Exciting future for stroke rehabilitation
National Stroke Week (2–8 September) is a great time to reflect on what we, as physiotherapists, can do to help stroke survivors achieve their movement, recreational and life goals. It is an exciting time for stroke recovery and rehabilitation—there is a lot of momentum in this area and physiotherapists continue to be part of the movement that is leading the way forward.
‘The future of stroke rehabilitation is exciting and there is an important role for physiotherapists.’
Reflecting on the past 15 years, we have seen Australian physiotherapists lead large randomised controlled trials in stroke recovery and rehabilitation. This includes investigation of early mobilisation, treadmill training, circuit class therapy and upper limb electromechanical device therapy. Unfortunately, not all trials have realised the recovery gains they set out to achieve. To accelerate development and facilitate the implementation of effective treatments to enhance recovery, the international Stroke Recovery and Rehabilitation Roundtables (SRRR) have taken place.
The ﬁrst roundtable, in 2016, led to the publication of ﬁve consensus-based recommendations including standardised measurement, agreed deﬁnitions and intervention development. Importantly, for front-line clinicians, these are freely downloadable here.
In 2018, the second roundtable was convened and will see the release of a further four consensus-based recommendations in late 2019. The second roundtable focused on cognitive impairment, standardising measurement of movement quality, improving development of recovery trials and moving knowledge into practice. This collective body of work puts the focus on stroke recovery as the next frontier.
Professor Julie Bernhardt, who spearheaded the development of the SRRR initiative says ‘The role of physiotherapists in championing the SRRR recommendations is to continue to be influential and vocal drivers of change in research and practice that is geared towards improving patient outcomes. If we work together and align our efforts, it will increase the rate of positive change in recovery and rehabilitation.’
Clinical guidelines are a great tool to bridge the gap between research and practice to improve patient outcomes. In 2017, the Clinical Guidelines for Stroke Management were updated. Clinicians can ﬁnd recommended evidence-based treatments with just a few clicks.
The guidelines include a summary of the evidence, recommendation rationale and practical information. But the best part is what’s coming—the latest iteration of the guidelines marks the start of ‘living guidelines.’ Associate Professor Coralie English, co-chair of the Clinical
Guidelines, says ‘the living guidelines model will ensure recommendations are kept updated as new evidence emerges. This means that frontline clinicians can have even greater conﬁdence in the guideline recommendations—knowing they are always up-to-date and based on the latest evidence.’
The future of stroke rehabilitation is exciting and there is an important role for physiotherapists. We encourage all to be involved, whether it’s implementing guidelines in your daily practice or taking part in research projects—each contributes to the bigger goal of improving outcomes for stroke survivors.
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