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 NonProfit 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]
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
www.ebrsr.com
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. www.bul.med.utoronto.ca/reps
ASSESSMENT AND OUTCOME MEASURES Resource Best Practice Guidelines – Assessment and Measurement Tools
Website and Path to the Resource 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 StrokEngine Detailed information on a number of assessment tools RNAO Best Practice Guideline: Stroke Assessment Across the Continuum of Care
www.ebrsr.com
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.chedokeassessment.ca
www.medicine.mcgill.ca/Strokengin e-assess www.rnao.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets
www.ninds.nih.gov/doctors/NIH_Str oke_Scale_Booklet.pdf
AMBULATION AND MOBILITY RESOURCES Resource Heart and Stroke Foundation of Ontario
Website and Path to the Resource Heart and Stroke Foundation of Ontario www.heartandstroke.ca/profed
Assessment and Outcome Measurement
=> Ontario Stroke System => Best Practice Guidelines=> Assessment & Outcome Measurement Tools
Tips and Tools Section 5 – Mobility and Skin care Evidence Based Review of Stroke Rehabilitation (EBRSR)
=>Ontario Stroke System => Professional Resources => Long-term care/Community www.ebrsr.com
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 Ontario
www.medicine.mcgill.ca/Strokengine
www.strokestrategyseo.ca/ => Professional Education => Education Video Series
Tips and Tools DVD – Mobility
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 Resource Heart and Stroke Foundation of Ontario Tips and Tools
Website and Path to the Resource www.heartandstroke.ca/profed =>Ontario Stroke System => Professional Resources => Long-term care/Community
Section 3 – Communication Section 12 – Aphasia Evidence Based Review of Stroke Rehabilitation (EBRSR)
www.ebrsr.com
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 Ontario 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 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 Order form: www.heartandstroke.ca/orderform
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) The above resources are available at www.ydac.on.ca
COGNITIVE, PERCEPTUAL AND BEHAVIOURAL PROBLEMS Resource Heart and Stroke Foundation of Ontario Best Practice Guidelines • Rehabilitation Management • Community Re-engagement
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Tips and Tools Section 7 Cognitive and Perceptual Problems
Evidence Based Review of Stroke Rehabilitation (EBRSR)
Website and Path to the Resource www.heartandstroke.ca/profed =>Ontario Stroke System => Best Practice Guidelines => Rehabilitation Management or Community Reengagement =>Ontario Stroke System => Professional Resources => Long-term care/Community www.ebrsr.com
Module 2 – Clinical Consequences of Stroke Module 12 – Cognitive Disorders and Apraxia Module 13 - Perceptual Disorders Module 21 - Outcome Measures Stroke Strategy Southeastern Ontario http://www.strokestrategyseo.ca/ Tips and Tools DVD – Cognitive, Perceptual & Behavioural Problems
=> Professional Education => Education Video Series
P.I.E.C.E.S.
www.piecescanada.com or (866) 400-8823
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.
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
[email protected]
COMMUNITY RE-ENGAGEMENT/RE-INTEGRATION Resource Heart and Stroke Foundation of Ontario Best Practice Guidelines • Community Re-engagement
Website and Path to the Resource www.heartandstroke.ca/profed =>Ontario Stroke System => Best Practice Guidelines => Community Re-engagement
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Case Management Best Practices for Community Care
=>Ontario Stroke System => Professional Resources =>Long-Term Care/Community=>Case Management Best Practice for Community Care
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Modifying the Home After Stroke
=>Ontario Stroke System => Professional Resources => Rehabilitation
Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 9 – Community Re-integration Module 21 - Outcome Measures
www.ebrsr.com
CONTINENCE Resource Heart and Stroke Foundation of Ontario Tips and Tools for Everyday Living – Section 10 Managing Continence
Website and Path to the Resource www.heartandstroke.ca/profed =>Ontario Stroke System => Professional Resources => Long-term care/Community
Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 2 – Clinical Consequences Module 17- Medical Complication Post Stroke StrokEngine Urinary Incontinence
www.ebrsr.com
RNAO Best Practice Guidelines: • Promoting Continence Using Prompted Voiding • Prevention of Constipation in the Older Adult
www.rnao.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets
www.medicine.mcgill.ca/Strokengineassess
DEPRESSION AND MOOD Resource Heart and Stroke Foundation of Ontario Tips and Tools for Everyday Living – Section 2 Psychological Effects
Website and Path to the Resource www.heartandstroke.ca/profed =>Ontario Stroke System => Professional Resources => Long-term care/Community
Evidence Based Review of Stroke Rehabilitation (EBRSR) 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/Strokengineassess
Rehabilitation Education Program for Stroke (REPS)
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
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
DRIVING Resource Heart and Stroke Foundation of Ontario Driving Fact Sheet Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 19- Community Re-integration StrokEngine Driving After a Stroke (patient and family info)
Website and Path to the Resource www.heartandstroke.ca/profed =>Ontario Stroke System => Professional Resources => Stroke Rehabilitation Resource Guide www.ebrsr.com
www.medicine.mcgill.ca/Strokengineassess
Occupational Therapy Screening/Driving Assessment Guidelines Available at London Health Sciences Centre, contact
[email protected]
DYSPHAGIA AND NUTRITION Resource Heart and Stroke Foundation of 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
Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 15– Dysphagia and Aspiration Post Stroke Module 16– Nutritional Interventions Following Stroke
Website and Path to the Resource www.heartandstroke.ca/profed =>Ontario Stroke System => Professional Resources => Emergency and Acute Care
=>Ontario Stroke System => Professional Resources => Long-term care/Community www.ebrsr.com
StrokEngine Dysphagia
www.medicine.mcgill.ca/ Strokengine
Stroke Strategy Southeastern Ontario Tips and Tools DVD – Meal Assistance and Hydration
www.strokestrategyseo.ca/
TOR-BSST© - Dysphagia Screening
www.swallowinglab.uhnres.utoronto .ca => Highlight the ‘Order’ icon on the top right of the home page for details specific to the TOR-BSST©
=> Professional Education => Education Video Series
PAIN Resource Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 2 – Clinical Consequences Module 11 – Painful Hemiplegic Shoulder Module 17- Medical Complication Post Stroke StrokEngine Accupuncture
Website and Path to the Resource www.ebrsr.com
www.medicine.mcgill.ca/Strokengineassess
Comprehensive Advanced Palliative www.palliativecareswo.ca Care Education (CAPCE) Pain => Pocket Reference Guide Management Guide RNAO Best Practice Guidelines: Assessment and Management of Pain
www.rnao.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets
PEDIATRIC STROKE Resource
Stroke in Childhood: Clinical Guidelines for Diagnosis, Management and Rehabilitation • Stroke in Childhood Clinical guidelines • Stroke in Childhood Patient and Carer booklet
Website and Path to the Resource 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 Resource Heart and Stroke Foundation of Ontario Tips and Tools - Section 4- Leisure Activities
Website and Path to the Resource www.heartandstroke.ca/profed =>Ontario Stroke System => Professional Resources => Long-term care/Community
Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 19– Community Re-integration
www.ebrsr.com
StrokEngine Leisure Activities
www.medicine.mcgill.ca/Strokengine
SEXUALITY Resource Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 19 - Community Re-integration
Website and Path to the Resource www.ebrsr.com
UPPER EXTREMITY Resource Heart and Stroke Foundation of Ontario Management of the Post Stroke Arm and Hand: Treatment Recommendations of the 2001 Consensus Panel (2002)
Website and Path to the Resource www.heartandstroke.ca/profed =>Ontario Stroke System => Professional Resources => Rehabilitation
Evidence Based Review of Stroke Rehabilitation (EBRSR) 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
www.medicine.mcgill.ca/Strokengine
Champlain Stroke Centre Shoulder Electrical Stimulation
www.champlainstrokecentre.org/ Home =>Stroke Team =>Physiotherapy =>Shoulder Electrical Stimulation
SURVIVOR AND CAREGIVER INFORMATION AND SUPPORT Resource Heart and Stroke Foundation
Website and Path to the Resource www.heartandstroke.ca =>stroke/
Stroke Recovery Canada
www.strokerecoverycanada.com
Hamilton-Wentworth Stroke Recovery Ontario March of Dimes – Stroke Recovery Program
www.strokerecovery.org
Stroke Survivors Association of Ottawa StrokeNet
www.marchofdimes.ca =>for people with disabilities and caregivers => programs and services => stroke recovery program www.strokesurvivors.ca
www.strokesurvivor.net