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Rethinking the Continuum of Stroke Rehabilitation

  • Robert W. Teasell
    Correspondence
    Corresponding author Robert W. Teasell, MD, Department of Physical Medicine and Rehabilitation, Parkwood Hospital, Hobbins Building, Ste 404, 801 Commissioners Rd E, London, ON, N6C 5J1, Canada.
    Affiliations
    Aging, Rehabilitation, and Geriatric Care, Lawson Health Research Institute, St. Joseph's Parkwood Hospital, London, ON, Canada

    Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

    St. Joseph's Healthcare, St. Joseph's Parkwood Hospital, London, ON, Canada
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  • Manuel Murie Fernandez
    Affiliations
    Department of Neurology and Neurosurgery, University of Navarra, Pamplona, Navarra, Spain
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  • Amanda McIntyre
    Affiliations
    Aging, Rehabilitation, and Geriatric Care, Lawson Health Research Institute, St. Joseph's Parkwood Hospital, London, ON, Canada
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  • Swati Mehta
    Affiliations
    Aging, Rehabilitation, and Geriatric Care, Lawson Health Research Institute, St. Joseph's Parkwood Hospital, London, ON, Canada
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Published:February 19, 2014DOI:https://doi.org/10.1016/j.apmr.2013.11.014

      Abstract

      Suffering a stroke can be a devastating and life-changing event. Although there is a large evidence base for stroke rehabilitation in the acute and subacute stages, it has been long accepted that patients with stroke reach a plateau in their rehabilitation recovery relatively early. We have recently published the results of a systematic review designed to identify all randomized controlled trials (RCTs) where a rehabilitation intervention was initiated more than 6 months after the onset of the stroke. Of the trials identified, 339 RCTs met inclusion criteria, demonstrating an evidence base for stroke rehabilitation in the chronic phase as well. This seems at odds with the assumption that further recovery is unlikely and the subsequent lack of resources devoted to chronic stroke rehabilitation and management.

      Keywords

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      References

        • Teasell R.
        • Mehta S.
        • Pereira S.
        • et al.
        Time to rethink long-term rehabilitation management of stroke patients.
        Top Stroke Rehabil. 2012; 19: 457-462
        • Brainin M.
        • Norrving B.
        • Sunnerhagen K.S.
        • et al.
        Poststroke chronic disease management: towards improved identification and interventions for poststroke spasticity-related complications.
        Int J Stroke. 2011; 6: 42-46
        • Feigin V.L.
        • Barker-Collo S.
        • McNaughton H.
        • Brown P.
        • Kerse N.
        Long-term neuropsychological and functional outcomes in stroke survivors: current evidence and perspectives for new research.
        Int J Stroke. 2008; 3: 33-40
        • Sit J.W.
        • Wong T.K.
        • Clinton M.
        • Li L.S.
        • Fong Y.M.
        Stroke care in the home: the impact of social support on the general health of family caregivers.
        J Clin Nurs. 2004; 13: 816-824
        • Parag V.
        • Hackett M.L.
        • Yapa C.M.
        • et al.
        The impact of stroke on unpaid caregivers; results from the Auckland Regional Community Stroke study, 2002-2003.
        Cerebrovasc Dis. 2008; 25: 548-554
        • Aziz N.A.
        Long-term rehabilitation after stroke: where do we go from here?.
        Rev Clin Gerontol. 2010; 20: 239-245
        • Page S.J.
        • Gater D.R.
        • Bach-Y-Rita P.
        Reconsidering the motor recovery plateau after stroke.
        Arch Phys Med Rehabil. 2004; 85: 1377-1381
        • McIntyre A.
        • Viana R.
        • Janzen S.
        • Mehta S.
        • Pereira S.
        • Teasell R.
        Systematic review and meta-analysis of constraint-induced movement therapy in the hemiparetic upper extremity more than 6 months post stroke.
        Top Stroke Rehabil. 2012; 19: 499-513
        • Mehta S.
        • Pereira S.
        • Viana R.
        • et al.
        Resistance training for comfortable gait speed and total distance walked during the chronic stage of stroke.
        Top Stroke Rehabil. 2012; 19: 471-478
        • Mehta S.
        • Pereira S.
        • Janzen S.
        • et al.
        Cardiovascular conditioning for comfortable gait speed and total distance walked during the chronic stage of stroke: a meta-analysis.
        Top Stroke Rehabil. 2012; 19: 463-470
        • Pereira S.
        • Mehta S.
        • McIntyre A.
        • Lobo L.
        • Foley N.
        • Teasell R.
        Neuromuscular electrical stimulation for improving gait in persons with chronic stroke.
        Top Stroke Rehabil. 2012; 19: 491-498
        • Mehta S.
        • Pereira S.
        • Janzen S.
        • McIntyre A.
        • McClure A.
        • Teasell R.W.
        Effectiveness of psychological interventions in chronic stroke: a systematic review.
        Top Stroke Rehabil. 2012; 19: 536-544
        • Korner-Bitensky N.
        When does stroke rehabilitation end?.
        Int J Stroke. 2013; 8: 8-10