Make these guidelines public so stroke survivors can see exactly what should be done and how badly they don't work. Look at all these PhDs and MDs that should know better.
http://stroke.ahajournals.org/content/early/2016/05/04/STR.0000000000000098.abstract
A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
- Carolee J. Winstein, PhD, PT, Chair,
- Joel Stein, MD, Vice Chair,
- Ross Arena, PhD, PT, FAHA,
- Barbara Bates, MD, MBA,
- Leora R. Cherney, PhD,
- Steven C. Cramer, MD,
- Frank Deruyter, PhD,
- Janice J. Eng, PhD, BSc,
- Beth Fisher, PhD, PT,
- Richard L. Harvey, MD,
- Catherine E. Lang, PhD, PT,
- Marilyn MacKay-Lyons, BSc, MScPT, PhD,
- Kenneth J. Ottenbacher, PhD, OTR,
- Sue Pugh, MSN, RN, CNS-BC, CRRN, CNRN, FAHA,
- Mathew J. Reeves, PhD, DVM, FAHA,
- Lorie G. Richards, PhD, OTR/L,
- William Stiers, PhD, ABPP (RP),
- Richard D. Zorowitz, MD,
- on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research
Abstract
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.
Conclusions—As
systems of care evolve in response to healthcare reform efforts,
postacute care and rehabilitation are often considered
a costly area of care to be trimmed but
without recognition of their clinical impact and ability to reduce the
risk of downstream
medical morbidity resulting from immobility,
depression, loss of autonomy, and reduced functional independence. The
provision
of comprehensive rehabilitation programs with
adequate resources, dose, and duration is an essential aspect of stroke
care
and should be a priority in these redesign
efforts.
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