STROKE REHABILITATION RESOURCE GUIDE INTRODUCTION The intent of the Stroke Rehabilitation Guide is to enable stroke care providers seeking information related to the rehabilitation of the stroke survivor to access that information, in a user-friendly format, on the Heart and Stroke Foundation of s Professional Education Web site. Users are encouraged to contribute additional available resources for inclusion in this Guide by e-mailing css@hsf.on.ca. GENERAL STROKE REHAB RESOURCES Heart and Stroke Foundation of Best Practice Guidelines for Stroke Care: A for Implementing Optimal Stroke Care Best Practice Guidelines for Stroke Care is a resource for implementing optimal stroke care. It incorporates 19 evidence-based practice guidelines across the continuum of stroke care. => Stroke System => Best Practice Guidelines Stroke Rehabilitation System Consensus Panel Final Report 2007 A Consensus Panel was convened in 2006-2007 to develop a framework and key stroke rehabilitation standards for the purpose of provincial policy development and regional planning as well as evaluation and performance monitoring of stroke rehabilitation services. The Panel also identified the necessary tools and processes to support effective transitions to and from appropriate rehabilitation settings across the continuum. => Stroke System =>Rehabilitation Tips and Tools for Everyday Living: A Guide for Stroke Caregivers The Heart and Stroke Foundation of, together with the Association of Community Care Access Centres, the Association of Non- Profit Homes and Services for Seniors, the Long Term Care Association, and the Community Support Association, developed this guide and companion video in consultation with front line workers. => Stroke System => Professional s => Long-term care/community Heart and Stroke Foundation of (HSFO) resources can be ordered from (416) 489-7111 x 389 or csor@hsf.on.ca
Rehabilitation (EBRSR) The Evidence-Based Review of Stroke reviews current practices in stroke rehabilitation. The purpose of the Evidence-Based Review of Stroke Rehabilitation is to support the continuing review of stroke rehabilitation research with the purpose of maintaining timely and accurate information on effective stroke rehabilitation, identifying ideas for further research, supporting continuous peer-review and encouraging improved evidence-based practice. 1. Intro and Methods 2. Clinical Consequences of Stroke 3. Background Concepts in Stroke 4. Managing the Stroke Rehab Triage Process 5. The Efficacy of Stroke Rehab 6. The Elements of Stroke Rehab 7. Outpatient Stroke Rehab 8. Secondary Prevention of Stroke 9. Mobility and the Lower Extremity 10. Upper Extremity Interventions 11. Painful Hemiplegic Shoulder 12. Cognitive Disorders and Apraxia 13. Perceptual Disorders 14. Aphasia 15. Dysphagia and Aspiration Post-Stroke 16. Nutritional Interventions following Stroke 17. Medical Complications Post-Stroke 18. Post-Stroke Depression 19. Community Reintegration 20. Miscellaneous Treatments 21. Outcome Measures in Stroke Rehab EBRSR Appendices: 1. Anticoagulant Therapy 2. Antiplatelet Therapy 3. Hypertension 4. Hyperlipidemia 5. Management of Post-Stroke Pain 6. Botox in the Treatment of Limb Spasticity 7. Most Important Clinical Studies 8. Important Findings 9. Publications
StrokEngine Sponsored by McGill University, this site focuses on stroke rehabilitation and interventions. Information is derived from quality articles, websites and systematic reviews. Topics are listed alphabetically and all information has been reviewed using a systematic process. www.medicine.mcgill.ca/strokengine Stroke Strategy of Southeastern The Stroke Strategy of Southeastern is one of 11 regional systems established across the province to implement the Stroke Strategy. Its goal is to help healthcare professionals deliver best-practice stroke prevention and care in Southeastern. http://www.strokestrategyseo.ca/ Rehabilitation Education Program for Stroke (REPS) REPS was developed through a partnership between the Heart and Stroke Foundation of (HSFO), and the University of Toronto. A web-based program in stroke rehabilitation designed for registered nurses, occupational therapists, physiotherapists and speech-language pathologists. www.bul.med.utoronto.ca/reps
ASSESSMENT AND OUTCOME MEASURES Best Practice Guidelines Assessment and Measurement Tools Heart and Stroke Foundation of => Stroke System => Best Practice Guidelines => Assessment and Measurement Tools Module 21 Outcome Measures StrokEngine Detailed information on a number of assessment tools RNAO Best Practice Guideline: Stroke Assessment Across the Continuum of Care Chedoke-McMaster Stroke Assessment - A reliable and valid measure used to assess physical impairment and disability in clients with stroke and other neurological impairment National Institutes of Health Stroke Scale - For use in acute stroke rehabilitation www.medicine.mcgill.ca/strokengin e-assess www.rnao.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets www.chedokeassessment.ca www.ninds.nih.gov/doctors/nih_str oke_scale_booklet.pdf
AMBULATION AND MOBILITY RESOURCES Heart and Stroke Foundation of Assessment and Outcome Measurement Tips and Tools Section 5 Mobility and Skin care Heart and Stroke Foundation of => Stroke System => Best Practice Guidelines=> Assessment & Outcome Measurement Tools => Stroke System => Professional s => Long-term care/community Module 2- Clinical Consequences Module 3.3.4- Recovery of Specific Function Module 9 Mobility and Lower Extremity Module 21 Outcome measures StrokEngine Assistive devices Balance training Treadmill (Body Weight Supported Treadmill Training) Stroke Strategy Southeastern Tips and Tools DVD Mobility www.medicine.mcgill.ca/strokengine www.strokestrategyseo.ca/ => Professional Education => Education Video Series RNAO Best Practice Guideline: Prevention of Falls and Fall Injuries in the Older Adult www.rnao.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets
APHASIA AND OTHER COMMUNICATION IMPAIRMENTS Heart and Stroke Foundation of Tips and Tools Section 3 Communication Section 12 Aphasia => Stroke System => Professional s => Long-term care/community Module 2- Clinical Consequences Module 3.5.3-Aphasia Module 6.6.2 -Intensity of Aphasia Therapy Post Stroke Module 14-Aphasia StrokEngine Aphasia Stroke Strategy Southeastern Tips and Tools DVD Communication www.medicine.mcgill.ca/strokengine www.strokestrategyseo.ca/ => Professional Education => Education Video Series The Aphasia Institute www.aphasia.ca or (416) 226-3636 Heart and Stroke Foundation of Aphasia Beyond Words - A brochure designed to define and explain the condition of aphasia as well as to provide general facts about aphasia. Aphasia Poster - Designed to help health care providers and caregivers assist stroke survivors with aphasia to better understand others and to express themselves. To order contact: csor@hsf.on.ca (416) 489-7111 x 389 Order form: www.heartandstroke.ca/orderform
The CommuniKit Available at Trillium Health Centre (905) 848-7580 x 2389 or hsloan@thc.on.ca York-Durham Aphasia Centre Interactive Aphasia Tutor (on-line tutor) Aphasia: A New Life Skills Development for Community Partners (CD-ROM training materials) designed for volunteers. Aphasia: A New Life (a series of 8 booklets). Available in English, Italian and Chinese Aphasia: A New Life (Video) Includes content about YDAC s programs, history, personal insights from clients, caregivers and volunteers Evaluation of Effectiveness of a Community Based Program for Aphasic Adults (paper) The above resources are available at www.ydac.on.ca
COGNITIVE, PERCEPTUAL AND BEHAVIOURAL PROBLEMS Heart and Stroke Foundation of Best Practice Guidelines Rehabilitation Management Community Re-engagement Tips and Tools Section 7 - Cognitive and Perceptual Problems => Stroke System => Best Practice Guidelines => Rehabilitation Management or Community Reengagement => Stroke System => Professional s => Long-term care/community Module 2 Clinical Consequences of Stroke Module 12 Cognitive Disorders and Apraxia Module 13 - Perceptual Disorders Module 21 - Outcome Measures Stroke Strategy Southeastern Tips and Tools DVD Cognitive, Perceptual & Behavioural Problems P.I.E.C.E.S. Provincial strategy to enhance the ability of long-term care facility staff to meet the care requirements of residents with complex physical and cognitive/mental health needs with associated behavioural issues. http://www.strokestrategyseo.ca/ => Professional Education => Education Video Series www.piecescanada.com or (866) 400-8823 OT Assessment of Cognition in Acute Care Perceptual Deficits in Activities of Daily Living A Video for Health Care Staff Available at London Health Sciences Centre, contact sandra.briant@lhsc.on.ca
COMMUNITY RE-ENGAGEMENT/RE-INTEGRATION Heart and Stroke Foundation of Best Practice Guidelines Community Re-engagement Case Management Best Practices for Community Care Modifying the Home After Stroke Module 9 Community Re-integration Module 21 - Outcome Measures => Stroke System => Best Practice Guidelines => Community Re-engagement => Stroke System => Professional s =>Long-Term Care/Community=>Case Management Best Practice for Community Care => Stroke System => Professional s => Rehabilitation
CONTINENCE Heart and Stroke Foundation of Tips and Tools for Everyday Living Section 10 Managing Continence => Stroke System => Professional s => Long-term care/community Module 2 Clinical Consequences Module 17- Medical Complication Post Stroke StrokEngine Urinary Incontinence RNAO Best Practice Guidelines: Promoting Continence Using Prompted Voiding Prevention of Constipation in the Older Adult www.medicine.mcgill.ca/strokengineassess www.rnao.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets
DEPRESSION AND MOOD Heart and Stroke Foundation of Tips and Tools for Everyday Living Section 2 Psychological Effects Module 2 Clinical Consequences Module 18- Post Stroke Depression Module 21- Outcome Measures in Stroke Rehabilitation StrokEngine Depression (patient and family info only) Rehabilitation Education Program for Stroke (REPS) RNAO Best Practice Guidelines: Screening for Delirium, Dementia and Depression in Older Adults Strategies for Older Adults with Delirium, Dementia and Depression in Older Adults => Stroke System => Professional s => Long-term care/community www.medicine.mcgill.ca/strokengineassess www.bul.med.utoronto.ca/reps =>Recommendations for best practices => prevention of stroke and depression post stroke www.rnao.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets
DRIVING Heart and Stroke Foundation of Driving Fact Sheet Module 19- Community Re-integration StrokEngine Driving After a Stroke (patient and family info) => Stroke System => Professional s => Stroke Rehabilitation Guide www.medicine.mcgill.ca/strokengineassess Occupational Therapy Screening/Driving Assessment Guidelines Available at London Health Sciences Centre, contact sandra.briant@lhsc.on.ca
DYSPHAGIA AND NUTRITION Heart and Stroke Foundation of Improving Recognition and Management of Dysphagia in Acute Stroke Management of Dysphagia in Acute Stroke. An Educational Manual for the Dysphagia Screening Professional Nutrition Screening for Stroke Survivors. An Educational Manual for the Dysphagia Screening Professional Implementing a Regional Dysphagia Management Strategy Practical Considerations Tips and Tools - Section 8 Meal Assistance and Hydration Module 15 Dysphagia and Aspiration Post Stroke Module 16 Nutritional Interventions Following Stroke StrokEngine Dysphagia Stroke Strategy Southeastern Tips and Tools DVD Meal Assistance and Hydration TOR-BSST - Dysphagia Screening => Stroke System => Professional s => Emergency and Acute Care => Stroke System => Professional s => Long-term care/community www.medicine.mcgill.ca/ Strokengine www.strokestrategyseo.ca/ => Professional Education => Education Video Series www.swallowinglab.uhnres.utoronto.ca => Highlight the Order icon on the top right of the home page for details specific to the TOR-BSST
PAIN Module 2 Clinical Consequences Module 11 Painful Hemiplegic Shoulder Module 17- Medical Complication Post Stroke StrokEngine Accupuncture Comprehensive Advanced Palliative Care Education (CAPCE) Pain Management Guide RNAO Best Practice Guidelines: Assessment and Management of Pain www.medicine.mcgill.ca/strokengineassess www.palliativecareswo.ca => Pocket Reference Guide www.rnao.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets
PEDIATRIC STROKE Stroke in Childhood: Clinical Guidelines for Diagnosis, Management and Rehabilitation Stroke in Childhood Clinical guidelines Stroke in Childhood Patient and Carer booklet www.rcplondon.ac.uk/pubs/books/c hildstroke/
PUSHER SYNDROME Website Poststroke Pushing : Natural History and Relationship to Motor and Functional Recovery. Cynthia Danells, Sandra E. Black, David J. Gladstone and William E. McIlroy, Stroke, 2004;35;2873-2878. http://stroke.ahajournals.org/cgi/reprint/35/12/2873?maxtoshow=&hits=10 &hits=10&resultformat=&fulltext=poststroke+%93pushing%94%3a+n atural+history+and+relationship+to+motor+and+functional+r&searchid=1 &FIRSTINDEX=0&resourcetype=HWCIT
RECREATION Heart and Stroke Foundation of Tips and Tools - Section 4- Leisure Activities Module 19 Community Re-integration StrokEngine Leisure Activities => Stroke System => Professional s => Long-term care/community www.medicine.mcgill.ca/strokengine
SEXUALITY Module 19 - Community Re-integration
UPPER EXTREMITY Heart and Stroke Foundation of Management of the Post Stroke Arm and Hand: Treatment Recommendations of the 2001 Consensus Panel (2002) => Stroke System => Professional s => Rehabilitation Module 2 Clinical Consequences of Stroke Module 3.3.4 Recovery of Specific Function Module 10 - Upper Extremity Interventions Module 11 Painful Hemiplegic Shoulder Module 21- Outcome Measures in Stroke Rehabilitation StrokEngine Functional Electrical Stimulation for Upper Extremities Functional Electrical Stimulation for Hemiplegic Shoulder Bio Feedback Upper Extremities Champlain Stroke Centre Shoulder Electrical Stimulation www.medicine.mcgill.ca/strokengine www.champlainstrokecentre.org/ Home =>Stroke Team =>Physiotherapy =>Shoulder Electrical Stimulation
SURVIVOR AND CAREGIVER INFORMATION AND SUPPORT Heart and Stroke Foundation Stroke Recovery Canada Hamilton-Wentworth Stroke Recovery March of Dimes Stroke Recovery Program Stroke Survivors Association of Ottawa StrokeNet www.heartandstroke.ca =>stroke/ www.strokerecoverycanada.com www.strokerecovery.org www.marchofdimes.ca =>for people with disabilities and caregivers => programs and services => stroke recovery program www.strokesurvivors.ca www.strokesurvivor.net