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Visites depuis le 23/10/2011

Stratégie intégrée de l'AVC

  Rapports AVC

Rapport Bardet 
Cliquer ici 

Rapport 
Fery Lemonnier ; synthèse

Plan AVC

Peter Langhorne, Julie Bernhardt, Gert Kwakkel . 
Stroke rehabilitation. 
 
Lancet 2011; 377: 1693–702
 Parcours AVC Sofmer - Fedmer


==> Early Supported Discharge



Transformer le système de soins et les vies qui en dépendent

Canada: Recommandations canadiennes de l'AVC
http://www.canadianstrokenetwork.ca/fr/outils/downloads/CSSManualFR.pdf
http://www.canadianstrokestrategy.ca/fr/outilsressources/documents/CSS%202007_FR.ppt

EBRSR:Evidence-Based Review of Stroke Rehabilitation 
http://www.ebrsr.com/

Canadian best practice recommendations for stroke care (updated 2008) Cliquer ici

GTA REHAB NETWORK et Ontario Stroke System ==> Stratégie régionale coordonnée(plus de liens sur l'organisation++)
Ontario stroke strategy
http://www.hhrc.net/pubs/workshops/pds_stroke.pdf

Low Tolerance Long Duration Rehabilitation (LTLD)
Low Tolerance Long Duration Stroke Rehabilitation Initiative Report
http://www.gtarehabnetwork.ca/downloads/rpt-LTLD-final-june2006.pdf nouveau 2006

AVC Québec
SERVICES POSTHOSPITALIERS DE RÉADAPTATION ET DE CONVALESCENCE
http://www.cmis.mtl.rtss.qc.ca/pdf/publications/isbn2-89510-232-5.pdf

West GTA Stroke Network Glossary
http://profed.heartandstroke.ca/ClientImages/1/Glossary%5B1%5D.pdf

CONVERTING STROKE BEST PRACTICES NURSING EDUCATION INTO A PROVINCE WIDE TELE-EDUCATION MODULE
Cliquer ici

COMMUNITY STROKE RESOURCES
Cliquer ici

Stroke Rehab Definitions Framework Self-Assessment Tool – Outpatient/Ambulatory Stroke Rehab
http://www.gtarehabnetwork.ca/downloads/self-assessment-tool-stroke-outpatient.pdf

Europe:
European Stroke Organisation (ESO): à comparer aux modèles canadiens
http://www.eusi-stroke.com/

Belgique: réadaptation locomotrice et neurologique en Belgique et groupe de travail interministériel


Early supported discharge ==> Cliquer ici

Pathways (itinéraires cliniques/programmes cliniques)

STROKE CARE PATHWAY A Resource for Health Professionals

Patient Pathway Stroke Discharge Issues.19th September 2007 Cliquer ici

The Grampian Stroke Pathway Cliquer ici

STROKE CARE PATHWAY GUIDELINES FOR USE OF STROKE CARE PATHWAYS
Cliquer ici (déglutition)

The integrated care pathway epidemic - is stroke next? Cliquer ici

Voir aussi: analyse des pathways en réadaptation locomotrice et neurologique (rapport belge KCE)


Recommandations, textes, études françaises

Circulaire AVC du 9 octobre 2003 Cliquer ici

Circulaire AVC du 22 mars 2007 Cliquer ici

Critères d'orientation AVC Mulhouse 2008: Texte courtsynthèse

Travaux de la MEAH sur les AVC: où est la réadaptation? Cliquer ici

Rapport Bardet Cliquer ici Rapport Fery Lemonnier ; synthèse

INNOVATION ORGANISATIONNELLE EN SANTE. CENTRAGE PATIENT ET PROCESSUS-RESEAUX : ESPOIRS ET DIFFICULTES.

A la recherche d'une stratégie intégrée

Ile-de-france: Volet SSR du SROS 3 ; volet AVCRapport AVC ARHIF 2002

Nouveautés ARHIF révision des SROS 3
Enquête flash FHF 2007
Enquête séjour long en SSR 2006 ARHIF
Colloque du 14 novembre 2008 sur les Accidents Vasculaires Cérébraux ; Evaluation des unités neurovasculaires en Ile-de-France
Données lits SSR
MAS FAM
Démographie libéraux 93

USLD ARHIF Sept 2008 Cliquer ici

AVC Organisation divers France

HAS 2007 France Woimant

Avis FHF Cliquer ici

Pahrtage Cliquer ici

Table ronde HAS prise en charge initiale Quelles voies d'amélioration Cliquer ici

COTRIM et AVC Cliquer ici

Découverte d'un site: http://profed.heartandstroke.ca/

http://profed.heartandstroke.ca/ ; puis Stroke ; puis Ontario Stroke system (voir aussi les autres rubriques) puis Organizing Stroke Care +++
Au chapitre Organizing Stroke Care
Organized Stroke Care: Managing Change

A GUIDE FOR ESTABLISHING A REGIONAL COORDINATED STROKE STRATEGY Cliquer ici

A Guide to Organizing Acute Stroke Care Cliquer ici
Au chapitre Stroke Care Resources
Stroke Rehabilitation System Consensus Panel Final Report 2007
Consensus Panel on the Stroke Rehabilitation System “Time is Function” A Report

Rehab Consensus Panel Standards - Definition of Terms Cliquer ici

EBRSR: Evidence-Based Review of Stroke Rehabilitation

Implementing a Regional Vision for Stroke Rehabilitation. Handbook for Regional Stroke Rehabilitation Coordinators (2006)

A handbook designed specifically for the Regional Stroke Rehabilitation Coordinators to provide background information and to assist in developing a coordinated and comprehensive stroke rehabilitation system in Ontario. Cliquer ici

STROKE REHABILITATION RESOURCE GUIDE Cliquer ici


Réadaptation post-AVC fondée sur les données probantes

Peter Langhorne, Julie Bernhardt, Gert Kwakkel . 
Stroke rehabilitation. 
 
Lancet 2011; 377: 1693–702


Evidence-based stroke rehabilitation PETER LANGHORNE, LYNN LEGG, AL EXANDRA POL LOCK, CAMERON SE L LARS


Services for reducing duration of hospital care for acute stroke patients +++ Early Supported Discharge Trialists à lire absolument

Main results: Outcome data are currently available for 11 trials (1597 patients). Patients tended to be a selected elderly group with moderate disability. The ESD group showed significant reductions (P < 0.0001) in the length of hospital stay equivalent to approximately 8 days. Overall, the odds ratios (OR) (95% confidence interval (CI)) for death, death or institutionalisation, death or dependency at the end of scheduled follow up were OR 0.90, 95% CI 0.64 to 1.27, P = 0.56, OR 0.74, 95% CI 0.56 to 0.96, P = 0.02 and OR 0.79, 95% CI 0.64 to 0.97, P = 0.02, respectively. The greatest benefits were seen in the trials evaluating a co-ordinated ESD team and in stroke patients with mild-moderate disability. Improvements were also seen in patients' extended activities of daily living scores (standardised mean difference 0.12, 95% CI 0.00 to 0.25, P = 0.05) and satisfaction with services (OR 1.60, 95% CI 1.08 to 2.38, P = 0.02) but no statistically significant differences were seen in carers' subjective health status, mood or satisfaction with services.

Authors' conclusionsAppropriately resourced ESD services provided for a selected group of stroke patients can reduce long term dependency and admission to institutional care as well as reducing the length of hospital stay. No adverse impact was observed on the mood or subjective health status of patients or carers.

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Therapy-based rehabilitation services for stroke patients at home Authors' conclusions
Therapy-based rehabilitation services targeted towards stroke patients living at home appear to improve independence in personal activities of daily living. However, the evidence is derived from a review of heterogeneous interventions and therefore further exploration of the interventions is justifiable.

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Hospital at home versus in-patient hospital care Authors' conclusions
Despite increasing interest in the potential of hospital at home services as a cheaper alternative to in-patient care, this review provides insufficient objective evidence of economic benefit. Early discharge schemes for patients recovering from elective surgery and elderly patients with a medical condition may have a place in reducing the pressure on acute hospital beds, providing the views of the carers are taken into account. For these clinical groups hospital length of stay is reduced, although this is offset by the provision of hospital at home. Future primary research should focus on rigorous evaluations of admission avoidance schemes and standards for original research should aim at assisting future meta-analyses of individual patient data from these and future trials.
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Therapy-based rehabilitation services for patients living at home more than one year after stroke protocole en cours à suivre...Cliquer ici
Occupational therapy for patients with problems in activities of daily living after stroke Authors' conclusions Patients who receive occupational therapy interventions are less likely to deteriorate and are more likely to be independent in their ability to perform personal activities of daily living. However, the exact nature of the occupational therapy intervention to achieve maximum benefit needs to be defined.
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Speech and language therapy for aphasia following strokeCliquer ici
Speech and language therapy for dysarthria due to non-progressive brain damageCliquer ici
Interventions to promote collaboration between nurses and doctorsCliquer ici
In-hospital care pathways for stroke protocole en cours à suivre...Cliquer ici
Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costsCliquer ici
Physiotherapy treatment approaches for the recovery of postural control and lower limb function following strokeCliquer ici
Electrical stimulation for preventing and treating post-stroke shoulder painCliquer ici
Electrostimulation for promoting recovery of movement or functional ability after strokeCliquer ici
Electromechanical-assisted training for walking after strokeCliquer ici
Supportive devices for preventing and treating subluxation of the shoulder after strokeCliquer ici
Repetitive task training for improving functional ability after strokeCliquer ici
Treadmill training and body weight support for walking after strokeCliquer ici
EMG biofeedback for the recovery of motor function after strokeCliquer ici
Force platform feedback for standing balance training after strokeCliquer ici
Constraint induced movement therapy for upper extremities in stroke patients
Sirtori V, Corbetta D, Moja L, Gatti R. Constraint-induced movement therapy for upper extremities in stroke patients. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD004433. DOI: 10.1002/14651858.CD004433.pub2 
Authors' conclusions: 

CIMT is a multifaceted intervention: the restriction to the normal limb is accompanied by a certain amount of exercise of the appropriate quality. It is associated with a moderate reduction in disability assessed at the end of the treatment period. However, for disability measured some months after the end of treatment, there was no evidence of persisting benefit. Further randomised trials, with larger sample sizes and longer follow up, are justified.

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Very early delayed mobilization after stroke
Bernhart J ...
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Multi-disciplinary rehabilitation for acquired brain injury in adults of working ageCliquer ici
Interventions for motor apraxia following strokeCliquer ici
Cognitive rehabilitation for attention deficits following strokeCliquer ici
Cognitive rehabilitation for memory deficits following strokeCliquer ici
Cognitive rehabilitation for spatial neglect following strokeCliquer ici
Multidisciplinary rehabilitation for adults with multiple sclerosisCliquer ici
Exercise therapy for multiple sclerosisCliquer ici

Occupational therapy for rheumatoid arthritis Authors' conclusions
There is "gold" level evidence that occupational therapy can help people with rheumatoid arthritis to do daily chores such as dressing, cooking and cleaning and with less pain. Benefits are seen with occupational therapy that includes training, advice and counseling and also with advice on joint protection.

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Occupational therapy for multiple sclerosisCliquer ici
Services for helping acute stroke patients avoid hospital admissionCliquer ici

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