The revised Stroke Rehabilitation recommendations are published in the International Journal of Stroke and are part of the fifth edition of the Heart and Stroke Foundation Canadian Stroke Best Practice Recommendations. Supporting information including rationale, system implications, performance measures and implementation resources are available online at the Heart and Stroke Foundation at www.strokebestpractices.ca.
The 2015 update of the Canadian Stroke Best Practice Recommendations (CSBPR) Stroke Rehabilitation recommendations continue to emphasize specialized stroke care provided by an interdisciplinary team, and the inclusion of the patient and caregiver(s) as an important part of the rehabilitation team. Stroke rehabilitation refers to a progressive, dynamic, goal orientated process aimed at enabling patients to reach their optimal physical, cognitive, emotional, communicative, and social functional level. It begins soon after the initial stroke event, and can be offered in a range of settings. Although most rehabilitation and recovery occurs within the first three months after stroke onset, some patients continue to make new gains many months and even years later.
Specific highlights of the updates and additions include:
Revision of many of the recommendations to higher levels of evidence.
Recommendations that have evolved and become more specific, to guide clinicians in tailoring their treatment to the individual.
Emphasis that rehabilitation and recovery after stroke is a dynamic and ongoing process that occurs in all settings and over time.
The recommendations are grouped into two parts: organization of stroke rehabilitation within a system of care; and specific functional areas of stroke recovery and direct clinical care.
Some previous recommendation sections have been combined, and new sections provide guidance to ensure a holistic approach to the rehabilitation.
Advocacy in system implications for system funders to commit to improving the stroke rehabilitation system. Family members and informal caregivers play a key role in post-stroke rehabilitation and recovery.
Development of specific recommendations for paediatric stroke rehabilitation.
The theme for the 2014 – 2015 updates is Working Together with Stroke Survivors and their Caregivers to Achieve Optimal Outcomes, emphasizing the need for a committed interprofessional team approach to stroke care across the continuum, and for ensuring patient-centred care. Patients and family caregivers particularly should receive education and be empowered as active participants throughout their journey of recovery to ensure meaningful contributions to goal setting and treatment planning.