ABSTRACT
Stroke is the major cause of neurological disability in the United States. The 2003 American Heart Association stroke statistics update placed the annual costs of stroke at $51.2 billion, of which $31 billion were direct medical costs and $20.2 billion were indirect costs due to lost productivity (1). A 1998 projection indicated that the number of strokes may be dramatically higher than previously estimated, reaching in excess of 730,000 every year. Moreover, more than half of these individuals are left with sensorimotor disability and two-thirds of these survivors have persistent disability 5 years later, 37% mildly so and 29% moderately or severely so (2). It is likely that the number of stroke survivors will increase greatly as the population progressively ages over the next 50 years; indeed, a recent projection is that the prevalence of stroke will more than double during this period (3). The high prevalence of stroke and its major economic costs makes the reduction of stroke-related disability a national health care priority.
