D2D Visit Report – Dr. Alexander Heinrich Nave, Switzerland

With support of the ESO department-to-department visiting programme, I was able to spend a week with Prof. Andreas Luft and his team in Zurich to broaden my view on academic stroke rehabilitation. Prof. Luft is an attending neurologist and head of the Stroke Center at the Department of Neurology, Universitätsspital Zürich, as well as the Medical Director at cereneo – Center for Neurology and Rehabilitation, Weggis/Vitznau in Switzerland. Due to this double position, he is able to follow patients beyond the acute phase of stroke to the post-acute rehabilitation clinic. Furthermore, this concept of sector–overarching clinical care of stroke patients can ultimately improve clinical stroke rehabilitation research.

I joined Prof. Luft at the Stroke Center of the Universitätsspital Zurich, where we saw patients during daily rounds on the stroke unit and intermediate care unit. We had in-depth discussions on the suspected rehabilitation potential of patients with post-stroke delirium or prolonged impaired level of consciousness. How can we predict functional recovery in these patients early after stroke? How can we accurately assess the benefit of continued and intensified rehabilitation for patients with stroke? How long should patients receive in-patient stroke rehabilitation? And is there a way to prove that intensified stroke rehabilitation can improve pure neurological recovery after stroke? Based on these questions, we talked about ways to collaborate in new pilot trials and the necessity to start multicenter stroke rehabilitation trials. Together with members of his lab, I was able to experience important aspects of preforming regular assessments during stroke aftercare.

During my week I spent three days with Prof. Luft and Dr. Meret Branscheidt at the cereneo clinics in Vitznau and Weggis, which are located at most beautiful sites directly adjacent to the Lake Lucerne. I joined the interdisciplinary team on daily rounds, where we visited patients with cerebellar strokes, brainstem hemorrhages, or large middle cerebral artery strokes. Most patients were still making progress in motor recovery months after the event. For me it was fascinating to see how regular domain-specific assessments during stroke rehabilitation gradually track improvements of patients, which then eventually will lead to adjustments of the individual rehabilitative treatment plan.

Overall, the time in Zurich and Weggis/Vitznau was a most inspiring one and I am thankful for the support of ESO and for the opportunity to have been able to have an in-depth exchange with Prof. Luft and his team. The visit helped me to improve my current and future research projects and served me as a starting point for international scientific collaborations in stroke rehabilitation research.