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 css@hsf.on.ca.

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 csor@hsf.on.ca
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 Website and Path to the Resource
Best Practice Guidelines – Heart and Stroke Foundation of Ontario
Assessment and Measurement www.heartandstroke.ca/profed
Tools
=>Ontario Stroke System => Best
Practice Guidelines => Assessment
and Measurement Tools

Evidence Based Review of Stroke www.ebrsr.com

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.medicine.mcgill.ca/Strokengin
e-assess
www.rnao.org/bestpractices
=>Nursing best practice guidelines=>
Clinical practice guidelines program =>
Guidelines and fact sheets

Chedoke-McMaster Stroke www.chedokeassessment.ca

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 www.ninds.nih.gov/doctors/NIH_Str
Scale - For use in acute stroke oke_Scale_Booklet.pdf
rehabilitation
 AMBULATION AND MOBILITY RESOURCES

Resource Website and Path to the Resource

Heart and Stroke Foundation of Heart and Stroke Foundation of Ontario
Ontario www.heartandstroke.ca/profed

Assessment and Outcome => Ontario Stroke System => Best

Measurement Practice Guidelines=> Assessment
& Outcome Measurement Tools

=>Ontario Stroke System =>

Tips and Tools Section 5 – Professional Resources => Long-term
Mobility and Skin care care/Community

Evidence Based Review of Stroke www.ebrsr.com

Rehabilitation (EBRSR)

Module 2- Clinical Consequences

Module 3.3.4- Recovery of Specific
Function
Module 9 – Mobility and Lower
Extremity
Module 21 – Outcome measures

StrokEngine www.medicine.mcgill.ca/Strokengine

Assistive devices
Balance training
Treadmill (Body Weight Supported
Treadmill Training)
Stroke Strategy Southeastern www.strokestrategyseo.ca/
Ontario => Professional Education =>
Education Video Series
Tips and Tools DVD – Mobility

RNAO Best Practice Guideline: www.rnao.org/bestpractices

Prevention of Falls and Fall Injuries =>Nursing best practice guidelines=>
in the Older Adult Clinical practice guidelines program =>
Guidelines and fact sheets
 APHASIA AND OTHER COMMUNICATION IMPAIRMENTS

Resource Website and Path to the Resource

Heart and Stroke Foundation of
Ontario
Tips and Tools
Section 3 – Communication
Section 12 – Aphasia
www.heartandstroke.ca/profed
=>Ontario Stroke System =>
Professional Resources => Long-term
care/Community

Evidence Based Review of Stroke www.ebrsr.com

Rehabilitation (EBRSR)

Module 2- Clinical Consequences

Module 3.5.3-Aphasia
Module 6.6.2 -Intensity of Aphasia
Therapy Post Stroke
Module 14-Aphasia

StrokEngine www.medicine.mcgill.ca/Strokengine
Aphasia
Stroke Strategy Southeastern www.strokestrategyseo.ca/
Ontario => Professional Education =>
Tips and Tools DVD – Education Video Series
Communication

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: csor@hsf.on.ca

(416) 489-7111 x 389
Order form: www.heartandstroke.ca/orderform
The CommuniKit
Available at Trillium Health Centre (905) 848-7580 x 2389 or hsloan@thc.on.ca

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 Website and Path to the Resource
Heart and Stroke Foundation of www.heartandstroke.ca/profed
Ontario =>Ontario Stroke System => Best
Best Practice Guidelines Practice Guidelines => Rehabilitation
• Rehabilitation Management Management or Community Re-
• Community Re-engagement engagement

=>Ontario Stroke System =>

• Tips and Tools Section 7 - Professional Resources => Long-term
Cognitive and Perceptual Problems care/Community

Evidence Based Review of Stroke www.ebrsr.com

Rehabilitation (EBRSR)

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, => Professional Education =>

Perceptual & Behavioural Problems 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 sandra.briant@lhsc.on.ca
 COMMUNITY RE-ENGAGEMENT/RE-INTEGRATION

Resource Website and Path to the Resource

Heart and Stroke Foundation of www.heartandstroke.ca/profed
Ontario =>Ontario Stroke System => Best
Best Practice Guidelines Practice Guidelines => Community
• Community Re-engagement Re-engagement

• Case Management Best Practices =>Ontario Stroke System =>

for Community Care Professional Resources =>Long-Term
Care/Community=>Case Management
Best Practice for Community Care

• Modifying the Home After Stroke =>Ontario Stroke System =>

Professional Resources =>
Rehabilitation
Evidence Based Review of Stroke www.ebrsr.com
Rehabilitation (EBRSR)
Module 9 – Community Re-integration
Module 21 - Outcome Measures
 CONTINENCE

Resource Website and Path to the Resource

Heart and Stroke Foundation of www.heartandstroke.ca/profed
Ontario =>Ontario Stroke System =>
Tips and Tools for Everyday Living Professional Resources => Long-term
– Section 10 Managing Continence care/Community

Evidence Based Review of Stroke www.ebrsr.com

Rehabilitation (EBRSR)
Module 2 – Clinical Consequences
Module 17- Medical Complication
Post Stroke
StrokEngine www.medicine.mcgill.ca/Strokengine-
Urinary Incontinence assess

RNAO Best Practice Guidelines: www.rnao.org/bestpractices

• Promoting Continence Using =>Nursing best practice guidelines=>
Prompted Voiding Clinical practice guidelines program =>
• Prevention of Constipation in the Guidelines and fact sheets
Older Adult
 DEPRESSION AND MOOD
Resource
Heart and Stroke Foundation of
Ontario
Tips and Tools for Everyday Living
– Section 2 Psychological Effects
Evidence Based Review of Stroke
Rehabilitation (EBRSR)
Module 2 – Clinical Consequences
Module 18- Post Stroke Depression
Module 21- Outcome Measures in
Stroke Rehabilitation
StrokEngine
Depression (patient and family info
only)
Rehabilitation Education Program
for Stroke (REPS)
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
Website and Path to the Resource
www.heartandstroke.ca/profed
=>Ontario Stroke System =>
Professional Resources => Long-term
care/Community
www.ebrsr.com
www.medicine.mcgill.ca/Strokengine-
assess
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
 DRIVING

Resource Website and Path to the Resource

Heart and Stroke Foundation of
Ontario
Driving Fact Sheet
Evidence Based Review of Stroke
Rehabilitation (EBRSR)
Module 19- Community Re-integration
www.heartandstroke.ca/profed
=>Ontario Stroke System =>
Professional Resources => Stroke
Rehabilitation Resource Guide
www.ebrsr.com

StrokEngine www.medicine.mcgill.ca/Strokengine-
Driving After a Stroke (patient and assess
family info)

Occupational Therapy Screening/Driving Assessment Guidelines

Available at London Health Sciences Centre, contact sandra.briant@lhsc.on.ca
 DYSPHAGIA AND NUTRITION
Resource Website and Path to the Resource
Heart and Stroke Foundation of www.heartandstroke.ca/profed
Ontario =>Ontario Stroke System =>
• Improving Recognition and Professional Resources => Emergency
Management of Dysphagia in and Acute Care
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 =>Ontario Stroke System =>

Assistance and Hydration Professional Resources => Long-term
care/Community
Evidence Based Review of Stroke www.ebrsr.com
Rehabilitation (EBRSR)
Module 15– Dysphagia and Aspiration
Post Stroke
Module 16– Nutritional Interventions
Following Stroke

StrokEngine www.medicine.mcgill.ca/
Dysphagia Strokengine

Stroke Strategy Southeastern www.strokestrategyseo.ca/

Ontario => Professional Education =>
Tips and Tools DVD – Meal Education Video Series
Assistance and Hydration

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©
 PAIN

Resource Website and Path to the Resource

Evidence Based Review of Stroke www.ebrsr.com
Rehabilitation (EBRSR)
Module 2 – Clinical Consequences
Module 11 – Painful Hemiplegic
Shoulder
Module 17- Medical Complication
Post Stroke
StrokEngine www.medicine.mcgill.ca/Strokengine-
Accupuncture assess

Comprehensive Advanced Palliative www.palliativecareswo.ca

Care Education (CAPCE) Pain => Pocket Reference Guide
Management Guide

RNAO Best Practice Guidelines: www.rnao.org/bestpractices

Assessment and Management of =>Nursing best practice guidelines=>
Pain Clinical practice guidelines program =>
Guidelines and fact sheets
 PEDIATRIC STROKE

Resource Website and Path to the Resource

www.rcplondon.ac.uk/pubs/books/c
Stroke in Childhood: Clinical hildstroke/
Guidelines for Diagnosis,
Management and Rehabilitation
• Stroke in Childhood Clinical
guidelines
• Stroke in Childhood Patient and
Carer booklet
 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 Website and Path to the Resource

Heart and Stroke Foundation of www.heartandstroke.ca/profed
Ontario =>Ontario Stroke System =>
Tips and Tools - Section 4- Leisure Professional Resources => Long-term
Activities care/Community

Evidence Based Review of Stroke www.ebrsr.com

Rehabilitation (EBRSR)
Module 19– Community Re-integration

StrokEngine www.medicine.mcgill.ca/Strokengine
Leisure Activities
 SEXUALITY

Resource Website and Path to the Resource

Evidence Based Review of Stroke www.ebrsr.com
Rehabilitation (EBRSR)
Module 19 - Community Re-integration
 UPPER EXTREMITY

Resource Website and Path to the Resource

Heart and Stroke Foundation of
Ontario
Management of the Post Stroke Arm
and Hand: Treatment
Recommendations of the 2001
Consensus Panel (2002)
www.heartandstroke.ca/profed
=>Ontario Stroke System =>
Professional Resources =>
Rehabilitation

Evidence Based Review of Stroke www.ebrsr.com

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

StrokEngine www.medicine.mcgill.ca/Strokengine
Functional Electrical Stimulation for
Upper Extremities
Functional Electrical Stimulation for
Hemiplegic Shoulder
Bio Feedback Upper Extremities

Champlain Stroke Centre www.champlainstrokecentre.org/

Shoulder Electrical Stimulation Home =>Stroke Team
=>Physiotherapy =>Shoulder
Electrical Stimulation
 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 www.strokerecovery.org

Recovery
Ontario March of Dimes – Stroke www.marchofdimes.ca
Recovery Program =>for people with disabilities and
caregivers => programs and services
=> stroke recovery program
Stroke Survivors Association of www.strokesurvivors.ca
Ottawa

StrokeNet www.strokesurvivor.net