The strategy may also be impacted by the availability of different types of specialist seating. The recommendations may change current practice in stroke units where there is an 'as soon as possible' focus on mobilisation. They will encourage healthcare professionals to consider the intensity of very early mobilisation and advice on intensity of activities to people discharged from hospital early after a stroke. Return to recommendations Decompressive hemicraniectomy for people with acute stroke Why the committee made the recommendations The evidence showed that surgery improved mortality rates and, to a lesser extent, functional outcomes as measured by the mRS. The benefit on mortality was seen in all age groups considered, although the benefit for functional outcome was smaller in people aged over 60 years than in people under 60 years. Based on this, and to ensure that people over 60 have similar opportunities for the surgery as younger people, the committee removed the previous age cut-off for considering surgery. The committee also acknowledged that although surgery results in more people surviving and better functional outcome than without surgery, many still have overall poor functional outcome and their quality of life may be low. The acceptability of this trade-off was agreed to be a very individual judgement. Some people may choose not to have surgery if there is a risk of severe disability, whereas others may wish to go ahead based on mortality benefit alone. Therefore, the committee highlighted the need for careful discussion about risks and benefits between clinicians and family members or carers. They noted that patients would not be able to be involved at the time because of the severity of the stroke, so the family or carers would be responsible for making the decision. 