T. Johnson, “Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration,” PLoS Medicine, Vol. 5, No. 2, 2008, p. e45. doi:10.1371/journal.pmed.0050045
  32. N. B. Lincoln, T. Flannaghan, L. Sutcliffe and L. Rother, “Evaluation of Cognitive Behavioural Treatment for Depression after Stroke: A Pilot Study,” Clinical Rehabilitation, Vol. 11, No. 2, 1997, pp. 114-122. doi:10.1177/026921559701100204
  33. S. M. C. Rasquin, P. Van De Sande, A. J. Praamstra and C. M. Van Heugten, “Cognitive-Behavioural Intervention for Depression after Stroke: Five Single Case Studies on Effects and Feasibility,” Neuropsychological Rehabilitation, Vol. 19, No. 2, 2009, pp. 208-222. doi:10.1080/09602010802091159
  34. A. Forster and J. Young, “Specialist Nurse Support for Patients with Stroke in the Community: A Randomised Controlled Trial,” BMJ, Vol. 312, No. 7047, 1996, pp. 1642-1646. doi:10.1136/bmj.312.7047.1642
  35. N. B. Lincoln and T. Flannaghan, “Cognitive Behavioral Psychotherapy for Depression Following Stroke: A Randomized Controlled Trial,” Stroke, Vol. 34, No. 1, 2003, pp. 111-115. doi:10.1161/01.STR.0000044167.44670.55
  36. I. I. Kneebone and E. Dunmore, “Psychological Management of Post-Stroke Depression,” The British Journal of Clinical Psychology, Vol. 39, 2000, pp. 53-65. doi:10.1348/014466500163103
  37. P. Cuijpers, A. van Straten, A. van Schaik and G. Andersson, “Psychological Treatment of Depression in Primary Care: A Meta-Analysis,” The British Journal of General Practic, Vol. 59, No. 559, 2009, pp. e51-60. doi:10.3399/bjgp09X395139
  38. K. C. M. Wilson, P. G. Mottram and C. A. Vassilas, “Psychotherapeutic Treatments for Older Depressed People,” Cochrane Database of Systematic Reviews (Online), No. 1, 2008, p. CD004853.
  39. M. L. Hackett, M. Yang, C. S. Anderson, J. A. Horrocks and A. House, “Pharmaceutical Interventions for Emotionalism after Stroke,” Cochrane Database of Systematic Reviews (Online), No. 2, 2010, p. CD003690.
  40. S. Sacco, M. Sarà, F. Pistoia, M. Conson, G. Albertini and A. Carolei, “Management of Pathologic Laughter and Crying in Patients with Locked-In Syndrome: A Report of 4 Cases,” Archives of Physical Medicine and Rehabilitation, Vol. 89, 2008, pp. 775-778. doi:10.1016/j.apmr.2007.09.032
  41. E. Ohtomo, S. Hirai, A. Terashi and K. Araki, “Clinical Evaluation of Aniracetam on Psychiatric Symptoms Related to Cerebrovascular Disease,” Journal of Clinical and Experimental Medicine, Vol. 156, 1991, pp. 143-187.
  42. P. Wu and S. Liu, “Clinical Observation on Post-Stroke Anxiety Neurosis Treated by Acupuncture,” Journal of Traditional Chinese Medicine, Vol. 28, No. 3, 2008, pp. 186-188. doi:10.1016/S0254-6272(08)60043-6
  43. E. Mok and C. P. Woo, “The Effects of Slow-Stroke Back Massage on Anxiety and Shoulder Pain in Elderly Stroke Patients,” Complementary Therapies in Nursing & Midwifery, Vol. 10, No. 4, 2004, pp. 209-216. doi:10.1016/j.ctnm.2004.05.006
  44. C. R. Ayers, J. T. Sorrell, S. R. Thorp and J. L. Wetherell, “Evidence-Based Psychological Treatments for Late-Life Anxiety,” Psychology and Aging, Vol. 22, No. 1, 2007, pp. 8-17. doi:10.1037/0882-7974.22.1.8
  45. A. C. Butler, J. E. Chapman, E. M. Forman and A. T. Beck, “The Empirical Status of Cognitive-Behavioral Therapy: A Review of Meta-Analyses,” Clinical Psychology Review, Vol. 26, No. 1, 2006, pp. 17-31. doi:10.1016/j.cpr.2005.07.003
  46. V. Hunot, R. Churchill, M. Silva de Lima and V. Teixeira, “Psychological Therapies for Generalised Anxiety Disorder,” Cochrane Database of Systematic Reviews (Online), No. 1, 2007, p. CD001848.
  47. D. J. Stein, J. C. Ipser and S. Seedat, “Pharmacotherapy for Post Traumatic Stress Disorder (PTSD),” Cochrane Database of Systematic Reviews (Online), No. 1, 2006, p. CD002795.
  48. J. Bisson and M. Andrew, “Psychological Treatment of post-Traumatic Stress Disorder (PTSD),” Cochrane Database of Systematic Reviews (Online), No. 3, 2007, p. CD003388.
  49. S. Tennstedt, J. Howland, M. Lachman, E. Peterson, L. Kasten and A. Jette, “A Randomized, Controlled Trial of a Group Intervention to Reduce Fear of Falling and Associated Activity Restriction in Older Adults,” The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, Vol. 53, No. 6, 1998, pp. 384-392. doi:10.1093/geronb/53B.6.P384
  50. G. A. R. Zijlstra, J. C. M. van Haastregt, E. van Rossum, J. T. M. van Eijk, L. Yardley and G. I. J. M. Kempen, “Interventions to Reduce Fear of Falling in CommunityLiving Older People: A Systematic Review,” Journal of the American Geriatrics Society, Vol. 55, No. 4, 2007, pp. 603-615. doi:10.1111/j.1532-5415.2007.01148.x
  51. G. D. Glancy and T. F. Knott, “Part III: The Psychopharmacology of Long Term Aggression-Towards an Evidences Based Algorithm,” Canadian Psychiatric Association Bulletin, 2003, pp. 13-18.
  52. T. Del Vecchio and K. D. O’Leary, “Effectiveness of Anger Treatments for Specific Anger Problems: A MetaAnalytic Review,” Clinical Psychology Review, Vol. 24, No. 1, 2004, pp. 15-34. doi:10.1016/j.cpr.2003.09.006
  53. M. L. Hackett, C. S. Anderson, A. House and C. Halteh, “Interventions for preventing depression after stroke,” Cochrane Database of Systematic Reviews (Online), No. 3, 2008, p. CD003689.
  54. J. Smith, A. Forster, A. House, P. Knapp, J. Wright and J. Young, “Information Provision for Stroke Patients and Their Caregivers,” Cochrane Database of Systematic Reviews (Online), No. 2, 2008, p. CD001919.
  55. G. M. S. Nys, M. J. E. van Zandvoort, P. L. M. de Kort, B. P. W. Jansen, E. H. F. de Haan and L. J. Kappelle, “Cognitive Disorders in Acute Stroke: Prevalence and Clinical Determinants,” Cerebrovascular Diseases, Vol. 23, No. 5-6, 2007, pp. 408-416. doi:10.1159/000101464
  56. M. Leśniak, T. Bak, W. Czepiel, J. Seniów and A. Członkowska, “Frequency and Prognostic Value of Cognitive Disorders in Stroke Patients,” Dementia and Geriatric Cognitive Disorders, Vol. 26, No. 4, 2008, pp. 356-363. doi:10.1159/000162262
  57. J. B. Hochstenbach, P. G. Anderson, J. van Limbeek and T. T. Mulder, “Is There a Relation between Neuropsychologic Variables and Quality of Life after Stroke?,” Archives of Physical Medicine and Rehabilitation, Vol. 82, No. 10, 2001, pp. 1360-1366. doi:10.1053/apmr.2001.25970
  58. M. Hommel, S. T. Miguel, B. Naegele, N. Gonnet and A. Jaillard, “Cognitive Determinants of Social Functioning after a First Ever Mild to Moderate Stroke at Vocational Age,” Journal of Neurology, Neurosurgery, and Psychiatry, Vol. 80, No. 8, 2009, pp. 876-880. doi:10.1136/jnnp.2008.169672
  59. G. M. S. Nys, et al., “The Prognostic Value of Domainspecific Cognitive Abilities in Acute First-Ever Stroke,” Neurology, Vol. 64, No. 5, 2005, pp. 821-827. doi:10.1212/01.WNL.0000152984.28420.5A
  60. M. F. Folstein, S. E. Folstein and P. R. McHugh, “‘Minimental State’. A Practical Method for Grading the Cognitive State of Patients for the Clinician,” Journal of Psychiatric Research, Vol. 12, No. 3, 1975, pp. 189-198. doi:10.1016/0022-3956(75)90026-6
  61. V. Srikanth, et al., “The Validity of Brief Screening Cognitive Instruments in the Diagnosis of Cognitive Impairment and Dementia after First-Ever Stroke,” International Psychogeriatrics, Vol. 18, No. 2, 2006, pp. 295-305. doi:10.1017/S1041610205002711
  62. Z. S. Nasreddine, et al., “The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool for Mild Cognitive Impairment,” Journal of the American Geriatrics Society, Vol. 53, No. 4, 2005, pp. 695-699. doi:10.1111/j.1532-5415.2005.53221.x
  63. S. T. Pendlebury, F. C. Cuthbertson, S. J. V. Welch, Z. Mehta and P. M. Rothwell, “Underestimation of Cognitive Impairment by Mini-Mental State Examination versus the Montreal Cognitive Assessment in Patients with Transient Ischemic Attack and Stroke: A PopulationBased Study,” Stroke, Vol. 41, No. 6, 2010, pp. 1290- 1293. doi:10.1161/STROKEAHA.110.579888
  64. E. Golding, “Middlesex Elderly Assessment of Mental State,” Thames Valley Test Company, Sullfolk, 1989.
  65. A. Cartoni and N. B. Lincoln, “The Sensitivity and Specificity of the Middlesex Elderly Assessment of Mental State (MEAMS) for Detecting Cognitive Impairment after Stroke,” Neuropsychological Rehabilitation, Vol. 15, No. 1, 2005, pp. 55-67. doi:10.1080/09602010443000029
  66. P. M. Enderby, V. Wood and D. Wade, “Frenchay Aphasia Screening Tes,” Whurr Publishers, Oxford, 1997.
  67. D. Syder, R. Body, M. Parker and M. Boddy, “Sheffield Screening Test for Acquired Language Disorders,” NFER Nelson, Slough, 1993.
  68. T. Manly, et al., “Assessment of Unilateral Spatial Neglect: Scoring Star Cancellation Performance from Video Recordings—Method, Reliability, Benefits, and Normative Data,” Neuropsychology, Vol. 23, No. 4, 2009, pp. 519-528. doi:10.1037/a0015413
  69. A. Rey, “Le Test de Copie de Figure Complexe,” Journals of Gerontology, Vol. 38, 1959, pp. 344-348.
  70. J. Raven, “Manual for Raven’s Progressive Matrices and Vocabulary Scales,” Oxford Psychologists Press, Oxford, 1989.
  71. C. M. van Heugten, J. Dekker, B. G. Deelman, F. C. Stehmann-Saris and A. Kinebanian, “A Diagnostic Test for Apraxia in Stroke Patients: Internal Consistency and Diagnostic Value,” The Clinical Neuropsychologist, Vol. 13, No. 2, 1999, pp. 182-192. doi:10.1076/clin.
  72. J. Moye and D. C. Marson, “Assessment of DecisionMaking Capacity in Older Adults: An Emerging Area of Practice and Research,” The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, Vol. 62, No. 1, 2007, pp. 3-11. doi:10.1093/geronb/62.1.P3
  73. S. Saeki, “Disability Management after Stroke: Its Medical Aspects for Workplace Accommodation,” Disability and Rehabilitation, Vol. 22, No. 13-14, 2000, pp. 578- 582. doi:10.1080/09638280050138241
  74. F. M. Nouri and N. B. Lincoln, “Predicting Driving Performance after Stroke,” BMJ, Vol. 307, No. 6902, 1993, pp. 482-483. doi:10.1136/bmj.307.6902.482
  75. A. E. Akinwuntan, H. Feys, W. De Weerdt, G. Baten, P. Arno and C. Kiekens, “Prediction of Driving after Stroke: a Prospective Study,” Neurorehabilitation and Neural Repair, Vol. 20, No. 3, 2006, pp. 417-423. doi:10.1177/1545968306287157
  76. S. George and M. Crotty, “Establishing Criterion Validity of the Useful Field of View Assessment and Stroke Drivers’ Screening Assessment: Comparison to the Result of On-Road Assessment,” The American Journal of Occupational Therapy, Vol. 64, No. 1, 2010, pp. 114-122. doi:10.5014/ajot.64.1.114
  77. M. McKinney, H. Blake, K. A. Treece, N. B. Lincoln, E. D. Playford and J. R. F. Gladman, “Evaluation of Cognitive Assessment in Stroke Rehabilitation,” Clinical Rehabilitation, Vol. 16, No. 2, 2002, pp. 129-136. doi:10.1191/0269215502cr479oa
  78. K. D. Cicerone, et al., “Evidence-Based Cognitive Rehabilitation: Updated Review of the Literature from 1998 through 2002,” Archives of Physical Medicine and Rehabilitation, Vol. 86, No. 8, 2005, pp. 1681-1692. doi:10.1016/j.apmr.2005.03.024
  79. T. Manly, “Cognitive Rehabilitation for Unilateral Neglect: Review,” Neuropsychological Rehabilitation, Vol. 12, 2002, pp. 289-310. doi:10.1080/0960201044000101
  80. A. Bowen and N. B. Lincoln, “Cognitive Rehabilitation for Spatial Neglect Following Stroke,” Cochrane Database of Systematic Reviews (Online), No. 2, 2007, p. CD003586.
  81. R. D. das Nair and N. B. Lincoln, “Cognitive Rehabilitation for Memory Deficits Following Stroke,” Cochrane Database of Systematic Reviews (Online), No. 3, 2007, p. CD002293.
  82. N. B. Lincoln, M. J. Majid and N. Weyman, “Cognitive Rehabilitation for Attention Deficits Following Stroke,” Cochrane Database of Systematic Reviews (Online), No. 4, 2000, p. CD002842.
  83. C. West, A. Bowen, A. Hesketh and A. Vail, “Interventions for Motor Apraxia Following Stroke,” Cochrane Database of Systematic Reviews (Online), No. 1, 2008, p. CD004132.
  84. C. West, A. Hesketh, A. Vail and A. Bowen, “Interventions for Apraxia of Speech Following Stroke,” Cochrane Database of Systematic Reviews (Online), No. 4, 2005, p. CD004298.


*Corresponding author.

Journal Menu >>