All people admitted to hospital with acute stroke should have an initial assessment by rehabilitation professionals as soon as possible—preferably within the first 24 to 48 hours of admission—the Canadian Medical Association Journal recommends.

The Canadian Best Practice Recommendations for Stroke Care 2008 update is a result of an extensive review of international stroke research and published evidence-based best practice recommendations or guidelines pertaining to stroke.

Its contents include revisions to the 24 best practice recommendations released in 2006 and the addition of four new recommendations addressing emergency medical services, management of transient ischemic attack and minor stroke, acute inpatient care, and vascular cognitive impairment.

Recommendations tailored to rehabilitation call for patients to be treated in a comprehensive or rehabilitation stroke unit by an interdisciplinary team; rehabilitation therapy to start as early as possible once medical stability is reached; access to appropriate specialized stroke care and rehabilitation services at discharge; and regular and ongoing follow-up to assess recovery, prevent deterioration, and maximize functional outcome.  

The guidelines also address factors for successful implementation of the best practice recommendations, such as well-resourced stroke coordinators hired to manage implementation, identification and participation of key stroke champions, and integration of stroke programs and services into regional and hospital strategic and operational plans.

[Source: APTA]