Rehabilitation

 

Stroke is a leading cause of adult disability in Canada. Rehabilitation is known to reduce disability and dependence. Stroke Rehabilitation is a progressive, dynamic, goal-oriented process aimed at enabling a person with impairment to reach his or her optimal physical, cognitive, emotional, communicative and/or social functional level.

While access to stroke rehabilitation is a best practice, only 23% of all acute stroke survivors in Ontario were admitted to inpatient rehabilitation programs (SEAC Technical Report 2010).

 

3 Challenges in our Region:

1. Equitable access to inpatient rehabilitation for persons with stroke
2. Absence of a framework and standards for Rehabilitation services; continued erosion with budget cuts; many without consideration given to implementing best practices.
3. Standardization of assessment tools and outcome measures across the continuum.

Recommendations/Possible solutions:

1. A structured approach for determining stroke rehabilitation needs is required to ensure equitable access to inpatient rehabilitation. Implementation of the Stroke Rehabilitation Candidacy Screening Tool in acute care facilities across the region is recommended.
2. The Ontario Stroke Network has created a Provincial Reference Group who will serve as a resource regarding stroke best practices to the work of the MOH/LHIN Expert Panel on Rehabilitation and Complex Continuing Care.
3. Adoption of a core set of outcome measures that will serve to standardize tools, enable transfer of information across settings, and facilitate measurement of client and system outcomes.

The Southwestern Ontario Stroke Network Rehabilitation Coordinator is eager to work with its regional stakeholders to address these gaps. Please contact me so that we can discuss how we can work together.
Deborah Willems, Rehabilitation Coordinator, Southwestern Ontario Stroke Network, Parkwood Hospital, H404-801 Commissioners Road East, London, N6C 5J1 at deb.willems@lhsc.on.ca or 519-685-4292 extension 42681

 

Best Practices in Rehabilitation:

• The 2010 Canadian Best Practice Recommendations for Stroke Care give detailed recommendations to guide practice in stroke rehabilitation. These can be viewed at: Canadian Stroke Strategy Best Practice Recommendations for Stroke Care 2010
• A Patient’s Guide to Canadian Best Practice Recommendations for Stroke Care

 

Stroke Rehabilitation Candidacy Screening Tool:

1. Stroke Rehabilitation Candidacy Screening Tool
2. Instruction Package
3. Inter-rater Reliability of the Stroke Rehabilitation Candidacy Screening Tool
4. Determining the Need for Rehabilitation Services Post Stroke Phase Two

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Outcome Measures:

• Resource List for Outcome Measures
• Canadian Best Practices in Stroke Rehabilitation Outcomes Report of the Expert Panel
• Measuring the Outcomes of Stroke Rehabilitation
• Outcome Measures Bulletin: April 2009
• Stroke Rehabilitation Outcome Measures Forum Summary Report 2009
• Outcome Measures Toolbox

 

Resources:

• SCORE Evidence Based Recommendations for the Upper and Lower Extremities and Risk Assessment Post-Stroke 2005
• Hemiplegic Arm Protocol
• Driving Fact Sheet
• Referral Form

 

Professional:

• Evidence Based Review of Stroke Rehabilitation
• StrokEngine
• Tips and Tools for Everyday Living
• Post Stroke Arm and Hand
• Community Best Practice Guidelines
• Community Stroke Rehabilitation Teams
• Community Stroke Rehabilitation Teams Brochure

 

Public:

• Modifying the Home After Stroke 2005
• Driving After Stroke: Patient/Family Information
• Specialized Stroke Rehabilitation Teams in Your Community
• Community Stroke Rehabilitation Teams Brochure

 

Reports:

• November 2006 Rehab Action Planning Day Report
• Bulletin Stroke Rehabilitation Units July 2007
• Stroke Rehabilitation Candidacy Screening Tool: Results of the Inter-rater Reliability Study

 

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Contact:

Stroke Rehabilitation Advisory Group

For more information about Stroke Rehabilitation in the Southwest Region, please contact:

Deborah Willems, Rehabilitation Coordinator, Southwestern Ontario Stroke Strategy, Parkwood Hospital, C401-801 Commissioners Road East, London, N6C 5J1 at deb.willems@lhsc.on.ca

Eileen Britt, Co-chair
Coordinator Rehabilitation Stroke Program
Parkwood Hospital, St Josephs Health Care London
801 Commissioners Road East
London, Ontario
(519) 685-4292 x42537

Bernice Markham, Co-chair
Program Manager, Inpatient Rehabilitation Unit
Windsor Regional Hospital, Western Campus
1453 Prince Road
Windsor, Ontario
(519) 257-5111 x75263