Purpose—The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods—Writing group members were nominated by th...

Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association

National Clinical Guidelines for Stroke. Intercollegiate Working Party for Stroke, Royal College of Physicians. (Pp 150; £15.95.) Lavenham Press, 2000. ISBN 1-86016-120-0.\***|

Stroke is a common problem, being the third cause of mortality in the UK and the leading cause of adult disability with a resultant significant cost burden to the NHS and social services. The guidelines highlight the wide national variation in the implementation of evidence based practice as seen in the Stroke Association's National Survey and the Royal College of Physicians …

https://pmj.bmj.com/content/postgradmedj/77/906/286.9.full.pdf

National Clinical Guidelines for Stroke.

A comprehensive evidence-based review of stroke rehabilitation was created to be an up-to-date review of the current evidence in stroke rehabilitation and to provide specific conclusions based on evidence that could be used to help direct stroke care at the bedside and at home. A literature search using multiple data-bases was used to identify all trials from 1968 to 2001. Methodological quality of the individual randomized controlled trials was assessed using the Physiotherapy Evidence Database (PEDro) quality assessment scale. A five-stage level-of-evidence approach was used to determine the best practice in stroke rehabilitation. Over 403 treatment-based articles investigating of various areas of stroke rehabilitation were identified. This included 272 randomized controlled trials.

An Evidence-Based Review of Stroke Rehabilitation

Background and Purpose—The purpose of this statement is to delineate basic expectations regarding primary palliative care competencies and skills to be considered, learned, and practiced by provide...

Palliative and End-of-Life Care in Stroke A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Systematic review of randomised controlled trials

Background and Purpose —Hemiplegic shoulder pain is not uncommon after stroke. Its origin is still unknown, and although many different methods of treatment are applied, none have yet been proved to be effective. We sought to study the efficacy of 3 injections of intra-articular triamcinolone acetonide on pain and arm function in stroke patients with hemiplegic shoulder pain. Methods —In a multicenter, randomized, placebo-controlled clinical trial, patients with hemiplegic shoulder pain received either 3 intra-articular injections of 40 mg triamcinolone acetonide or 1 mL physiological saline solution (placebo). Primary outcomes were pain measured according to 3 visual analogue scales (score range, 0 to 10), and arm function was measured by means of the Action Research Arm test and the Fugl-Meyer assessment scale; secondary outcomes were passive external rotation of the shoulder and general functioning measured according to Barthel Index and the Rehabilitation Activities Profile. Results —In the triamcinolone group (n=18), the median decrease in pain, 3 weeks after the last injection, was 2.3 (interquartile range, 0.3 to 4.3) versus 0.2 (interquartile range, −0.5 to 2.2) in the placebo group. This result was not statistically significant. The change in the other outcome measures did not differ significantly between the 2 treatment groups. Twenty-five patients reported side effects. Conclusions —In the 37 participants included in this study, triamcinolone injections seemed to decrease hemiplegic shoulder pain and to accelerate recovery, but this effect was not statistically significant. Therefore, on the basis of the results of this study, these injections cannot be recommended for the treatment of patients with hemiplegic shoulder pain.

/pdf/effect-of-triamcinolone-acetonide-injections-on-hemiplegic-yv4wkd6kos.pdf

Effect of Triamcinolone Acetonide Injections on Hemiplegic Shoulder Pain A Randomized Clinical Trial

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Effect of Triamcinolone Acetonide Injections on Hemiplegic Shoulder Pain A Randomized Clinical Trial