Clinical Pathways in Stroke Rehabilitation : : Evidence-Based Clinical Practice Recommendations.

• Author: Platz, Thomas.
• Place / Publishing House: Cham : : Springer International Publishing AG,, 2021.; ©2021.
• Year of Publication: 2021
• Edition: 1st ed.
• Language: English
• Physical Description: 1 online resource (284 pages)

Table of Contents

Intro -- Preface -- Acknowledgements -- Contents -- Neurobiology of Stroke Recovery -- 1 Changes in Structural Plasticity After Stroke -- 2 Changes in Functional Plasticity After Stroke -- 3 Conclusion Regarding the Neurobiology of Stroke Recovery -- 4 Take Home Message for Clinical Practice in Stroke Rehabilitation -- References -- Clinical Pathways in Stroke Rehabilitation: Background, Scope, and Methods -- 1 Introduction -- 2 Clinical Pathways -- 3 The Evidence Gap -- 4 International Provision of Practice Recommendations -- 5 Scope, Content, and Methodology Used for the Generation of the Practice Recommendations -- 5.1 Scope of the Evidence-Based Clinical Practice Recommendations -- 5.2 Target Users of the Practice Recommendations -- 5.3 Stakeholder Involvement -- 5.3.1 Practice Recommendations Developer Group -- 5.3.2 Integration of Views and Preferences of the Target Population -- 5.4 Methods Used for Evidence Synthesis and Recommendation Development -- 5.4.1 General Remarks -- 5.4.2 Systematic Search -- 5.4.3 Criteria and Methods for Evidence Selection and Data Extraction -- 5.4.4 Critical Appraisal, Level of Evidence, Evidence Synthesis, and Grading its Quality -- 5.4.5 Synthesis of Evidence-Based Recommendations -- 5.4.6 Dissemination, Implementation, Monitoring, and Auditing -- 5.4.7 Process of Updating the Clinical Practice Recommendations -- 5.4.8 Funding of the Work -- 6 Conclusions -- References -- Goal Setting with ICF (International Classification of Functioning, Disability and Health) and Multidisciplinary Team Approach in Stroke Rehabilitation -- 1 Introduction -- 2 Methodological Considerations -- 3 Multidisciplinary Team Building and Coordination -- 3.1 Improving Quality of Stroke Care -- 3.2 Low Access to Rehabilitation -- 3.3 The Chronic Care Model for Stroke Patients.

4 ICF-Based Common Language in Reporting and Documentation Along the Care Pathway of Stroke Patients -- 4.1 ICF-Based Scales and Assessments -- 4.2 ICF-Based Goal Setting -- 5 Theoretical Background in Goal-Setting Practice -- 5.1 Goal-Setting Theory (Locke and Latham) -- 5.2 Goal Setting and Action Planning (Scobbie) -- 5.3 Goal Achievement and Goal Attainment Scaling -- 5.4 Examples on ICF-Based Goal Setting -- 6 Goal Setting in Stroke Patients in Practice -- 7 Recommendations for Multidisciplinary Team Approach and ICF-Based Goal Setting in Stroke Rehabilitation -- 8 Summary -- References -- Disorders of Consciousness -- 1 Introduction -- 2 Methods -- 3 DoC Assessment: Clinical Behavioral and Instrumental Diagnostic Tools -- 3.1 Clinicals and Behavioral Tools for DoC Assessments -- 3.2 Instrumental Diagnostic Tools for DoC Assessment -- 4 DoC Rehabilitation -- 5 Pharmacological Therapies for DoC -- 6 Other Specific Therapies for DoC -- References -- Airway and Ventilation Management -- 1 Introduction -- 2 Clinical Evidence and Reasoning -- 2.1 Weaning of Neurological Patients -- 2.2 Existing Studies on Weaning Success -- 2.3 Difficulties in the Weaning Process -- 2.4 Weaning Strategies -- 2.5 Weaning Protocols and Special Ventilation Techniques -- 2.6 Special Features of Prolonged Weaning in Neurological Patients -- 2.6.1 Definition of Successful Weaning from Mechanical Ventilation -- 2.6.2 Invasive and Non-Invasive Ventilation -- 2.6.3 Accompanying Neurological-Neurosurgical (Early) Rehabilitation -- 3 Clinical Practice Recommendations for Weaning in Stroke Patients (and Other Patients with Neurological Conditions) -- 3.1 Methodological Explanations -- 3.2 Recommendations -- 3.2.1 Organizational Setting -- 3.2.2 Weaning Strategy -- 3.2.3 Weaning Process Characteristics -- References -- Recovery of Swallowing.

1 Introduction -- 2 Dysphagia Screening Early after Stroke -- 3 Instrumental Assessments to Detect Dysphagia or Aspiration -- 4 Treatment of Dysphagia -- 4.1 Behavioral Interventions -- 4.2 Neuromuscular Electrical Stimulation (NMES) -- 4.3 Acupuncture -- 4.4 Noninvasive Brain Stimulation (NIBS) -- 4.5 Oral Hygiene -- 5 Enteral Tube Feedings -- 6 Summary -- References -- Arm Rehabilitation -- 1 Introduction -- 2 Methods for the Best Evidence Synthesis -- 3 Assessment -- 3.1 Measures of Impairment -- 3.1.1 Active Motor Control -- 3.1.2 Spasticity/Resistance to Passive Movement -- 3.2 Measures of Arm, Hand, and/or Finger Function -- 3.3 Measure of Self-Perceived Usefulness of the Affected Arm in Daily Life -- 4 Therapy -- 4.1 Training -- 4.1.1 Dosage of the Therapeutic Time Prescribed and Organizational Forms of Therapy -- 4.1.2 "Schools" of Therapy -- 4.1.3 Type of Feedback Given -- 4.1.4 Bilateral Training -- 4.1.5 Impairment-Oriented Training -- 4.1.6 Task-Specific Training -- 4.1.7 Constraint-Induced Movement Therapy (CIMT) -- 4.1.8 Strength Training -- 4.1.9 Mirror Therapy -- 4.1.10 Mental Practice -- 4.1.11 Action Observation -- 4.1.12 Music Therapy and Rhythmic Auditory Stimulation -- 4.2 Technology-Supported Training -- 4.2.1 Passive Devices for Repetitive Arm and Hand Training -- 4.2.2 Trunk Restraint -- 4.2.3 Splints and Strapping -- 4.2.4 Arm Rehabilitation Using Virtual Reality (VR) Applications -- 4.2.5 EMG- and Neuro-Biofeedback -- 4.2.6 Neuromuscular Electrical Stimulation (NMES) -- 4.2.7 Arm Robot Therapy -- 4.2.8 Repetitive Transcranial Magnetic Stimulation (rTMS) -- 4.2.9 Repetitive Peripheral Magnetic Stimulation (rPMS) -- 4.2.10 Transcranial Direct Current Stimulation (tDCS) -- 4.2.11 Somatosensory Stimulation -- 4.2.12 Acupuncture -- 4.2.13 Investigational Devices -- 4.3 Medication.

4.3.1 Botulinum Neurotoxin A (BoNT A) -- 4.3.2 Drugs to Enhance Recovery -- 5 Clinical Pathway and Practice Recommendations -- 5.1 General Comments -- 5.2 Dosage and Organization of Treatment -- 5.2.1 Acute and Subacute Phase After Stroke -- 5.2.2 Chronic Phase After Stroke -- 5.3 Therapeutic Options (Table 1) -- 5.3.1 Therapeutic Options for Stroke Survivors with Severe Paresis -- 5.3.2 Therapeutic Options for Stroke Survivors with Moderate and Mild Paresis -- 5.3.3 Therapeutic Options Independent of Stage of Disease or Severity of Paresis -- References -- Mobility After Stroke: Relearning to Walk -- 1 Introduction -- 2 Best Evidence for Rehabilitations of Gait: Methodology -- 3 Early Intensive Training in the Acute Phase (24 H) After Stroke -- 4 Restoration of Gait in Severely Affected Patients Who cannot Walk Without Help -- 4.1 Discussion: Restoration of Gait in Non-Ambulatory Patients -- 4.2 Summary -- 5 Improvement of Gait in Patients Who Walk Independently or With Little Help -- 5.1 Discussion: Improving Walking Ability in Ambulatory and Nearly Ambulatory Patients -- 5.2 Summary -- 6 Improvement of Balance, Reduction of Falls -- 6.1 Discussion: Improvement of Balance, Reduction of Falls -- 6.2 Summary -- 7 Improvement of Walking Speed -- 7.1 Discussion: Improvement of Walking Speed -- 7.2 Summary -- 8 Improvement of Walking Distance -- 8.1 Discussion: Increasing Walking Distance -- 8.2 Summary -- 9 General Discussion and Conclusions -- References -- Post-Stroke Spasticity -- 1 Introduction -- 2 Methods Used for Evidence Synthesis and Practice Recommendations -- 3 Problem Identification and Clinical Assessment -- 4 Treatment Goal Setting -- 4.1 Goal Setting -- 4.2 Goal Attainment Scaling -- 5 Pharmacological and Surgical Treatment -- 5.1 Systemic Medications -- 5.2 Botulinum Toxin Treatment.

5.2.1 Treatment Outcomes: Upper Limbs -- 5.2.2 Treatment Outcomes: Lower Limbs -- 5.2.3 Treatment Outcomes: Spasticity- or Spasm-Associated Pain -- 5.2.4 Botulinum Toxin A Injection Guidance -- 5.2.5 BoNT-A Products -- 5.2.6 BoNT-A Dosing -- 5.2.7 Adjuvant Therapies to BoNT-A -- 5.3 Neurolysis -- 5.4 Intrathecal Baclofen (ITB) -- 5.5 Surgical Management -- References -- Rehabilitation of Communication Disorders -- 1 Introduction: The Clinical Problem -- 1.1 Aphasia -- 1.2 Dysarthria -- 1.3 Apraxia -- 2 Recommendations for the Assessment and Treatment of Post-Stroke Communication Disorders -- 2.1 Clinical Assessment of Communication Disorders -- 2.2 Behavioural Therapy Interventions -- 2.2.1 Aphasia Therapy -- Impairment Focus -- Activity/Participation Focus -- 2.2.2 Dysarthria Therapy -- 2.2.3 Apraxia of Speech -- 2.3 Biological Therapies -- 2.3.1 Pharmacological Treatments -- 2.3.2 Non-Invasive Brain Stimulation (NIBS) -- 2.4 Timing, Intensity, Dose and Duration of Therapy -- 2.4.1 Timing -- 2.4.2 Intensity, Dose and Duration -- 2.5 Methods of Therapy Delivery -- 2.5.1 Group Therapy -- 2.5.2 Use of Volunteers -- 2.5.3 Use of Computers/Telepractice -- 2.6 Alternative and Augmentative Communication -- 2.7 Communication Environment -- 2.7.1 Conversation/Communication Partner Training -- 2.8 Psychosocial Interventions to Manage Mood Disorders Secondary to Aphasia -- 3 Top Ten Best Practice Recommendations for Aphasia and Forthcoming Information -- References -- Treating Neurovisual Deficits and Spatial Neglect -- 1 Neurovisual Disorders After Brain Damage -- 1.1 Assessment of Neurovisual Disorders -- 1.2 Therapy of Neurovisual Disorders -- 1.2.1 Saccadic Compensation (or Scanning) Training -- 1.2.2 Hemianopic Reading Training -- 1.2.3 Compensatory or Restorative Visual Field Training?.

1.2.4 Ineffective or Disadvantageous Therapies in VFDs.