Clinical Pathways in Stroke Rehabilitation (2025)

Clinical Pathways in Stroke Rehabilitation: Background, Scope, and Methods

2021

The prevalence of stroke and stroke-related disability is increasing considerably worldwide. Comprehensive stroke rehabilitation can reduce disability and promote participation and improve quality of life among stroke survivors. The evidence for interventions to promote functional recovery of respiration, swallowing, arm function and activities, gait, ambulation, visual and other sensory functions, as well as cognitive and emotional functions is rapidly increasing. Clinical practice guidelines and their local adaptation, i.e. clinical pathways can help to bring this knowledge to clinical practice and to ensure effective treatment thereby reducing the burden of stroke-related disability globally.

Things to Note in Stroke Rehabilitation

Journal of Nursing & Care, 2015

Stroke results in impairment of motor, cognitive and sensory/perceptual functions. As such, activities of daily living (ADL) after stroke can be affected. These affectations can persist for a long time depending on the extent of the affectation in the brain and rehabilitation. In fact, stroke has lately been recognized as a long term condition. Thus, stroke rehabilitation requires intensive time. When stroke occurred, the brain capitalizes heavily on learning to recover function; and the best way to induce such learning is known to be through task specific training. Effective stroke rehabilitation requires knowledge of the current available evidence base. However, to embrace the current available evidence, skills in information retrieval and critical appraisal of the literature are needed. Unfortunately, the skills of a say, entry level physiotherapists may not be adequate for them to be abreast of the evidence-based practice. Thus, there is a need to summarize the literature for such therapists to help them note some important issues in stroke rehabilitation.

Chapter 6 : The elements of stroke rehabilitation

2020

The primary goals of stroke rehabilitation are to encourage and foster functional improvement and neurological recovery. Organised stroke care, processes of care, early timing of rehabilitation and high intensity of rehabilitation therapies are important factors which have been identified as promoting better overall outcomes for individuals with stroke. This chapter examines the evidence for those elements which have been proven to be important in the effectiveness of stroke rehabilitation. Norine Foley, MSc Norhayati Hussein MBBS, Marcus Saikaley, BSc Jerome Iruthayarajah, MSc Joshua Wiener, PhD Candidate Mark Speechley, PhD Robert Teasell, MD

Guidelines Abstracted from the Department of Veterans Affairs/Department of Defense Clinical Practice Guideline for the Management of Stroke Rehabilitation

Journal of the American Geriatrics Society, 2006

To assist facilities in identifying those evidence-based processes of poststroke care that enhance measurable patient outcomes. The guideline(s) should be used by facilities (hospitals, subacute-care units and providers of longterm care) to implement a structured approach to improve rehabilitative practices and by clinicians to determine best interventions to achieve improved patient outcomes. OPTIONS: The guideline considers five elements of poststroke rehabilitation care: interdisciplinary teams; use of standardized assessments; intensity, timing, and duration of therapy; involvement of patients' families and caregivers in decision-making; and educational interventions for patients, families, and caregivers. Evidence, benefits, harms, and recommendations for each of the five designated elements and specific annotated recommendations for poststroke managements are presented separately. OUTCOMES: The overall guideline considers improvement in functional status measures as the primary outcome. Achieving community-dwelling status and preventing complications, death, and rehospitalization are also important outcomes. Costs are not specifically addressed. PARTICIPANTS: The Department of Veterans Affairs/Department of Defense (VA/DoD) Stroke Rehabilitation Working Group consisted of 28, largely VA and military hospital, representatives of medical and allied professions concerned with stroke diagnosis, management, and rehabilitation. Nine additional members with similar credentials served as the editorial committee. Technical consultation was contracted from ACS Federal Health Care, Inc., and the Center for Evidence-Based Practice, State University of New YorkFUpstate Medical University, Department of Family Medicine conducted evidence appraisal. Consensus was achieved over several years of facilitated group discussion and iterative evaluation of draft documents and supporting evidence. SPONSOR: The guideline was prepared under the auspices of the VA/DoD. No other source of support was identified in the document, or supporting documents. This guideline abstract summarizes the contents of the Veterans Administration/Department of Defense Clinical Practice Guideline for Stroke Rehabilitation. Electronic copies are available at www.oqp.med.va.gov/cpg/ and print copies are available from the Office of Quality and Performance (10Q),

3. Background Concepts in Stroke Rehabilitation

WSO873597 Supplemental Material - Supplemental material for Moving stroke rehabilitation research evidence into clinical practice: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable

2019

Supplemental material, WSO873597 Supplemental Material for Moving stroke rehabilitation research evidence into clinical practice: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable by Janice J Eng, Marie-Louise Bird, Erin Godecke, Tammy C Hoffmann, Carole Laurin, Olumide A Olaoye, John Solomon, Robert Teasell, Caroline L Watkins and Marion F Walker: on behalf of the Bowell Group in International Journal of Stroke

Protocol of the Sunnaas International (SIN) Stroke Project an International Multicenter Study of Specialized Rehabilitation for Stroke Patients

Journal of Clinical Trials, 2014

Stroke is leading cause of serious, long-term disability in adults. Consequently, many individuals with stroke are in need of specialized rehabilitation. However, the content of specialized rehabilitation may vary.

Stroke: A Practical Guide to Management

Archives of Neurology, 2002

Guidelines for Adult Stroke Rehabilitation and Recovery 201620190529 95310 1pp68qk

Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness and efficiency of rehabilitation and underlie this entire guideline. Without communication and coordination, isolated efforts to rehabilitate the stroke survivor are unlikely to achieve their full potential.

Supplemental_Material – Supplemental material for Accelerating Stroke Recovery: Body Structures and Functions, Activities, Participation, and Quality of Life Outcomes From a Large Rehabilitation Trial

2018

Supplemental material, Supplemental_Material for Accelerating Stroke Recovery: Body Structures and Functions, Activities, Participation, and Quality of Life Outcomes From a Large Rehabilitation Trial by Rebecca Lewthwaite, Carolee J. Winstein, Christianne J. Lane, Sarah Blanton, Burl R. Wagenheim, Monica A. Nelsen, Alexander W. Dromerick and Steven L. Wolf in Neurorehabilitation and Neural Repair