The 18th Annual Conference of the Indian Stroke Association (INSC 2025) brought together medical professionals, researchers, and healthcare experts to discuss stroke care in India. The conference, themed “Innovation and Integration in Stroke,” addressed the high incidence and mortality rates associated with stroke, the burden of disability, and gaps in awareness, timely treatment, and rehabilitation.
Dr Nirmal Surya, President of the Indian Stroke Association (ISA), presented an overview of stroke care in India, emphasising the need for improved stroke rehabilitation and long-term care. “Stroke care remains a critical challenge in India due to high incidence and mortality rates, disability burden, delayed treatment, and gaps in infrastructure and awareness. There is an urgent need for stroke rehabilitation and long-term care to improve patient outcomes,” said Dr Surya.
He highlighted past efforts in stroke care, recalling training initiatives from 1988-1989, where 20 ICU nurses were trained in stroke management, leading to reduced mortality rates and improved patient recovery. He also referenced a global webinar on stroke awareness during the COVID-19 pandemic, which attracted over 5,000 participants from 36 countries. Dr Surya noted the introduction of specialised courses such as a weekly spasticity management programme and continued advancements through research studies and publications.
Discussing the state of stroke rehabilitation in India, Dr Surya referenced findings from his study, Education, Training, and Practice of Neurorehabilitation in India During COVID-19, published in February 2021. The study highlighted the concentration of rehabilitation centres in urban areas, with 38 per cent offering multidisciplinary care, limited education and training opportunities, low financial incentives for professionals, and an increasing shift towards tele-rehabilitation.
“India has approximately 1,250 stroke rehabilitation centres. Some offer comprehensive multidisciplinary care, while others provide only basic physiotherapy services. Around 80 per cent of these centres are located in metros and tier-I cities, with well-equipped hospitals having neurologists, physiotherapists, and occupational therapists. The average travel time to a rehabilitation centre in urban areas is 30-60 minutes. In contrast, only 20 per cent of stroke rehab centres serve rural areas, where patients often travel nearly 120 km for treatment,” said Dr Surya.
Providing a regional breakdown, Dr Surya stated that South India has the highest share of stroke rehabilitation centres (35 per cent, 438 centres), followed by North India (25 per cent, 313 centres), West India (20 per cent, 250 centres), East & Northeast (15 per cent, 188 centres), and Central India (5 per cent, 63 centres).
Explaining the types of stroke rehabilitation facilities, he noted, “Thirty per cent of centres are advanced multidisciplinary facilities with neurologists, physiotherapists, occupational therapists, speech therapists, and cognitive rehabilitation specialists. Fifty per cent are basic rehabilitation clinics focusing on physiotherapy and mobility training, mostly in tier-2 cities and district hospitals. Twenty per cent provide home-based and telerehabilitation services through mobile apps and online consultations, aiding patients in remote and underserved areas.”
Looking ahead, Dr Surya discussed the future of neurorehabilitation in India, with a focus on low-cost, AI-enabled rehabilitation under the Make in India initiative. This technology integrates computer vision to track movement, angles, velocity, and repetitions, offering real-time feedback and measurable insights. “The mission is to expand stroke rehabilitation in India over the next five years by introducing a stroke rehab fellowship, accreditation programmes, and specialised training for post-stroke spasticity. We remain committed to establishing dedicated rehabilitation institutes and centres, developing affordable rehab equipment, conducting multicentric trials, and exploring brain-computer interfaces to enhance stroke care nationwide,” he concluded.
The conference underscored the urgent need for improved stroke rehabilitation, early intervention, and enhanced accessibility to care, particularly in rural areas.