STROKE REHABILITATION RESOURCE GUIDE

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STROKE REHABILITATION RESOURCE GUIDE

INTRODUCTION

The intent of the Stroke Rehabilitation Resource 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 Ontario’s Professional Education Web site.

Users are encouraged to contribute additional available resources for inclusion in this Guide by e-mailing [email protected].

GENERAL STROKE REHAB RESOURCES

Heart and Stroke Foundation of Ontario

• Best Practice Guidelines for Stroke Care: A Resource 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.

www.heartandstroke.ca/profed =>Ontario 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.

www.heartandstroke.ca/profed =>Ontario Stroke System =>Rehabilitation

•

Tips and Tools for Everyday Living: A Guide for Stroke Caregivers

The Heart and Stroke Foundation of Ontario, together with the Ontario

Association of Community Care Access Centres, the Ontario Association of Non-Profit Homes and Services for Seniors, the Ontario Long Term Care Association, and the Ontario Community Support Association, developed this guide and companion video in consultation with front line workers.

www.heartandstroke.ca/profed =>Ontario Stroke System => Professional Resources => Long-term care/Community

Heart and Stroke Foundation of Ontario (HSFO) resources can be ordered from (416) 489-7111 x 389 or [email protected]

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Evidence Based Review of Stroke Rehabilitation

(EBRSR)

The Evidence-Based Review of Stroke Rehabilitation (EBRSR) 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

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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 Ontario

The Stroke Strategy of Southeastern Ontario is one of 11 regional systems established across the province to implement the Ontario Stroke Strategy. Its goal is to help healthcare professionals deliver best-practice stroke prevention and care in Southeastern Ontario.

http://www.strokestrategyseo.ca/

Rehabilitation Education Program for Stroke (REPS)

REPS was developed through a partnership between the Heart and Stroke Foundation of Ontario (HSFO), and the University of Toronto. A web-based program in stroke rehabilitation designed for registered nurses, occupational therapists, physiotherapists and speech-language pathologists.

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ASSESSMENT AND OUTCOME MEASURES

Resource Website and Path to the Resource Best Practice Guidelines –

Assessment and Measurement Tools

Heart and Stroke Foundation of Ontario

www.heartandstroke.ca/profed

=>Ontario Stroke System => Best Practice Guidelines => Assessment and Measurement Tools

Evidence Based Review of Stroke Rehabilitation (EBRSR)

Module 21 – Outcome Measures

www.ebrsr.com

StrokEngine

Detailed information on a number of assessment tools

www.medicine.mcgill.ca/Strokengin e-assess

RNAO Best Practice Guideline:

Stroke Assessment Across the Continuum of Care

www.rnao.org/bestpractices

=>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets

Chedoke-McMaster Stroke Assessment - A reliable and valid

measure used to assess physical impairment and disability in clients with stroke and other neurological

impairment

www.chedokeassessment.ca

National Institutes of Health Stroke Scale - For use in acute stroke

rehabilitation

www.ninds.nih.gov/doctors/NIH_Str oke_Scale_Booklet.pdf

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AMBULATION AND MOBILITY RESOURCES

Resource Website and Path to the Resource Heart and Stroke Foundation of

Ontario

Assessment and Outcome Measurement

Tips and Tools Section 5 –

Mobility and Skin care

Heart and Stroke Foundation of Ontario

=> Ontario Stroke System => Best

Practice Guidelines=> Assessment

& Outcome Measurement Tools

=>Ontario Stroke System =>

Professional Resources => 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

www.ebrsr.com

StrokEngine

Assistive devices Balance training

Treadmill (Body Weight Supported Treadmill Training)

www.medicine.mcgill.ca/Strokengine

Stroke Strategy Southeastern Ontario

Tips and Tools DVD – Mobility

www.strokestrategyseo.ca/

=> Professional Education => Education Video Series

RNAO Best Practice Guideline: Prevention of Falls and Fall Injuries in the Older Adult

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APHASIA AND OTHER COMMUNICATION IMPAIRMENTS

Ontario

Tips and Tools

Section 3 – Communication Section 12 – Aphasia

Module 2- Clinical Consequences Module 3.5.3-Aphasia

Module 6.6.2 -Intensity of Aphasia

Therapy Post Stroke

Module 14-Aphasia

www.ebrsr.com

StrokEngine Aphasia

Tips and Tools DVD – Communication

www.strokestrategyseo.ca/

The Aphasia Institute

www.aphasia.ca or (416) 226-3636

Heart and Stroke Foundation of Ontario

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: [email protected]

(416) 489-7111 x 389

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The CommuniKit

Available at Trillium Health Centre (905) 848-7580 x 2389 or [email protected]

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)

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COGNITIVE, PERCEPTUAL AND BEHAVIOURAL PROBLEMS

Ontario

Best Practice Guidelines

• Rehabilitation Management • Community Re-engagement

• Tips and Tools Section 7 -

Cognitive and Perceptual Problems

=>Ontario Stroke System => Best Practice Guidelines => Rehabilitation Management or Community Re-engagement

Module 2 – Clinical Consequences of

Stroke

Module 12 – Cognitive Disorders and

Apraxia

Module 13 - Perceptual Disorders Module 21 - Outcome Measures

www.ebrsr.com

Stroke Strategy Southeastern Ontario

Tips and Tools DVD – Cognitive, Perceptual & Behavioural Problems

http://www.strokestrategyseo.ca/

=> Professional Education =>

Education Video Series

P.I.E.C.E.S.

Ontario 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.

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

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COMMUNITY RE-ENGAGEMENT/RE-INTEGRATION

Ontario

Best Practice Guidelines

• Community Re-engagement • Case Management Best Practices

for Community Care

• Modifying the Home After Stroke

=>Ontario Stroke System => Best Practice Guidelines => Community Re-engagement

Professional Resources =>Long-Term Care/Community=>Case Management Best Practice for Community Care =>Ontario Stroke System => Professional Resources => Rehabilitation

Module 9 – Community Re-integration Module 21 - Outcome Measures

www.ebrsr.com

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CONTINENCE

Ontario

Tips and Tools for Everyday Living – Section 10 Managing Continence

Module 2 – Clinical Consequences Module 17- Medical Complication

Post Stroke www.ebrsr.com StrokEngine Urinary Incontinence www.medicine.mcgill.ca/Strokengine-assess

RNAO Best Practice Guidelines:

• Promoting Continence Using Prompted Voiding

• Prevention of Constipation in the Older Adult

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DEPRESSION AND MOOD

Ontario

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

www.ebrsr.com

StrokEngine

Depression (patient and family info

only)

www.medicine.mcgill.ca/Strokengine-assess

Rehabilitation Education Program for Stroke (REPS)

www.bul.med.utoronto.ca/reps

=>Recommendations for best practices => prevention of stroke and depression post stroke

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

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DRIVING

Ontario

Driving Fact Sheet

=>Ontario Stroke System => Professional Resources => Stroke Rehabilitation Resource Guide

Module 19- Community Re-integration

www.ebrsr.com

StrokEngine

Driving After a Stroke (patient and

family info)

www.medicine.mcgill.ca/Strokengine-assess

Occupational Therapy Screening/Driving Assessment Guidelines

Available at London Health Sciences Centre, contact [email protected]

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DYSPHAGIA AND NUTRITION

Ontario

• 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

Professional Resources => Emergency and Acute Care

Module 15– Dysphagia and Aspiration

Post Stroke

Module 16– Nutritional Interventions

Following Stroke www.ebrsr.com StrokEngine Dysphagia

www.medicine.mcgill.ca/

Strokengine

Tips and Tools DVD – Meal Assistance and Hydration

www.strokestrategyseo.ca/

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PAIN

Resource Website and Path to the Resource Evidence Based Review of Stroke

Rehabilitation (EBRSR)

Module 2 – Clinical Consequences Module 11 – Painful Hemiplegic

Shoulder

Module 17- Medical Complication

Post Stroke www.ebrsr.com StrokEngine Accupuncture www.medicine.mcgill.ca/Strokengine-assess

Comprehensive Advanced Palliative Care Education (CAPCE) Pain

Management Guide

www.palliativecareswo.ca

=> Pocket Reference Guide

RNAO Best Practice Guidelines: Assessment and Management of Pain

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PEDIATRIC STROKE

Resource Website and Path to the Resource

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/

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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

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RECREATION

Ontario

Tips and Tools - Section 4- Leisure Activities

Module 19– Community Re-integration

www.ebrsr.com

StrokEngine Leisure Activities

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SEXUALITY

Resource Website and Path to the Resource Evidence Based Review of Stroke

Rehabilitation (EBRSR)

Module 19 - Community Re-integration

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UPPER EXTREMITY

Ontario

Management of the Post Stroke Arm and Hand: Treatment

Recommendations of the 2001 Consensus Panel (2002)

=>Ontario Stroke System => Professional Resources => 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

www.ebrsr.com

StrokEngine

Functional Electrical Stimulation for Upper Extremities

Functional Electrical Stimulation for Hemiplegic Shoulder

Bio Feedback Upper Extremities

Champlain Stroke Centre

Shoulder Electrical Stimulation

www.champlainstrokecentre.org/

Home =>Stroke Team

=>Physiotherapy =>Shoulder Electrical Stimulation

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SURVIVOR AND CAREGIVER INFORMATION AND SUPPORT

Resource Website and Path to the Resource Heart and Stroke Foundation www.heartandstroke.ca

=>stroke/

Stroke Recovery Canada www.strokerecoverycanada.com

Hamilton-Wentworth Stroke Recovery

www.strokerecovery.org

Ontario March of Dimes – Stroke Recovery Program

www.marchofdimes.ca

=>for people with disabilities and caregivers => programs and services => stroke recovery program

Stroke Survivors Association of Ottawa

www.strokesurvivors.ca

StrokeNet www.strokesurvivor.net