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 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 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

ca/ Rehabilitation Education Program for Stroke (REPS) REPS was developed through a partnership between the Heart and Stroke Foundation of Ontario (HSFO). www.ca/reps .mcgill.bul.utoronto.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. Topics are listed alphabetically and all information has been reviewed using a systematic process. Its goal is to help healthcare professionals deliver best-practice stroke prevention and care in Southeastern Ontario. this site focuses on stroke rehabilitation and interventions.medicine. and the University of Toronto. http://www.med. physiotherapists and speech-language pathologists. A web-based program in stroke rehabilitation designed for registered nurses. occupational therapists.StrokEngine Sponsored by McGill University. Information is derived from quality articles. websites and systematic reviews. www.strokestrategyseo.

mcgill.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 .gov/doctors/NIH_Str oke_Scale_Booklet.medicine.ninds.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.ca Chedoke-McMaster Stroke Assessment .For use in acute stroke rehabilitation www.chedokeassessment.nih.rnao.ca/Strokengin e-assess www.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.pdf .ebrsr.com www.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets www.

AMBULATION AND MOBILITY RESOURCES Resource Heart and Stroke Foundation of Ontario Assessment and Outcome Measurement Website and Path to the Resource Heart and Stroke Foundation of Ontario www.mcgill.ebrsr.medicine.ca/profed => Ontario Stroke System => Best Practice Guidelines=> Assessment & Outcome Measurement Tools =>Ontario Stroke System => Professional Resources => Long-term care/Community www.Clinical Consequences Module 3.rnao.4.strokestrategyseo.ca/Strokengine www.com Tips and Tools Section 5 – Mobility and Skin care Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 2.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets .heartandstroke.3.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 Tips and Tools DVD – Mobility www.ca/ => Professional Education => Education Video Series RNAO Best Practice Guideline: Prevention of Falls and Fall Injuries in the Older Adult www.

mcgill. Aphasia Poster .ebrsr.3-Aphasia Module 6.on.5.ca/ => Professional Education => Education Video Series The Aphasia Institute www.Clinical Consequences Module 3.ca or (416) 226-3636 Heart and Stroke Foundation of Ontario Aphasia Beyond Words .com Website and Path to the Resource www.ca/Strokengine www. To order contact: csor@hsf.aphasia.heartandstroke.ca (416) 489-7111 x 389 Order form: www.6.strokestrategyseo.ca/orderform .heartandstroke.APHASIA AND OTHER COMMUNICATION IMPAIRMENTS Resource Heart and Stroke Foundation of Ontario Tips and Tools Section 3 – Communication Section 12 – Aphasia Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 2.Designed to help health care providers and caregivers assist stroke survivors with aphasia to better understand others and to express themselves.medicine.2 -Intensity of Aphasia Therapy Post Stroke Module 14-Aphasia StrokEngine Aphasia Stroke Strategy Southeastern Ontario Tips and Tools DVD – Communication www.ca/profed =>Ontario Stroke System => Professional Resources => Long-term care/Community www.A brochure designed to define and explain the condition of aphasia as well as to provide general facts about aphasia.

ydac.ca . personal insights from clients.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. caregivers and volunteers Evaluation of Effectiveness of a Community Based Program for Aphasic Adults (paper) The above resources are available at www.on. Aphasia: A New Life (a series of 8 booklets). Available in English.The CommuniKit Available at Trillium Health Centre (905) 848-7580 x 2389 or hsloan@thc.on. Italian and Chinese Aphasia: A New Life (Video) Includes content about YDAC’s programs. history.

ebrsr.COGNITIVE. => Professional Education => Education Video Series www. 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.com • Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 2 – Clinical Consequences of Stroke Module 12 – Cognitive Disorders and Apraxia Module 13 .C.Outcome Measures Stroke Strategy Southeastern Ontario http://www.E.strokestrategyseo.S.briant@lhsc.ca .Perceptual Disorders Module 21 .heartandstroke.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 Available at London Health Sciences Centre.E.ca/profed =>Ontario Stroke System => Best Practice Guidelines => Rehabilitation Management or Community Reengagement =>Ontario Stroke System => Professional Resources => Long-term care/Community www. Perceptual & Behavioural Problems P. PERCEPTUAL AND BEHAVIOURAL PROBLEMS Resource Heart and Stroke Foundation of Ontario Best Practice Guidelines • Rehabilitation Management • Community Re-engagement Tips and Tools Section 7 Cognitive and Perceptual Problems Website and Path to the Resource www. contact sandra.I.on.ca/ Tips and Tools DVD – Cognitive.

ebrsr.heartandstroke.COMMUNITY RE-ENGAGEMENT/RE-INTEGRATION Resource Heart and Stroke Foundation of Ontario Best Practice Guidelines • Community Re-engagement • Case Management Best Practices for Community Care Website and Path to the Resource www.ca/profed =>Ontario Stroke System => Best Practice Guidelines => Community Re-engagement =>Ontario Stroke System => Professional Resources =>Long-Term Care/Community=>Case Management Best Practice for Community Care =>Ontario Stroke System => Professional Resources => Rehabilitation www.Outcome Measures .com • Modifying the Home After Stroke Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 9 – Community Re-integration Module 21 .

rnao.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets .ca/Strokengineassess www.ebrsr.mcgill.com 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.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.Medical Complication Post Stroke StrokEngine Urinary Incontinence RNAO Best Practice Guidelines: • Promoting Continence Using Prompted Voiding • Prevention of Constipation in the Older Adult www.medicine.

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.medicine.com www.ca/reps =>Recommendations for best practices => prevention of stroke and depression post stroke www.ca/profed =>Ontario Stroke System => Professional Resources => Long-term care/Community www.bul.ebrsr.utoronto.mcgill.heartandstroke. Dementia and Depression in Older Adults • Strategies for Older Adults with Delirium. Dementia and Depression in Older Adults www.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets .med.rnao.ca/Strokengineassess RNAO Best Practice Guidelines: • Screening for Delirium.Outcome Measures in Stroke Rehabilitation StrokEngine Depression (patient and family info only) Rehabilitation Education Program for Stroke (REPS) Website and Path to the Resource www.Post Stroke Depression Module 21.

medicine.briant@lhsc.Community Re-integration StrokEngine Driving After a Stroke (patient and family info) Website and Path to the Resource www.com www.ca .ca/Strokengineassess Occupational Therapy Screening/Driving Assessment Guidelines Available at London Health Sciences Centre.on.heartandstroke. contact sandra.mcgill.ebrsr.ca/profed =>Ontario Stroke System => Professional Resources => Stroke Rehabilitation Resource Guide www.DRIVING Resource Heart and Stroke Foundation of Ontario Driving Fact Sheet Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 19.

ca => Highlight the ‘Order’ icon on the top right of the home page for details specific to the TOR-BSST© .mcgill.com www.heartandstroke.strokestrategyseo. An Educational Manual for the Dysphagia Screening Professional • Nutrition Screening for Stroke Survivors.uhnres.ebrsr. An Educational Manual for the Dysphagia Screening Professional • Implementing a Regional Dysphagia Management Strategy – Practical Considerations • Tips and Tools .ca/ Strokengine www.swallowinglab.Section 8 – Meal Assistance and Hydration Website and Path to the Resource www.medicine.ca/ => Professional Education => Education Video Series www.ca/profed =>Ontario Stroke System => Professional Resources => Emergency and Acute Care Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 15– Dysphagia and Aspiration Post Stroke Module 16– Nutritional Interventions Following Stroke StrokEngine Dysphagia Stroke Strategy Southeastern Ontario Tips and Tools DVD – Meal Assistance and Hydration TOR-BSST© .utoronto .Dysphagia Screening =>Ontario Stroke System => Professional Resources => Long-term care/Community www.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.

rnao.PAIN Resource Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 2 – Clinical Consequences Module 11 – Painful Hemiplegic Shoulder Module 17.ca/Strokengineassess Comprehensive Advanced Palliative www.com www.ebrsr.medicine.palliativecareswo.org/bestpractices =>Nursing best practice guidelines=> Clinical practice guidelines program => Guidelines and fact sheets .ca Care Education (CAPCE) Pain => Pocket Reference Guide Management Guide RNAO Best Practice Guidelines: Assessment and Management of Pain www.Medical Complication Post Stroke StrokEngine Accupuncture Website and Path to the Resource www.mcgill.

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

2873-2878. David J. Gladstone and William E. Black. McIlroy. Sandra E. http://stroke.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 . Cynthia Danells.35. Stroke.ahajournals.PUSHER SYNDROME Website Poststroke “Pushing”: Natural History and Relationship to Motor and Functional Recovery. 2004.

Leisure Activities Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 19– Community Re-integration StrokEngine Leisure Activities Website and Path to the Resource www.com www.ca/profed =>Ontario Stroke System => Professional Resources => Long-term care/Community www.RECREATION Resource Heart and Stroke Foundation of Ontario Tips and Tools .medicine.Section 4.mcgill.ebrsr.ca/Strokengine .heartandstroke.

ebrsr.Community Re-integration Website and Path to the Resource www.com .SEXUALITY Resource Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 19 .

mcgill.4 – Recovery of Specific Function Module 10 .org/ Home =>Stroke Team =>Physiotherapy =>Shoulder Electrical Stimulation .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.com www.Upper Extremity Interventions Module 11 – Painful Hemiplegic Shoulder Module 21.medicine.champlainstrokecentre.ca/profed =>Ontario Stroke System => Professional Resources => Rehabilitation Evidence Based Review of Stroke Rehabilitation (EBRSR) Module 2– Clinical Consequences of Stroke Module 3.3.ebrsr.Outcome Measures in Stroke Rehabilitation StrokEngine Functional Electrical Stimulation for Upper Extremities Functional Electrical Stimulation for Hemiplegic Shoulder Bio Feedback Upper Extremities Champlain Stroke Centre Shoulder Electrical Stimulation www.ca/Strokengine www.

org www.ca =>for people with disabilities and caregivers => programs and services => stroke recovery program www.strokerecoverycanada.strokesurvivor.heartandstroke.marchofdimes.strokesurvivors.ca =>stroke/ www.net .strokerecovery.com www.SURVIVOR AND CAREGIVER INFORMATION AND SUPPORT Resource Heart and Stroke Foundation Website and Path to the Resource www.ca Stroke Recovery Canada Hamilton-Wentworth Stroke Recovery Ontario March of Dimes – Stroke Recovery Program Stroke Survivors Association of Ottawa StrokeNet www.

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