Post-Acute Care Cliff: Stroke, a Chronic Condition - Kimberly Erler, OT, PhD & Kathryn Sabo, MSN, PhD

In this episode, we explore why stroke is best understood not as a single acute event but as a chronic condition with lifelong functional consequences. We trace the clinical arc with occupational therapist Dr. Kimberly Erler and nurse educator Dr. Kathy Sabo, from the intensive first two weeks of inpatient rehabilitation targeting neuroplasticity, through the steep "post-acute care cliff" where coordinated, multidisciplinary support drops away and the responsibility shifts almost entirely onto unpaid care partners.

We then turn to the central question for the neurotechnology field: why so many promising stroke recovery technologies — robotic gloves, dynamic splints, communication devices — succeed in controlled research settings yet go unused in the home. Drs. Erler and Sabo make the case for embedding implementation science at the design phase rather than the endpoint, accounting for health literacy, setup burden, cost and coverage, and the care partner's time and capacity. Throughout, we look at how Tedy's Team Center of Excellence for Stroke Recovery operationalizes this philosophy through evidence-based, strategically designed programming for survivors and care partners alike.

Dr. Kimberly Erler, OT, PhD, is an Associate Professor in the Department of Occupational Therapy at the MGH Institute of Health Professions, School of Health and Rehabilitation Sciences. She is the Director of Tedy's Team Center of Excellence. Her research and scholarship span neurorehabilitation following traumatic brain injury and stroke, as well as ethical decision-making in clinical practice.

Dr. Kathy Sabo, MSN, PhD is an Assistant Professor in the School of Nursing at the MGH Institute of Health Professions, with expertise in adult and population health and the caregiver population. She is the Director of the Ruth Sleeper Nursing Center for Clinical Education and Wellness and developed the Health Promoting Self-Care for Older Adults model that guides her program of research. She serves as a faculty representative and member of the stroke research team for the Institute's Impact Practice Center Tedy's Team Center of Excellence for Stroke Recovery.