Post-stroke rehabilitation in inflammatory rheumatic diseases: outcome measures, digital tools, and patient education perspectives

Rheumatol Int. 2026 Jul 1;46(7):183. doi: 10.1007/s00296-026-06228-8.

ABSTRACT

Inflammatory rheumatic diseases (IRDs) represent a significant risk factor for cerebrovascular events, independent of traditional cardiovascular risk factors. The elevated risk of stroke in individuals with IRDs arises from chronic systemic inflammation, endothelial dysfunction, accelerated atherosclerosis, prothrombotic effects of antiphospholipid antibodies, and cumulative corticosteroid exposure. Post-stroke rehabilitation in patients with IRDs involves distinct clinical challenges that extend beyond standard neurorehabilitation, including joint involvement, chronic pain, fatigue, and treatment-related limitations. Assessment tools that focus exclusively on neurological recovery are inadequate for this population. Dual-layered protocols that integrate both neurological and rheumatological criteria are required. Although wearable sensors, telemonitoring, and electronic patient-reported outcome measures provide a foundation for continuous monitoring, barriers such as limited digital literacy, insufficient infrastructure, and the absence of IRD-specific content addressing symptom overlap persist. Post-stroke cognitive impairment is frequent and multifactorial in this group, necessitating cognitive assessment approaches tailored to IRD subgroups, as disease-specific manifestations may confound the interpretation of standard screening tools. Physiotherapy, occupational therapy, telerehabilitation, and virtual reality-based interventions may be beneficial when specifically adapted to accommodate joint limitations and pain. While artificial intelligence-based tools hold promise, there remains a need for clinically validated, domain-specific expert platforms. Nurses are integral to this process, providing patient education, monitoring medication adherence, offering psychosocial support, and coordinating remote care. Optimal management of stroke associated with IRDs requires multidisciplinary, technology-enabled, and patient-centered care models that integrate neurology, rheumatology, rehabilitation medicine, and digital health. Given the predominantly indirect nature of current evidence, prospective studies employing validated assessment tools are urgently needed.

PMID:42384268 | DOI:10.1007/s00296-026-06228-8