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Stroke: European Stroke Organisation: evidence-based stroke rehabilitation.

Latest update: January 2009. Next update: Not indicated. Patient group: Adults with ischaemic stroke or transient ischaemic attacks (TIAs). Intended audience: Clinicians caring for patients with ischaemic stroke or TIAs. Additional versions: This guideline is an expanded document from The European Stroke Organisation (ESO) Executive Committee and ESO Writing Committee. Guidelines for the Management of Ischaemic Stroke and Transient Ischaemic Attack 2008, 125 pages. Available from: http://www.eso-stroke.org /recommendations. php?cid%20=%209. Expert working group: Thirty-six people comprised the guideline development group. This included experts from predominantly medicine from 13 European countries. Funded by: The European Stroke Organisation. Consultation with: Not stated. Approved by: The European Stroke Organisation. Location: Quinn TJ et al (2008) Evidence-based stroke rehabilitation: an expanded guidance document from the European stroke organisation (ESO) guidelines for management of ischaemic stroke and transient ischaemic attack. Journal of Rehabilitation Medicine 41: 99-111.

Description: This 14-page article outlines evidence for rehabilitation of stroke patients. It builds on the 2008 ESO guidelines outlined above, which are much broader, with rehabilitation only one aspect of stroke management presented in that document. The article presents evidence for the evaluation of rehabilitation trials, the setting and timing of rehabilitation, duration, intensity and content of rehabilitation therapy, prognosis, cost effectiveness, and common complications post stroke. The content of rehabilitation presented includes physiotherapy, occupational therapy, speech and language therapy, stroke liaison, cognitive intervention, and other groups. The document discusses the evidence for each section, provides summary key points, and recommendations for future research. The levels of evidence are not clearly presented in the article, but are detailed in the 125-page guideline document. In the physiotherapy section, evidence for models of physiotherapy are presented (eg Bobath, motor relearning), and for specific physiotherapy interventions such as constraint-induced movement therapy, strength training, functional electrical stimulation, treadmill training, virtual reality, mental imagery, bilateral training, and aerobic exercise training. Prevalence, evidence for prevention, and intervention to improve common complications are presented. These include shoulder pain, depression, falls, urinary disturbance, and aspiration pneumonia. The guidelines are supported by 144 references.

Sandra Brauer

The University of Queensland
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Title Annotation:Appraisal: Clinical Practice Guidelines
Author:Brauer, Sandra
Publication:Australian Journal of Physiotherapy
Geographic Code:8AUST
Date:Jun 1, 2009
Words:347
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