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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).

American Journal of Physical Medicine & Rehabilitation
|June 29, 2022
PubMed
Summary
This summary is machine-generated.

New Canadian guidelines promote virtual stroke rehabilitation, enhancing access to care for stroke survivors. These recommendations aim to improve rehabilitation accessibility and quality across Canada.

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Area of Science:

  • Neurology and Rehabilitation Medicine
  • Health Services Research
  • Digital Health

Background:

  • The Canadian Stroke Best Practice Recommendations have been updated to include virtual stroke rehabilitation.
  • Existing rehabilitation models face challenges in providing equitable access to care for all stroke survivors.
  • Technological advancements enable new models for delivering healthcare services.

Purpose of the Study:

  • To introduce and detail the new section on virtual stroke rehabilitation within the Canadian Stroke Best Practice Recommendations.
  • To provide evidence-based guidance for the implementation and delivery of virtual stroke rehabilitation.
  • To address key considerations for healthcare providers, patients, administrators, and funders involved in virtual stroke rehabilitation.

Main Methods:

  • A consensus statement developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology.
  • A comprehensive literature search of PubMed, Embase, and Cochrane databases.
  • Review and synthesis of evidence by an expert writing group, with consensus-based considerations for areas with insufficient evidence.

Main Results:

  • New recommendations specifically address virtual stroke rehabilitation across various care settings (hospital, ambulatory, community).
  • Guidance covers critical aspects including access, eligibility, consent, privacy, technology, training, assessment, service delivery, and evaluation.
  • Virtual stroke rehabilitation is demonstrated to safely and effectively improve access to therapies and care providers.

Conclusions:

  • Virtual stroke rehabilitation offers a viable solution to increase access to high-quality, evidence-based stroke care.
  • Adoption of these recommendations is crucial for improving stroke rehabilitation outcomes irrespective of location or personal circumstances.
  • These guidelines are essential for optimizing stroke care delivery and patient recovery across Canada.