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Canadian Stroke Best Practice Recommendations: Virtual Stroke Rehabilitation Interim Consensus Statement 2022
Nancy M Salbach1, Anita Mountain, M Patrice Lindsay
1From the Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada (NMS); The KITE Research Institute, University Health Network, Toronto, Canada (NMS, EI); Acquired Brain Injury Program, Queen Elizabeth II Health Sciences Centre, Halifax, Canada (AM); Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada (AM); Heart and Stroke Foundation of Canada, Toronto, Canada (MPL, RM, NG); Ottawa Stroke Program, Division of Neurology, The Ottawa Hospital, Ottawa, Canada (DB); Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, Canada (DB); WorkHORSE Consulting Group, London, Canada (NF); Physiotherapy Department, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada (HC); School of Physical and Occupational Therapy, McGill University, Montreal, Canada (JF); Department of Physical Therapy, Rehabilitation Sciences Institute, Temetry Faculty of Medicine, University of Toronto, Toronto, Canada (EI); Regional Stroke and Neurovascular Programs and North & East GTA Stroke Network, Sunnybrook Health Sciences Centre, Toronto, Canada (EL); Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada (EL); Stan Cassidy Centre for Rehabilitation, Horizon Health Network, Fredericton, Canada (CO); Dalhousie University Faculty of Medicine, Dalhousie Medicine, Fredericton, Canada (CO); Centre for Chronic Disease Prevention and Management, The University of British Columbia, Kelowna, Canada (BS); Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, Canada (BS); Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada (EES); Calgary Stroke Program, Foothills Medical Centre, Calgary, Canada (EES); School of Rehabilitation Science, McMaster University, Hamilton, Canada (AT); Physical Medicine and Rehabilitation, Pembroke Regional Hospital, Pembroke, Canada (DT); Hamilton Health Sciences, Hamilton, Canada (TV); Stroke Services BC, Provincial Health Authority, Vancouver, Canada (KW); Acquired Brain Injury Program, G.F. Strong Rehabilitation Centre, Vancouver, Canada (JY); and Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, Canada (JY).
Abstract:
The seventh edition of the Canadian Stroke Best Practice Recommendations for Rehabilitation and Recovery following Stroke includes a new section devoted to the provision of virtual stroke rehabilitation. This consensus statement uses Grading of Recommendations, Assessment, Development and Evaluations methodology and Appraisal of Guidelines for Research & Evaluation II principles. A literature search was conducted using PubMed, Embase, and Cochrane databases. An expert writing group reviewed all evidence and developed recommendations, as well as consensus-based clinical considerations where evidence was insufficient for a recommendation. All recommendations underwent internal and external review. These recommendations apply to hospital, ambulatory care, and community-based settings where virtual stroke rehabilitation is provided. This guidance is relevant to health professionals, people living with stroke, healthcare administrators, and funders. Recommendations address issues of access, eligibility, consent and privacy, technology and planning, training and competency (for healthcare providers, patients and their families), assessment, service delivery, and evaluation. Virtual stroke rehabilitation has been shown to safely and effectively increase access to rehabilitation therapies and care providers, and uptake of these recommendations should be a priority in rehabilitation settings. They are key drivers of access to high-quality evidence-based stroke care regardless of geographical location and personal circumstances in Canada.
