Bridgepoint Health

Stroke Rehab Scoping Review

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Stroke patient JaneStroke rehabilitation programs across Canada are being transformed to align with the Canadian Stroke Strategy's Stroke Best Practice Recommendations. However, patients with multimorbidity are often excluded from the gold standard evidence studies that clinical practice guidelines are founded upon.  

We may be building stroke (and other chronic disease) best practices based on a mismatch between the participant groups used to generate evidence and the patient populations seen in practice.

Stroke care presents unique challenges for clinicians, as most stroke patients have on average 5 other chronic conditions. A recent assessment of capacity for implementing 'best practice' stroke care found clinicians reporting a strong need for training specific to patient/system complexity and multimorbidity (patients with two or more chronic conditions). Correspondingly, rehabilitation clinicians in a complex care facility have questioned the applicability of the evidence to their patients.

The research team includes expertise in stroke rehabilitation, scoping review and systematic review methodology, statistics, qualitative research and knowledge translation, and represents important user groups. All team members have collaborated in the development of the scoping design and knowledge translation strategies.

Objectives:

1. To identify stroke rehabilitation intervention literature pertaining to patients with multimorbidity;

2. To identify gaps in the literature and issues for further dialogue and research

3. To examine and share the research findings with stakeholders through an evidence map and excel database to support application of the results and inform stroke rehabilitation best practice.

Outcomes and Relevance: The processes and results will be relevant for researchers, clinicians, and policy makers concerned with stroke rehabilitation by expanding the understanding of the current evidence, and supporting development of best practice guidelines for stroke rehabilitation for patients with multimorbidity. Although this study is designed to assess the stroke rehabilitation intervention evidence, the methodology and findings will be relevant to researchers and clinicians in chronic disease management, health system performance and quality clinical care in multimorbidity. The findings from this research will also contribute important insights for designing strategies for improved rehabilitative care for patients with multimorbidity.  

Researcher: Michelle Nelson

Funders: Canadian Institutes for Health Research