title: Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015.
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.
authors.affiliation: Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada.
authors.forename: Debbie
authors.initials: D
authors.lastname: Hebert
authors.affiliation: University of Toronto, Toronto, Ontario, Canada Heart and Stroke Foundation Canada, Ottawa, Canada plindsay@hsf.ca.
authors.forename: M Patrice
authors.initials: MP
authors.lastname: Lindsay
authors.affiliation: St. Joseph's Healthcare - Parkwood Institute, London, ON, Canada Lawson Health Research Institute, London, ON, Canada.
authors.forename: Amanda
authors.initials: A
authors.lastname: McIntyre
authors.affiliation: Calgary Paediatric Stroke Program, Department of Paediatrics, University of Calgary, Calgary, Canada University of Calgary, Calgary, Canada.
authors.forename: Adam
authors.initials: A
authors.lastname: Kirton
authors.affiliation: Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Rumney
authors.affiliation: Queen's University, Ontario, Canada.
authors.forename: Stephen
authors.initials: S
authors.lastname: Bagg
authors.affiliation: Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Bayley
authors.affiliation: The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
authors.forename: Dar
authors.initials: D
authors.lastname: Dowlatshahi
authors.affiliation: University of Calgary, Calgary, Canada.
authors.forename: Sean
authors.initials: S
authors.lastname: Dukelow
authors.affiliation: Queen Elizabeth Hospital, Charlottetown, Prince Edward Island, Canada.
authors.forename: Maridee
authors.initials: M
authors.lastname: Garnhum
authors.affiliation: Heart and Stroke Foundation Canada, Ottawa, Canada.
authors.forename: Ev
authors.initials: E
authors.lastname: Glasser
authors.affiliation: Alberta Health Services, Stroke Program, Edmonton Zone, Edmonton, Canada.
authors.forename: Mary-Lou
authors.initials: ML
authors.lastname: Halabi
authors.affiliation: Saskatoon Health Region, Saskatchewan, Canada.
authors.forename: Ester
authors.initials: E
authors.lastname: Kang
authors.affiliation: Dalhousie University, Nova Scotia, Canada.
authors.forename: Marilyn
authors.initials: M
authors.lastname: MacKay-Lyons
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Martino
authors.affiliation: Université de Montréal, Quebec, Canada.
authors.forename: Annie
authors.initials: A
authors.lastname: Rochette
authors.affiliation: GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Rowe
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: Salbach
authors.affiliation: Health Sciences Centre, University of Manitoba, Manitoba, Canada.
authors.forename: Brenda
authors.initials: B
authors.lastname: Semenko
authors.affiliation: Horizon Health Network, New Brunswick, Canada.
authors.forename: Bridget
authors.initials: B
authors.lastname: Stack
authors.affiliation: Cardiovascular Health & Stroke Strategic Clinical Network, Alberta Health Services, Alberta, Canada.
authors.forename: Luchie
authors.initials: L
authors.lastname: Swinton
authors.affiliation: Montreal Neurological Hospital, Montreal, Canada.
authors.forename: Valentine
authors.initials: V
authors.lastname: Weber
authors.affiliation: Heart and Stroke Foundation Canada, Ottawa, Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: Mayer
authors.affiliation: Northeastern Ontario Stroke Network, Ontario, Canada.
authors.forename: Sue
authors.initials: S
authors.lastname: Verrilli
authors.affiliation: University of Toronto, Toronto, Ontario, Canada Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: DeVeber
authors.affiliation: Glenrose Rehabilitation Hospital, University of Alberta, Alberta, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Andersen
authors.affiliation: University of Calgary, Calgary, Canada Alberta Children's Hospital, Calgary, Alberta, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Barlow
authors.affiliation: St. Joseph's Healthcare - Parkwood Institute, London, ON, Canada.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Cassidy
authors.affiliation: Montreal Children's Hospital, Montreal, Canada McGill University, Montreal, Canada.
authors.forename: Marie-Emmanuelle
authors.initials: ME
authors.lastname: Dilenge
authors.affiliation: University of Toronto, Toronto, Ontario, Canada Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
authors.forename: Darcy
authors.initials: D
authors.lastname: Fehlings
authors.affiliation: Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
authors.forename: Ryan
authors.initials: R
authors.lastname: Hung
authors.affiliation: St. Joseph's Healthcare - Parkwood Institute, London, ON, Canada.
authors.forename: Jerome
authors.initials: J
authors.lastname: Iruthayarajah
authors.affiliation: Canadian Paediatric Stroke Support Association, Ontario, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Lenz
authors.affiliation: Montreal Children's Hospital, Montreal, Canada McGill University, Montreal, Canada.
authors.forename: Annette
authors.initials: A
authors.lastname: Majnemer
authors.affiliation: BC Children's Hospital, Vancouver, British Columbia, Canada Faculty of Medicine, University of British Columbia, Canada.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Purtzki
authors.affiliation: Children's Hospital, University of Manitoba, Manitoba, Canada.
authors.forename: Mubeen
authors.initials: M
authors.lastname: Rafay
authors.affiliation: Glenrose Rehabilitation Hospital, University of Alberta, Alberta, Canada Stollery Children's Hospital, Edmonton, Canada.
authors.forename: Lyn K
authors.initials: LK
authors.lastname: Sonnenberg
authors.affiliation: University of Calgary, Calgary, Canada.
authors.forename: Ashleigh
authors.initials: A
authors.lastname: Townley
authors.affiliation: St. Joseph's Healthcare - Parkwood Institute, London, ON, Canada.
authors.forename: Shannon
authors.initials: S
authors.lastname: Janzen
authors.affiliation: workHORSE Consulting Limited, London, Ontario, Canada Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
authors.forename: Norine
authors.initials: N
authors.lastname: Foley
authors.affiliation: St. Joseph's Healthcare - Parkwood Institute, London, ON, Canada Lawson Health Research Institute, London, ON, Canada Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Teasell
mesh_terms: D002170:Canada; D019317:Evidence-Based Medicine; D006801:Humans; D000071939:Stroke Rehabilitation / Q000379:methods
keywords: Stroke; adults; guidelines; pediatrics; rehabilitation; therapy; transient ischemic attack