Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada.
University of Toronto, Toronto, Ontario, Canada Heart and Stroke Foundation Canada, Ottawa, Canada
Int J Stroke. 2016 Jun;11(4):459-84. doi: 10.1177/1747493016643553. Epub 2016 Apr 14.
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.
中风康复是一个渐进的、动态的、以目标为导向的过程，旨在使有功能障碍的人达到最佳的身体、认知、情感、沟通、社交和/或功能活动水平。中风后，患者通常仍需要康复治疗，以解决与痉挛、上下肢功能障碍、肩部和中枢性疼痛、活动/步态、吞咽困难、视力和沟通相关的持续缺陷。在加拿大，每年有 62000 人经历中风。在中风幸存者中，超过 6500 人接受住院中风康复治疗，平均住院时间为 30 天（四分位距 19 至 45 天）。2015 年加拿大中风最佳实践推荐更新：中风康复实践指南是对在各种环境中工作的多学科团队的所有成员的当前基于证据的推荐的综合总结，为中风后患者提供护理。这些建议旨在解决中风康复在护理系统中的组织（即初始康复评估；中风康复单位；中风康复团队；交付；门诊和社区康复）以及中风康复和直接临床护理中的具体干预和管理（即上肢功能障碍；下肢功能障碍；吞咽困难和营养不良；视觉感知缺陷；中枢性疼痛；沟通；生活角色）。此外，中风可发生在任何年龄，因此 2015 年更新版增加了一个新的章节，重点介绍经历中风的儿童的中风康复组成部分，无论是在产前、新生儿期还是在儿童期。所有建议都被分配了一个证据水平，反映了支持该建议的现有研究证据的强度和质量。更新后的康复临床实践指南有几个新增内容，反映了新的研究领域和现有建议的更强证据。预计这些指南将为加拿大和国际上的患者、家庭/照顾者和临床医生提供指导和标准化。
