The Risks and Benefits of Humour Use With Individuals After Stroke.

96.7% of participants identified as women, so the panel's views may not reflect how men in the profession experience humour in stroke practice. 83% of participants practiced in just two provinces (Ontario and Alberta), and all were required to be fluent in English, which limits how well the findings transfer to other regions or cultural contexts. The panel had no 'no comment' option in Rounds 2 and 3, so participants who were unsure about a statement (for example, the neuroplasticity claim) had to choose a side, which may have inflated agreement on topics outside their expertise. The sample dropped from 30 to 21 across the three rounds, and the authors note this attrition could introduce bias. All findings reflect the therapists' own perceptions. No patient perspectives were collected, and the authors themselves call for future work that includes the people after stroke. The Delphi format, completed electronically, did not allow participants to expand on or qualify their ratings in Rounds 2 and 3, so the context behind each agreement is thin.

The authors declare no conflict of interest and state they received no financial support for the research, authorship, or publication.

Do not read the 32 consensus benefits as evidence that humour improves stroke recovery. These are the opinions of 21–30 Canadian OTs about what they believe helps their therapeutic relationship. No patient outcomes were measured, no control group existed, and the authors themselves note that the neuroplasticity claim in particular 'warrants further research.' A patient who does not find your humour funny, or who misreads sarcasm because of a cognitive deficit, is not a treatment failure. It is the risk the panel flagged.