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Ann Intern Med ; 171(12): 916-924, 2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31739317

RESUMO

Description: In June 2019, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) approved an update of the joint clinical practice guideline for rehabilitation after stroke. This synopsis summarizes the key recommendations from this guideline. Methods: In February 2018, the VA/DoD Evidence-Based Practice Work Group convened a joint VA/DoD guideline development effort that included clinical stakeholders and stroke survivors and conformed to the National Academy of Medicine (formerly the Institute of Medicine) tenets for trustworthy clinical practice guidelines. The guideline panel identified key questions, systematically searched and evaluated the literature, and developed 2 algorithms and 42 key recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Stroke survivors and their family members were invited to share their perspectives to further inform guideline development. Recommendations: The guideline recommendations provide evidence-based guidance for the rehabilitation care of patients after stroke. The recommendations are applicable to health care providers in both primary care and rehabilitation. Key features of the guideline are recommendations in 6 areas: timing and approach; motor therapy; dysphagia; cognitive, speech, and sensory therapy; mental health therapy; and other functions, such as returning to work and driving.


Assuntos
Transtornos do Humor/tratamento farmacológico , Transtornos das Habilidades Motoras/reabilitação , Guias de Prática Clínica como Assunto , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/complicações , Algoritmos , Antidepressivos de Segunda Geração/uso terapêutico , Terapia por Exercício , Humanos , Transtornos do Humor/etiologia , Transtornos do Humor/reabilitação , Transtornos das Habilidades Motoras/tratamento farmacológico , Transtornos das Habilidades Motoras/etiologia , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico , Estados Unidos , United States Department of Veterans Affairs
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