In this week's BMJ, Legg and colleagues present a systematic review of randomised trials assessing the effect of occupational therapy on personal activities of daily life in people who have had a stroke.1

Stroke is a leading cause of death and disability2 and sadly, despite medical advances and public health initiatives, its incidence is not declining.3 The sequelae are often devastating and can affect the full range of human life and functioning.4 The impact of stroke extends beyond the individual to the people closest to them—carers experience high rates of distress, depression, and social isolation; reduced health status; and even premature death.5 6 7 8 Prevention and acute medical management are a fundamental part of the response to the problem, but improving life after stroke is also …