Top Things to Know: Guidelines for Adult Stroke Rehabilitation and Recovery
Published: May 04, 2016
- Between 2000-2010, the rate of stroke deaths dropped by more than 35% in the United States (US), yet each year approximately 800,000 strokes occur in the US, incurring disability caused by stroke.
- While certified stroke centers provide evidence-based care (e.g. quicker use of IV thrombolysis), still many stroke patients are in need of effective stroke rehabilitation as neurological deficits persist.
- Stroke patients who are candidates for post-acute rehabilitation should receive organized, coordinated care from a full interdisciplinary care team.
- This guideline outlines the ideal situation of what the post-stroke rehabilitation program should address, including what facilities can offer in terms of care of the post-stroke patient.
- Stroke survivors who qualify for and have access to inpatient rehabilitation facilities should receive this care in preference to a skilled nursing facility.
- A functional assessment by a clinician with expertise in rehabilitation is recommended for patients with an acute stroke with residual functional deficits.
- An important key to safety in persons with stroke who have poor balance, low balance confidence, fear of falls, and/or are at risk for falls should be provided with a balance training program
- Included in this guideline is a comprehensive evidence-based review for best practices and care strategies in all areas of post-stroke rehabilitative care, including prevention and medical management as well as specific neurological deficits and how to approach rehabilitation addressing several specific deficits (sensorimotor impairments and activities, upper extremity activity, and transitions of care to home or community rehabilitation).
- After successful screening, patients should receive an individually tailored exercise program so they can safely improve their cardiovascular fitness through the proper exercise and physical activity after formal rehabilitation is complete.
- Stroke rehabilitation includes a sustained and coordinated effort from a large team, including the patient and his/her goals, family and friends, other caregivers, physicians, neurologists, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers and others. Communication and coordination among these professionals is paramount in the success in post-stroke rehabilitation and recovery.
Citation
Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, Deruyter F, Eng JJ, Fisher B, Harvey RL, Lang CE, MacKay-Lyons M, Ottenbacher KJ, Pugh S, Reeves MJ, Richards LG, Stiers W, Zorowitz RD; on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association [published online ahead of print May 4, 2016]. Stroke. doi: 10.1161/STR.0000000000000098.