{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:04:12Z","timestamp":1789977852141,"version":"4.0.1"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["NeuroRehabilitation"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Access to regional specialist services to support complex management needs (including spasticity) in the community is often variable in the UK and internationally. There are barriers to service access due to condition severity, resulting in inequity of provision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Service data covering a six-year period were extracted from a clinical database (2019\u20132025) from a regional service offering specialised community outreach (London and surrounding counties, UK). Yearly caseload, clinical activity and activity time were all calculated for the cohort. Method of delivery: face-to-face, telephone or virtual and type of assessment or review per year were counted and classified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Activity doubled during the 6-year period (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009360 (2019\u201320),\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009728 (2024\u201325). The primary reasons for referral were spasticity management (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20092821), and\/or complex physical management (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20092393). Other issues addressed were splinting or orthotics, re-assessment of Prolonged Disorders of Consciousness, management of pressure sores, communication and swallowing, wheelchairs and postural management.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is expanding utilisation to support and manage severe and complex disability for those with stroke and other acquired brain injury in the community, particularly for spasticity and contracture management. Service delivery partnership between specialised services and local rehabilitation services or teams, is likely to be key to providing more seamless care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10538135261479741","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:09:29Z","timestamp":1789740569000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Specialised Acquired Brain Injury Community Outreach Provision \u2013 a Service Evaluation Cohort to Enable Practice Development and Improvement"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5541-7063","authenticated-orcid":false,"given":"Stephen","family":"Ashford","sequence":"first","affiliation":[{"name":"King's College London"},{"name":"London North West University Healthcare NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Williams","sequence":"additional","affiliation":[{"name":"London North West University Healthcare NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary","family":"Rose","sequence":"additional","affiliation":[{"name":"London North West University Healthcare NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aideen","family":"Steed","sequence":"additional","affiliation":[{"name":"London North West University Healthcare NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie","family":"Alfonso","sequence":"additional","affiliation":[{"name":"London North West University Healthcare NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"issue":"3","key":"e_1_3_2_2_1","first-page":"100","article-title":"What to consider when developing a community spasticity service","volume":"19","author":"Ashford S.","year":"2024","unstructured":"Ashford S., Chivhunga M., Futter J., Moore J., Oo W. W., Robertson A., Ward C. (2024). What to consider when developing a community spasticity service. International Journal of Stroke, 19(3), 100. https:\/\/doi.org\/10.1177\/17474930241300284","journal-title":"International Journal of Stroke"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/ph9.0000000000000004"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pri.36"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arrct.2023.100299"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2016.1198432"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.2340\/20030711-1000004"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215519859621"},{"issue":"1","key":"e_1_3_2_9_1","article-title":"Module 1: Pathophysiology and assessment of spasticity; Goal setting","volume":"5","author":"Escaldi S.","year":"2022","unstructured":"Escaldi S., Bianchi F., Bavikatte G., Molteni F., Moraleda S., Deltombe T., Francisco G. E. (2022). Module 1: Pathophysiology and assessment of spasticity; Goal setting. Journal of the International Society of Physical and Rehabilitation Medicine, 5(Suppl 1), S3\u2013S22. https:\/\/journals.lww.com\/jisprm\/fulltext\/2022\/05001\/module_1__pathophysiology_and_assessment_of.2.aspx","journal-title":"Journal of the International Society of Physical and Rehabilitation Medicine"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27792"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-218003"},{"key":"e_1_3_2_12_1","unstructured":"legislation.gov.uk. (2026). Mental Capacity Act 2005."},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2016.1146351"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2010.03128.x"},{"key":"e_1_3_2_15_1","volume-title":"Prolonged disorders of consciousness following sudden onset brain injury: National clinical guidelines","author":"Royal College of Physicians (Ed.)","year":"2020","unstructured":"Royal College of Physicians (Ed.). (2020). Prolonged disorders of consciousness following sudden onset brain injury: National clinical guidelines. RCP."},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2021.2011437"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.7224\/1537-2073.2022-115"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.581991"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"issue":"10","key":"e_1_3_2_20_1","article-title":"Long-term trends in incidence and risk factors for ischaemic stroke subtypes","volume":"15","author":"Wafa H. A.","year":"2018","unstructured":"Wafa H. A., Wolfe C. D. A., Rudd A., Wang Y. (2018). Long-term trends in incidence and risk factors for ischaemic stroke subtypes. PL O S Medicine, 15(10), e1002669. https:\/\/doi.org\/10.1371\/journal.pmed.1002669","journal-title":"PL O S Medicine"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/2051415818754578"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1191\/0269215502cr512oa"}],"container-title":["NeuroRehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10538135261479741","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10538135261479741","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10538135261479741","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T07:18:02Z","timestamp":1789975082000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10538135261479741"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":21,"alternative-id":["10.1177\/10538135261479741"],"URL":"https:\/\/doi.org\/10.1177\/10538135261479741","relation":{},"ISSN":["1053-8135","1878-6448"],"issn-type":[{"value":"1053-8135","type":"print"},{"value":"1878-6448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,18]]},"article-number":"10538135261479741"}}