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Background The importance of long term rehabilitation for people with stroke is increasingly evident, yet it is not known whether such services can be materialised in countries with limited community resources. In this study, we explored the perception of rehabilitation professionals and people with stroke towards long term stroke rehabilitation services and potential approaches to enable provision of these services. Views from providers and users are important in ensuring whatever strategies developed for long term stroke rehabilitations are feasible and acceptable. Methods Focus group discussions were conducted involving 15 rehabilitation professionals and eight long term stroke survivors. All recorded conversations were transcribed verbatim and analysed using the principles of qualitative research. Results Both groups agreed that people with stroke may benefit from more rehabilitation compared to the amount of rehabilitation services presently provided. Views regarding the unavailability of long term rehabilitation services due to multi-factorial barriers were recognised. The groups also highlighted the urgent need for the establishment of community-based stroke rehabilitation centres. Family-assisted home therapy was viewed as a potential approach to continued rehabilitation for long term stroke survivors, given careful planning to overcome several family-related issues. Conclusions Barriers to the provision of long term stroke rehabilitation services are multi-factorial. Establishment of community-based stroke rehabilitation centres and training family members to conduct home-based therapy are two potential strategies to enable the continuation of rehabilitation for long term stroke survivors.

Background There has been scarcity of research to assess the costeffectiveness of rehabilitation interventions for post-stroke cases despite the increasing importance of this service to minimise post-stroke functional problems. The aim of this study was to evaluate the cost-effectiveness of a carerassisted home-based therapy against a usual therapy for long-term stroke survivors residing in the community.

Materials and methods A single-blinded randomised controlled trial was conducted on 91 stroke patients. In all, 76.5% males with mean age of 58.9±10.6 years and median stroke duration of 13.0 months (range 6-84) completed intensive rehabilitation at a tertiary hospital. The control group received outpatient group exercise led by therapists while the experimental group was assigned to a home-based familyassisted task-oriented training. Primary outcomes were mobility (Rivermead Mobility Scale), balance (Berg’s Balance Scale), lower limb strength (5-Times-Sit-to-Stand Test) and gait speed. Secondary outcome was healthrelated quality of life as measured using EQ5D-Visual analogue Scale. All assessments were carried out at baseline and at week twelve of intervention. An intention-totreat analysis was used to evaluate outcome of the interventions.