Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, April 19, 2016

Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015

 28 references to results in full text, so you will have to see if anything there is useful to your rehabilitation. I know you would rather your doctor tell you this stuff but that is very unlikely to occur.  I guess action observation is not yet considered useful which is interesting. In the core team is recommended that there be dieticians but I saw no actual recommendations for diet. No mention of where any protocols are so all these evidence based suggestions get to be implemented by however the therapist sees fit. 

Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015


  1. Debbie Hebert1,2
  2. M Patrice Lindsay2,3⇑
  3. Amanda McIntyre4,5
  4. Adam Kirton6,7
  5. Peter G Rumney8
  6. Stephen Bagg9
  7. Mark Bayley1,2
  8. Dar Dowlatshahi10
  9. Sean Dukelow7
  10. Maridee Garnhum11
  11. Ev Glasser3
  12. Mary-Lou Halabi12
  13. Ester Kang13
  14. Marilyn MacKay-Lyons14
  15. Rosemary Martino2
  16. Annie Rochette15
  17. Sarah Rowe16
  18. Nancy Salbach2
  19. Brenda Semenko17
  20. Bridget Stack18
  21. Luchie Swinton19
  22. Valentine Weber20
  23. Matthew Mayer3
  24. Sue Verrilli21
  25. Gabrielle DeVeber2,22
  26. John Andersen23
  27. Karen Barlow7,24
  28. Caitlin Cassidy4
  29. Marie-Emmanuelle Dilenge25,26
  30. Darcy Fehlings2,8
  31. Ryan Hung8
  32. Jerome Iruthayarajah4
  33. Laura Lenz27
  34. Annette Majnemer25,26
  35. Jacqueline Purtzki28,29
  36. Mubeen Rafay30
  37. Lyn K. Sonnenberg23,31
  38. Ashleigh Townley7
  39. Shannon Janzen4
  40. Norine Foley32,33
  41. Robert Teasell4,5,33
  1. 1Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
  2. 2University of Toronto, Toronto, Ontario, Canada
  3. 3Heart and Stroke Foundation Canada, Ottawa, Canada
  4. 4St. Joseph's Healthcare – Parkwood Institute, London, ON, Canada
  5. 5Lawson Health Research Institute, London, ON, Canada
  6. 6Calgary Paediatric Stroke Program, Department of Paediatrics, University of Calgary, Calgary, Canada
  7. 7University of Calgary, Calgary, Canada
  8. 8Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
  9. 9Queen’s University, Ontario, Canada
  10. 10The Ottawa Hospital, University of Ottawa, Ottawa, Canada
  11. 11Queen Elizabeth Hospital, Charlottetown, Prince Edward Island, Canada
  12. 12Alberta Health Services, Stroke Program, Edmonton Zone, Edmonton, Canada
  13. 13Saskatoon Health Region, Saskatchewan, Canada
  14. 14Dalhousie University, Nova Scotia, Canada
  15. 15Université de Montréal, Quebec, Canada
  16. 16GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
  17. 17Health Sciences Centre, University of Manitoba, Manitoba, Canada
  18. 18Horizon Health Network, New Brunswick, Canada
  19. 19Cardiovascular Health & Stroke Strategic Clinical Network, Alberta Health Services, Alberta, Canada
  20. 20Montreal Neurological Hospital, Montreal, Canada
  21. 21Northeastern Ontario Stroke Network, Ontario, Canada
  22. 22Hospital for Sick Children, Toronto, Ontario, Canada
  23. 23Glenrose Rehabilitation Hospital, University of Alberta, Alberta, Canada
  24. 24Alberta Children’s Hospital, Calgary, Alberta, Canada
  25. 25Montreal Children’s Hospital, Montreal, Canada
  26. 26McGill University, Montreal, Canada
  27. 27Canadian Paediatric Stroke Support Association, Ontario, Canada
  28. 28BC Children’s Hospital, Vancouver, British Columbia, Canada
  29. 29Faculty of Medicine, University of British Columbia, Canada
  30. 30Children’s Hospital, University of Manitoba, Manitoba, Canada
  31. 31Stollery Children’s Hospital, Edmonton, Canada
  32. 32workHORSE Consulting Limited, London, Ontario, Canada
  33. 33Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
  1. Patrice Lindsay, Heart and Stroke Foundation, 222 Queen Street, Suite 1402, Ottawa, Ontario K1P 5V9, Canada. Email: plindsay@hsf.ca

Abstract

Stroke rehabilitation is a progressive, dynamic, goal-orientated process aimed at enabling a person with impairment to reach their optimal physical, cognitive, emotional, communicative, social and/or functional activity level. After a stroke, patients often continue to require rehabilitation for persistent deficits related to spasticity, upper and lower extremity dysfunction, shoulder and central pain, mobility/gait, dysphagia, vision, and communication. Each year in Canada 62,000 people experience a stroke. Among stroke survivors, over 6500 individuals access in-patient stroke rehabilitation and stay a median of 30 days (inter-quartile range 19 to 45 days). The 2015 update of the Canadian Stroke Best Practice Recommendations: Stroke Rehabilitation Practice Guidelines is a comprehensive summary of current evidence-based recommendations for all members of multidisciplinary teams working in a range of settings, who provide care to patients following stroke. These recommendations have been developed to address both the organization of stroke rehabilitation within a system of care (i.e., Initial Rehabilitation Assessment; Stroke Rehabilitation Units; Stroke Rehabilitation Teams; Delivery; Outpatient and Community-Based Rehabilitation), and specific interventions and management in stroke recovery and direct clinical care (i.e., Upper Extremity Dysfunction; Lower Extremity Dysfunction; Dysphagia and Malnutrition; Visual-Perceptual Deficits; Central Pain; Communication; Life Roles). In addition, stroke happens at any age, and therefore a new section has been added to the 2015 update to highlight components of stroke rehabilitation for children who have experienced a stroke, either prenatally, as a newborn, or during childhood. All recommendations have been assigned a level of evidence which reflects the strength and quality of current research evidence available to support the recommendation. The updated Rehabilitation Clinical Practice Guidelines feature several additions that reflect new research areas and stronger evidence for already existing recommendations. It is anticipated that these guidelines will provide direction and standardization for patients, families/caregiver(s), and clinicians within Canada and internationally. 
  1. Published online before print April 14, 2016, doi: 10.1177/1747493016643553 Int J Stroke 1747493016643553
  1. » AbstractFree
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  4. Supplemental Material

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