Brazilian Academy of Neurology practice guidelines for stroke rehabilitation: part I

ABSTRACT

The Guidelines for Stroke Rehabilitation are the result of a joint effort by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology aiming to guide professionals involved in the rehabilitation process to reduce functional disability and increase individual autonomy. Members of the group participated in web discussion forums with predefined themes, followed by videoconference meetings in which issues were discussed, leading to a consensus. These guidelines, divided into two parts, focus on the implications of recent clinical trials, systematic reviews, and meta-analyses in stroke rehabilitation literature. The main objective was to guide physicians, physiotherapists, speech therapists, occupational therapists, nurses, nutritionists, and other professionals involved in post-stroke care. Recommendations and levels of evidence were adapted according to the currently available literature. Part I discusses topics on rehabilitation in the acute phase, as well as prevention and management of frequent conditions and comorbidities after stroke.

RESUMO

As Diretrizes Brasileiras para Reabilitação do AVC são fruto de um esforço conjunto do Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia com o objetivo de orientar os profissionais envolvidos no processo de reabilitação para a redução da incapacidade funcional e aumento da autonomia dos indivíduos. Membros do grupo acima participaram de fóruns de discussão na web com pré-temas, seguidos de reuniões por videoconferência em que as controvérsias foram discutidas, levando a um consenso. Essas diretrizes, divididas em duas partes, focam as implicações de recentes ensaios clínicos, revisões sistemáticas e metanálises sobre reabilitação do AVC. O objetivo principal é servir de orientação a médicos, fisioterapeutas, fonoaudiólogos, terapeutas ocupacionais, enfermeiros, nutricionistas e demais profissionais envolvidos no cuidado pós-AVC. As recomendações e níveis de evidência foram adaptados de acordo com a literatura disponível atualmente. Aqui é apresentada a Parte I sobre tópicos de reabilitação na fase aguda, prevenção e tratamento de doenças e comorbidades frequentes após o AVC.

Keywords:

Stroke - Guideline - Neurological Rehabilitation - Practice Guidelines as Topic

Palavras-chave:

Acidente Vascular Cerebral - Guia - Reabilitação Neurológica - Guias de Prática Clínica como Assunto

Authors’ contributions

RB, GJL, CM: Introduction, recommendation ratings, and levels of evidence - conceptualization, writing, review, editing, and validation of the original draft; MCL: participation as reviewer; CHCM, CM: Rehabilitation in the acute phase and the Stroke Unit - conceptualization, writing, review, editing, and validation of the original draft; MCL: participation as reviewer; GPM: Contractures - conceptualization, writing, review, editing, and validation of the original draft; CM: Physical deconditioning - conceptualization, writing, review, editing, and validation of the original draft; CM: Central Pain - conceptualization, writing, review, editing, and validation of the original draft; KJA: participation as reviewer; CM: Painful Shoulder - conceptualization, writing, review, editing, and validation of the original draft; KJA: participation as reviewer; BCL, ELP: Pressure Injury - conceptualization, writing, review, editing, and validation of the original draft; JTS: Nutritional Support - conceptualization, writing, review, editing, and validation of the original draft; GRR: Mood Disorders - conceptualization, writing, review, editing, and validation of the original draft; SRCF: Deep Vein Thrombosis - conceptualization, writing, review, editing, and validation of the original draft; SRCF: Secondary Stroke Prevention - conceptualization, writing, review, editing, and validation of the original draft; GFP, KC: Sleep Disorders - conceptualization, writing, review, editing, and validation of the original draft; MTAP, JJMT, CMAB, RSC, TDLQ, ED: Falls - conceptualization, writing, review, editing, and validation of the original draft; MTAP, JJMT, CMAB, RSC, TDLQ: Osteoporosis - conceptualization, writing, review, editing, and validation of the original draft; MRC, MTRPD, OMPN: Epilepsy - conceptualization, writing, review, editing, and validation of the original draft; MHST, BCO, BGRBO: Neurogenic Lower Urinary Tract Dysfunction and Fecal Incontinence - conceptualization, writing, review, editing, and validation of the original draft; CM, LON: Sexual Dysfunction - conceptualization, writing, review, editing, and validation of the original draft; JJF, SCOM: participation as reviewers; CM: General Coordinator; CM, RB, LON, MTP, SCSAB, ROC, GJL: Coordinating Nucleus; RB: Standardization and Guidelines Coordinator; RB, CM, LON, MTP, SCSAM, ROC, GJL: Standards and Guidelines Council; Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology: Execution.

Publication History

Received: 27 August 2021

Accepted: 18 January 2022

Article published online:
06 February 2023

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