Bridging Gaps in Neuropsychological Rehabilitation Intensity for Post-Stroke Population in Spain.

Abstract

Objective: This study aims to analyze the treatment intensity applied in neurorehabilitation centers in Spain and its relationship with sociodemographic, biomedical, and cognitive variables in post-stroke patients. Current guidelines recommend rehabilitation sessions lasting at least 45 min per day, 2-5 days/week, but there is no consensus on neuropsychology intensity.

Method: This Spanish multicenter, observational, descriptive cross-sectional study included 163 adult participants diagnosed with stroke, collecting 48 biopsychosocial variables. Statistical analyses, including non-parametric tests and linear regressions, were conducted to assess the relationship between intervention intensity and the studied variables.

Results: Our findings reveal an average neuropsychology of 59 min/week, significantly below international recommendations for intensive therapies. Patients in subacute phases (<6 months) and those with severe cognitive impairment (Montreal Cognitive Assessment <21) receive higher-intensity interventions, though still far from optimal standards. Significant differences were also identified between center types, reflecting variations in the resources available.

Conclusion: This study not only highlights the need to establish clear intensity criteria in neuropsychology but also provides a foundation for future experimental studies to evaluate the impact of increased intensity on cognitive outcomes. Additionally, future research should analyze whether the observed differences between center types could lead to inequalities in access to therapies. These unique data in the Spanish context can serve as a starting point for designing more equitable and effective clinical guidelines.