Guidelines for Adult Stroke Rehabilitation and Recovery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Guidelines for Adult Stroke Rehabilitation and Recovery

Organization of Poststroke Rehabilitation Care (Levels of Care

Class I
"1." (Level of Evidence:A ) "
"2." (Level of Evidence:B ) "
"3." (Level of Evidence:C ) "
Class IIb
"1.".(Level of Evidence:B ) "

Rehabilitation

Interventions in the Inpatient Hospital Setting

Class I
"1." (Level of Evidence:A ) "
"2." (Level of Evidence:B ) "
Class III
"1." . (Level of Evidence:A ) "

Prevention of Skin Breakdown and Contractures

Class I
"1." (Level of Evidence:C ) "
"2." (Level of Evidence:C ) "
"3." (Level of Evidence:C ) "
Class IIa
"1.".(Level of Evidence:B ) "
Class IIb
"1.".(Level of Evidence:C ) "
"2.".(Level of Evidence:C ) "
"3.".(Level of Evidence:B ) "
"4.".(Level of Evidence:B ) "

Prevention of DVT

Class I
"1." (Level of Evidence:A ) "
Class IIa
"1.".(Level of Evidence:A ) "
Class IIb
"1.".(Level of Evidence:B ) "
"2.".(Level of Evidence:C ) "
"3.".(Level of Evidence:C ) "
"4.".(Level of Evidence:C ) "
Class III
"1." . (Level of Evidence:B ) "
"2." .(Level of Evidence:C ) "

Treatment of Bowel and Bladder Incontinence

Class I
"1." (Level of Evidence:B ) "
"2." (Level of Evidence:B ) "
"3." (Level of Evidence:B ) "
Class IIa
"1.".(Level of Evidence:B ) "
"2.".(Level of Evidence:C ) "
Class IIb
"1.".(Level of Evidence:B ) "

Assessment, Prevention, and Treatment of Hemiplegic Shoulder Pain

Class IIa
"1.".(Level of Evidence:A ) "
"2.".(Level of Evidence:C ) "
"3.".(Level of Evidence:C ) "
"4.".(Level of Evidence:C ) "
Class IIb
"1.".(Level of Evidence:A ) "
"2.".(Level of Evidence:B ) "
"3.".(Level of Evidence:B ) "
"4.".(Level of Evidence:B ) "
"5.".(Level of Evidence:B ) "
"6.".(Level of Evidence:C ) "
Class III
"1." . (Level of Evidence:C ) "

Central Pain After Stroke

Class I
"1." (Level of Evidence:C ) "
"2." (Level of Evidence:C ) "
Class III
"1." . (Level of Evidence:B ) "
"2." . (Level of Evidence:B ) "
Class IIa
"1.".(Level of Evidence:B ) "
"2.".(Level of Evidence:C ) "
Class IIb
"1.".(Level of Evidence:B ) "
"2.".(Level of Evidence:C ) "
"3.".(Level of Evidence:B ) "

Prevention of Falls

Class I
"1." Defining TIA with a 24-hour maximum duration has the potential to delay the initiation of effective stroke therapies(Level of Evidence:B ) "
"2." Defining TIA with a 24-hour maximum duration has the potential to delay the initiation of effective stroke therapies(Level of Evidence:A ) "
Class IIa
"1.".(Level of Evidence:B ) "
"2.".(Level of Evidence:B ) "
Class IIb
"1.".(Level of Evidence:B ) "

Seizures

Class I
"1." Defining TIA with a 24-hour maximum duration has the potential to delay the initiation of effective stroke therapies(Level of Evidence:C ) "
Class III
"1." . (Level of Evidence:C ) "

Poststroke Depression, Including Emotional and Behavioral State

Class I
"1." Defining TIA with a 24-hour maximum duration has the potential to delay the initiation of effective stroke therapies(Level of Evidence:B ) "
"2." Defining TIA with a 24-hour maximum duration has the potential to delay the initiation of effective stroke therapies(Level of Evidence:B ) "
"3." Defining TIA with a 24-hour maximum duration has the potential to delay the initiation of effective stroke therapies(Level of Evidence:B ) "
Class IIb
Class IIa
"1.".(Level of Evidence:A ) "
"2.".(Level of Evidence:B ) "
"3.".(Level of Evidence:C ) "
Class IIa
"1.".(Level of Evidence:A ) "
"2.".(Level of Evidence:A ) "
"3.".(Level of Evidence:B ) "
"4.".(Level of Evidence:B ) "
"5.".(Level of Evidence:B ) "
"6.".(Level of Evidence:B ) "
Class III
"1." . (Level of Evidence:A ) "

Poststroke Osteoporosis

Class I
"1." Defining TIA with a 24-hour maximum duration has the potential to delay the initiation of effective stroke therapies(Level of Evidence:A ) "
"2." Defining TIA with a 24-hour maximum duration has the potential to delay the initiation of effective stroke therapies(Level of Evidence:B ) "
Class IIa
"1.".(Level of Evidence:B ) "

Assessment of Disability and Rehabilitation Needs

Class I
"1." (Level of Evidence:B ) "
"2." (Level of Evidence:B ) "
"3." (Level of Evidence:C ) "
"4." (Level of Evidence:C ) "
Class IIa
"1.".(Level of Evidence:B ) "
"2.".(Level of Evidence:C ) "
Class IIa
"1.".(Level of Evidence:B ) "

Assessment of Motor Impairment, Activity, and Mobility

Class IIa
"1.".(Level of Evidence:C ) "
"2.".(Level of Evidence:C ) "
"3.".(Level of Evidence:C ) "
"4.".(Level of Evidence:C ) "
"5.".(Level of Evidence:C ) "
"6.".(Level of Evidence:C ) "
"7.".(Level of Evidence:C ) "

Assessment of Communication Impairment

Class I
"1." (Level of Evidence:B ) "
Class IIa
"1.".(Level of Evidence:A ) "
Class IIb
"1.".(Level of Evidence:C ) "

Assessment of Cognition and Memory

Class I
"1." (Level of Evidence:B ) "
Class IIa
"1.".(Level of Evidence:C ) "

Sensory Impairments, Including Touch, Vision, and Hearing

Class IIa
"1.".(Level of Evidence:B ) "

Dysphagia Screening, Management, and Nutritional Support

Class I
"1." (Level of Evidence:B ) "
"2." (Level of Evidence:B ) "
"3." (Level of Evidence:B ) "
"4." (Level of Evidence:A ) "
"5." (Level of Evidence:B ) "
"6." (Level of Evidence:B ) "
Class IIa
"1.".(Level of Evidence:C ) "
"2.".(Level of Evidence:B ) "
"3.".(Level of Evidence:B ) "
"4.".(Level of Evidence:C ) "
Class IIb
"1.".(Level of Evidence:C ) "
"2.".(Level of Evidence:A ) "
"3.".(Level of Evidence:B ) "
Class III
"1." . (Level of Evidence:A ) "

Nondrug Therapies for Cognitive Impairment, Including Memory

Class I
"1." (Level of Evidence:A ) "
Class IIb
"1.".(Level of Evidence:B ) "
"2.".(Level of Evidence:B ) "
Class IIb
"1.".(Level of Evidence:C ) "
"2.".(Level of Evidence:C ) "
"3.".(Level of Evidence:A ) "
"4.".(Level of Evidence:B ) "
"5.".(Level of Evidence:B ) "
"6.".(Level of Evidence:B ) "

Use of Drugs to Improve Cognitive Impairments, Including Attention

Class IIb
"1.".(Level of Evidence:B ) "
"2.".(Level of Evidence:B ) "
"3.".(Level of Evidence:B ) "
"4.".(Level of Evidence:C ) "

Limb Apraxia

Class IIb
"1.".(Level of Evidence:B ) "
"2.".(Level of Evidence:C ) "

Hemispatial Neglect or Hemi-Inattention

Class IIa
"1.".(Level of Evidence:B ) "
Class IIb
"1.".(Level of Evidence:B ) "
"2.".(Level of Evidence:B ) "

Cognitive Communication Disorders

Class IIa
"1.".(Level of Evidence:B ) "

Aphasia

Class I
"1." (Level of Evidence:A ) "
"2." (Level of Evidence:B ) "
Class IIa
"1.".(Level of Evidence:B ) "
Class IIb
"1.".(Level of Evidence:A ) "
"2.".(Level of Evidence:B ) "
"3.".(Level of Evidence:B ) "
"4.".(Level of Evidence:B ) "
Class III
"1." . (Level of Evidence:B ) "

Motor Speech Disorders:Dysarthria and Apraxia of Speech

Class I
"1." (Level of Evidence:A ) "
"2." (Level of Evidence:B ) "
Class IIa
"1.".(Level of Evidence:A ) "
Class IIb
"1.".(Level of Evidence:C ) "
"2.".(Level of Evidence:C ) "

Spasticity

Class I
"1." (Level of Evidence:A ) "
"2." (Level of Evidence:A ) "
Class IIa
"1.".(Level of Evidence:A ) "
Class IIb
"1.".(Level of Evidence:A ) "
"2.".(Level of Evidence:A ) "
"3.".(Level of Evidence:A ) "
"4.".(Level of Evidence:C ) "
Class III
"1." . (Level of Evidence:B ) "

Balance and Ataxia

Class I
"1." (Level of Evidence:A ) "
"2." (Level of Evidence:A ) "
"3." (Level of Evidence:C ) "
Class IIb
"1.".(Level of Evidence:C ) "
"2.".(Level of Evidence:B ) "
"3.".(Level of Evidence:B ) "
"4.".(Level of Evidence:B ) "
"5.".(Level of Evidence:B ) "
"6.".(Level of Evidence:B ) "
"7.".(Level of Evidence:B ) "
"8.".(Level of Evidence:B ) "
"9.".(Level of Evidence:B ) "
"10.".(Level of Evidence:A ) "
"11.".(Level of Evidence:A ) "
"12.".(Level of Evidence:A ) "
"13.".(Level of Evidence:B ) "
Class III
"1." . (Level of Evidence:B ) "

References

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