The study was limited to medically stable stroke

The gap

Evidence profile

Stated in the discussion and recommendations and cells limitations sections of the source papers, classified as general, spanning 3 journals.

Supporting evidence — 3 representative gaps

• Effects of Neuromuscular Joint Facilitation on Scapular Stability and Upper Limb Function in Stroke: A PRISMA-ScR Guided Scoping Review (2026) · Indian Journal of Physiotherapy and Occupational Therapy - An International Journal · doi

  Therefore, future research should focus on well-designed, large-scale studies with standardized intervention protocols and longer follow- up durations to establish the long-term effectiveness and clinical applicability of NJF in stroke rehabilitation. Therefore, the long-term effectiveness of NJF remains unclear. Despite these promising results, the evidence is limited by small sample sizes, short intervention periods, and heterogeneity in protocols and outcome measures¹⁷˒²⁹.

  generalstated in discussionevidence 5/5
  Keywords: intervention protocols long term effectiveness future focus well designed large scale standardized longer follow durations
• Global research trends and emerging frontiers in young-onset stroke: a bibliometric analysis (1996–2026) (2026) · Frontiers in Neurology · doi

  remain Survivorship and long-term outcomes A notable finding was the emergence of rehabilitation, quality of life, fatigue, cognitive outcomes, caregivers, social support, unmet needs, and functional outcomes as recent or developing themes. These terms are highly relevant to young-onset stroke. The consequences of stroke may affect education, employment, family roles, mental health, and social participation for decades after the acute event. Previous studies have shown that young survivors may achieve good basic physical recovery but still experience important long-term problems, including cognitive impairment, depression, anxiety, fatigue, and return-to-work difficulties (24, 37). Cognitive and psychosocial outcomes are best interpreted as post-stroke survivorship issues within this bibliometric landscape. Long-term cognitive impairment after young stroke has been reported in cohort studies and systematic reviews (37, 38). Return to work is also closely related to cognitive performance and psychosocial functioning (25, 39). Depression and anxiety are frequent among young stroke survivors and may substantially affect quality of life (24). In addition, recurrence and long-term mortality remain major concerns, reinforcing the need for sustained secondary prevention and long-term follow-up (22, 40). Long- term prognosis, therefore, remains an important dimension of young-stroke survivorship (41). Clinical outcome studies in young adults also support the need to evaluate functional status beyond early survival (42). These findings align with the bibliometric shift from traditional risk-factor and etiologic research toward chronic outcome assessment and survivorship-oriented investigation. The field’s increasing attention to survivors, caregivers, social support, unmet needs, and functional outcomes suggests that future young-stroke research should move beyond acute hospitalization and early disability scales.

  generalstated in recommendationsevidence 5/5
  Keywords: young stroke long term outcomes cognitive survivorship social support functional survivors remain quality life fatigue
• Addressing the Mental Health Needs of Stroke Survivors in Developing Culturally Sensitive and Accessible Mental Health Programs: Basis for Program Enhancement (2026) · International Journal of Nursing, Healthcare and Hospital Administration · doi

  The study was limited to medically stable stroke survivors in one municipality and cannot be generalized to all stroke survivors in the Philippines. - The study identified relationships between variables but did not establish causation. - The study used a quantitative descriptive-correlational design, which may not capture the full complexity of the phenomenon being studied.

  generalstated in cells limitationsevidence 5/5
  Keywords: study was limited medically stable stroke survivors one

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