Fifty-three stroke patients with severe functional loss at two weeks following the stroke were followed up for one year. No improvement occurred in 47% during this time and this was associated with abnormalities of muscle tone, incontinence of urine or faeces, perceptual disorders and previous disabilities affecting locomotion. Remedial therapy continued for long periods especially in the group who did not improve. It is suggested that rehabilitation resources could have been used more appropriately. Further research is required to determine whether intensive therapy is of value in the severely disabled stroke patient especially those with perceptual and cognitive dysfunction.