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Visual problems caused by stroke can have a negative impact on patients’ daily lives, making essential tasks difficult. All too often such problems go undetected. This study aims to determine the major disabilities arising from post-stroke visual impairment, as well as to assess the acceptability of combining new technologies with a visual care pathway to improve both vision and function. 

Led by Dr Shirley Thomas of the Division of Rehabilitation and Ageing, BEADS is a pilot randomised controlled trial funded by the National Institute for Health Research Health Technology Assessment (HTA) programme. Its aim is to assess the feasibility of a study to investigate the clinical and cost-effectiveness of using behavioural activation therapy to treat depression in stroke patients. This builds on the success of Shirley’s Communication And Low Mood (CALM) study, which showed that behavioural therapy was effective for patients with depression and aphasia following stroke.

There is increasing evidence to suggest that a greater intensity of therapy after a stroke leads to a better outcome. Guidelines recommend 45 minutes of each appropriate active therapy, five days a week, but data suggests most patients do not receive this. By conducting in-depth qualitative studies in stroke units, we aim to establish an understanding of therapy provision, the barriers to receiving the recommended care, and the strategies needed to optimise the level of therapy patients receive.

Long-term support for stroke survivors is currently limited, partly due to a lack of evidence on the effectiveness of specific interventions and service models. This multi-centre randomised controlled trial is set within NHS stroke services which provide early supported discharge. It involves providing an 18-month extended rehabilitation service when routine stroke care ends. The results will help to shape the provision of future post-stroke care.