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Stroke is a leading cause of disability in older persons and an important cause of disability in younger people. Rehabilitation aims to hasten and maximize recovery from stroke by treating the disabilities caused by the stroke. It serves to restore function, teach people with disabilities new ways to perform daily activities, and provide critical education and support for the stroke survivor and family.
This Clinical Practice Guideline is intended for the use of practitioners who are responsible for the patient's care during each phase of recovery, from the acute hospitalization through subsequent rehabilitation, and after return home or to another community residence
Guideline recommendations focus on:
- The importance of thorough, consistent, and well-documented assessment at each stage of recovery to guide treatment decisions and monitor patient progress.
- Early implementation of rehabilitation interventions during acute care to facilitate recovery and prevent complications.
- Selection of the type of rehabilitation program or services best suited to the patient's needs.
- Establishment of realistic rehabilitation goals and provisions of treatment in accordance with a carefully developed rehabilitation management plan.
- The importance of combined followup and treatment during transition to a community residence.
Recommendations depend heavily on expert opinion, since scientific evidence on the efficacy of rehabilitation programs or individual interventions is limited. Further research is urgently needed. Nonetheless, adherence to these guidelines should help to reduce the variations that currently exist in stroke rehabilitation practices and lead to more effective use of rehabilitation facilities.
Contents
- [Inside Front Cover]
- Guideline Development and Use
- Foreword
- Panel Members
- Acknowledgments
- Executive Summary
- 1. Overview
- 2. Epidemiology and Natural History of Stroke
- 3. Assessment Methods for Patients With Strokes
- Introduction
- Stages of Assessment
- The Neurological Examination
- Assessment of Comorbid Diseases
- Assessment of Functional Health Patterns
- Assessment of Depression and Other Affective Disorders
- Assessment of Neuropsychological Function
- Assessment of Family Functioning and Other Contextual Factors
- Recommended Standardized Assessment Instruments
- 4. Rehabilitation During Acute Care for Stroke
- Introduction
- Treating the Acute Stroke With Coordinated Interdisciplinary Care
- Clinical Evaluation During Acute Care
- Preventing Recurrent Strokes
- Preventing Venous Thromboembolism
- Managing Complications
- Patient and Family Support and Education During the Acute Hospitalization
- Planning for Discharge From Acute Care
- 5. Screening for Rehabilitation and Choice of a Setting
- 6. Managing Rehabilitation
- Introduction
- Principles of Rehabilitation
- Transition From the Acute Care Hospital
- Managing the Rehabilitation Process
- Preventing Recurrent Stroke and Deep Vein Thrombosis
- Managing Comorbidities and Acute Illnesses
- Managing Functional Health Patterns
- Managing Sensorimotor Deficits and Impaired Mobility
- Preventing and Treating Complications
- Managing Cognitive and Perceptual Deficits
- Managing Emotional Disorders
- Treating Speech and Language Disorders
- Discharge
- 7. Transition to the Community
- Acronyms and Abbreviations
- Glossary
- Contributors
- Attachments
- Availability of Guidelines
- References
Suggested citation:
Gresham GE, Duncan PW, Stason WB, et al. Post-Stroke Rehabilitation. Clinical Practice Guideline, No. 16. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service, Agency for Health Care Policy and Research. AHCPR Publication No. 95-0662. May 1995.
- Post-Stroke RehabilitationPost-Stroke RehabilitationBookshelf
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