The 3rd Congress on Neuro-Rehabilitation and Neural Repair took place between 22 – 24 May 2019 in Maastricht. Headed by health experts Professor Gert Kwakkel, Professor Gaëtan Stoquart, Professor Jan Mehrholz and Professor Jane Burridge, an interesting and varied programme was guaranteed.

In his opening presentation, Professor Kwakkel examined the changing research and therapy approaches in stroke rehabilitation with a focus on the upper extremity. This was also the main theme of this year’s congress. In his presentation, Professor Kwakkel analysed the most important components of upper extremity rehabilitation: barriers that prevent a specific treatment, such as shoulder pain or depression, firstly need to be dealt with and eliminated. Secondly, the treatment team must have the specialist knowledge of how the patient’s impairment affects not only structures and functions but also patient participation. Patient-specific goals based on this then need to be developed to increase patient activity at home. This should be done with many repetitions in order to improve the movement quality and movement control for everyday activities. Promoting self-efficacy is also essential. In rehabilitation, patients must be given the knowledge, skills/methods and motivation to continue with their rehabilitation. This multi-layered approach to treatment is important because current research results re­peatedly highlight shortcomings in therapy. For example, 45% of stroke survivors still feel that they lack support after they have been discharged from hospital. In addition, a 2015 study by K. Hayward found that patients in rehabilitation are still inactive and alone. And despite the wide range of options now available in modern stroke rehabilitation. In order to turn this situation around, research is needed so we can identify which therapy provides optimal help for patients.

However, this seemingly simple question presents research challenges, as revealed in the content of published studies. Dr Louise Connell and Dr Liz Lynch demonstrated this in their presentation “Is it any wonder no one ever implements evidence-based practice?”. According to them, 65% of all therapy studies were non-intervention studies, 25% knowledge inquiry, 8% knowledge synthesis and only 2.5% of the studies dealt with the implementation of therapy methods. Of course, it is elementary evidence-based to demonstrate the effectiveness of a therapy method, but the implementation is at least as important for successful implementation in everyday clinical practice. And this is still not happening enough. This is perhaps one reason why translating clinical research into clinical practice takes 17 years on average. A drastic reduction in this time span for implementing an evidence-based therapy method would be welcome in the future.

Another important topic that was regularly addressed in the presentations related to daily life of neuropatients after hospital discharge, including the presentation “Managing daily life: evidence and implications for practice in neurorehabilitation” by D. Kos and Dr. T. Satink. In order to organise daily life as a patient, more resources are required than is generally assumed. Patients need to take responsibility not only for their emotional situation but their health situation as well. In addition, they also have to take care of everyday tasks such as shopping and eating. In order to manage daily life, patients should not rely solely on their own ability to function, but must be able to recognise when they need help, when they should ask for help and accept it. This correlates closely with a patient’s quality of life. According to Kos and Satink, managing everyday life is not about carrying out activities, but is rather about feeling and thinking about these activities. This is what gives the patient a ‘sense of purpose’. In summary, they came to the conclusion that managing everyday life in neuro-rehabilitation is about more than treating a chronic condition. It means taking responsibility and finding a new meaning in life. It is a dynamic process with several phases.

In summary, the Third Congress on Neuro­Rehabilitation and Neural Repair discussed every relevant issue in neuro-rehabilitation and there was something for every visitor, including the latest research findings, the application and implementation of new therapy methods and patient participation. It will be exciting to see what changes will occur in neuro-rehabilitation in the years ahead.