Difference between revisions of "STROKE-TIMING & INTENSITY OF REHAB"
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<br/>2. The Canadian Stroke Guidelines recommend that stroke rehabilitation patients should receive a minimum of 3 hrs of direct task-specific therapy, 5/week delivered by an interprofessional team. The evidence on weekend therapy providing better outcomes on 5 day per week therapy is mixed<ref>Teasell, R., Hussein, N., Mirkowski, M., Vanderlaan, D., Saikaley, M., Longval, M. and Iruthayarajah, J., 2020. <i>Brain Reorganization, Recovery and Organized Care. </i>[online] Ebrsr.com. Available at: [http://www.ebrsr.com/sites/default/files/EBRSR Handbook Chapter 4_Upper Extremity Post Stroke_ML.pdf Ebrsr.com] [Accessed 11 November 2020].</ref> | <br/>2. The Canadian Stroke Guidelines recommend that stroke rehabilitation patients should receive a minimum of 3 hrs of direct task-specific therapy, 5/week delivered by an interprofessional team. The evidence on weekend therapy providing better outcomes on 5 day per week therapy is mixed<ref>Teasell, R., Hussein, N., Mirkowski, M., Vanderlaan, D., Saikaley, M., Longval, M. and Iruthayarajah, J., 2020. <i>Brain Reorganization, Recovery and Organized Care. </i>[online] Ebrsr.com. Available at: [http://www.ebrsr.com/sites/default/files/EBRSR Handbook Chapter 4_Upper Extremity Post Stroke_ML.pdf Ebrsr.com] [Accessed 11 November 2020].</ref> | ||
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<br/>2. Bernhardt J. Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): A randomised controlled trial. The Lancet 2015;386:46-55. | <br/>2. Bernhardt J. Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): A randomised controlled trial. The Lancet 2015;386:46-55. | ||
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<br/>3. French B, Thomas LH, Coupe J, McMahon NE, Connell L, Harrison J, . . . Watkins CL. Repetitive task training for improving functional ability after stroke. Cochrane Database of Systematic Reviews 2016;11:CD006073. | <br/>3. French B, Thomas LH, Coupe J, McMahon NE, Connell L, Harrison J, . . . Watkins CL. Repetitive task training for improving functional ability after stroke. Cochrane Database of Systematic Reviews 2016;11:CD006073. | ||
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<br/> | <br/>4. Different authors have varying times: Hayes et al, Cifu et al, Teasell, Indredavik Trondheim, Bernhardt et al (AVERT study<ref>Bernhardt J. Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): A randomised controlled trial. The Lancet 2015;386:46-55.</ref> | ||
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<br/> | <br/>5. A Cochrane review by French et al. (2016) focused on repetitive task training following stroke and highlights differences between upper (≤ 20 hrs) and lower limb (≥ 20 hrs) rehabilitation<ref>French B, Thomas LH, Coupe J, McMahon NE, Connell L, Harrison J, . . . Watkins CL. Repetitive task training for improving functional ability after stroke. Cochrane Database of Systematic Reviews 2016;11:CD006073.</ref> | ||
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<br/> | <br/>6. Indredavik showed better outcomes with early mobilization. | ||
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<br/> | <br/>7. An RCT by Ronning & Guldvog (1998) showed significant evidence for benefits of inpatient stroke rehab for moderate to severe strokes, however there is minimal evidence for mild strokes. | ||
Revision as of 01:25, 22 February 2023
SUMMARY
1. Significant evidence for early rehabilitation in stroke, TBI, hip fractures, SCI and geriatric rehabilitation.
2. The Canadian Stroke Guidelines recommend that stroke rehabilitation patients should receive a minimum of 3 hrs of direct task-specific therapy, 5/week delivered by an interprofessional team. The evidence on weekend therapy providing better outcomes on 5 day per week therapy is mixed[1]
2. Bernhardt J. Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): A randomised controlled trial. The Lancet 2015;386:46-55.
3. French B, Thomas LH, Coupe J, McMahon NE, Connell L, Harrison J, . . . Watkins CL. Repetitive task training for improving functional ability after stroke. Cochrane Database of Systematic Reviews 2016;11:CD006073.
4. Different authors have varying times: Hayes et al, Cifu et al, Teasell, Indredavik Trondheim, Bernhardt et al (AVERT study[2]
).
5. A Cochrane review by French et al. (2016) focused on repetitive task training following stroke and highlights differences between upper (≤ 20 hrs) and lower limb (≥ 20 hrs) rehabilitation[3]
.
6. Indredavik showed better outcomes with early mobilization.
7. An RCT by Ronning & Guldvog (1998) showed significant evidence for benefits of inpatient stroke rehab for moderate to severe strokes, however there is minimal evidence for mild strokes.
Reference(s)
- ↑ Teasell, R., Hussein, N., Mirkowski, M., Vanderlaan, D., Saikaley, M., Longval, M. and Iruthayarajah, J., 2020. Brain Reorganization, Recovery and Organized Care. [online] Ebrsr.com. Available at: Handbook Chapter 4_Upper Extremity Post Stroke_ML.pdf Ebrsr.com [Accessed 11 November 2020].
- ↑ Bernhardt J. Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): A randomised controlled trial. The Lancet 2015;386:46-55.
- ↑ French B, Thomas LH, Coupe J, McMahon NE, Connell L, Harrison J, . . . Watkins CL. Repetitive task training for improving functional ability after stroke. Cochrane Database of Systematic Reviews 2016;11:CD006073.
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
