However, a recent random- ized trial in 364 patients in China was specific to ICH, in which a 3 stage in-hospital rehabilitation program was com- pared to standard ward and medical care. Improvement was significantly greater for the rehabilitation group, measured by Fugl-Meyer and Barthel scales over 6 months, with the greatest improvement evident in the first month after stroke.322 A similar result was seen in an Australian trial of very early mobilization in 72 patients, but the number of ICH patients was too small to make any sensible comparisons to those with The success of rehabilitation depends on caregiver train- ing and support; however, the likely configuration of services in any region will depend on available resources and fund- ing options. A key portion of rehabilitation should include education for the patient and caregiver regarding secondary stroke prevention and means to achieve rehabilitation goals. Rehabilitation programs should consider lifestyle changes, depression, and caregiver burden as important issues to address with the patient and caregivers. Rehabilitation and Recovery: Recommendations Given the potentially serious nature and complex pattern of evolving disability and the increasing evi- dence for efficacy, it is recommended that all patients with ICH have access to multidisciplinary rehabilita- tion (Class I; Level of Evidence A). (Revised from the previous guideline) Where possible, rehabilitation can be beneficial when begun as early as possible and continued in the community as part of a well-coordinated ( seam- less ) program of accelerated hospital discharge and home-based resettlement to promote ongoing recov- ery (Class IIa; Level of Evidence B). (Unchanged from the previous guideline) Future Considerations As documented above, the acute treatment of spontaneous ICH remains under intense investigation. Thanks largely to acute lowering of BP can now be considered safe and potentially effective for improving outcome in most instances of ICH. 