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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(07): 741-758
DOI: 10.1055/s-0042-1757692
Brazilian Academy of Neurology

Brazilian practice guidelines for stroke rehabilitation: Part II

Diretrizes brasileiras para reabilitação no acidente vascular cerebral: parte II
Cesar Minelli 
1   Hospital Carlos Fernando Malzoni, Matão SP, Brazil.
2   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.
3   Instituto Você sem AVC, Matão SP, Brazil.
,
Gustavo José Luvizutto 
4   Universidade Federal do Triângulo Mineiro, Departamento de Fisioterapia Aplicada, Uberaba MG, Brazil.
,
Roberta de Oliveira Cacho 
5   Universidade Federal do Rio Grande do Norte, Faculdade de Ciências da Saúde do Trairi, Santa Cruz RN, Brazil.
,
Luciana de Oliveira Neves 
6   Universidade de Fortaleza, Hospital São Carlos, Fortaleza CE, Brazil.
,
Sheila Cristina Sayuri Abe Magalhães 
7   Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu SP, Brazil.
,
Marco Túlio Araújo Pedatella 
8   Hospital Israelita Albert Einstein, Unidade Goiânia, Goiânia GO, Brazil.
9   Hospital Santa Helena, Goiânia GO, Brazil.
10   Hospital Encore, Goiânia GO, Brazil.
11   Hospital Estadual Geral de Goiânia Dr. Alberto Rassi, Goiânia GO, Brazil.
12   Hospital de Urgência de Goiânia, Goiânia, GO, Brazil.
,
Lucia Iracema Zanotto de Mendonça 
13   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Neurologia, São Paulo SP, Brazil.
14   Pontíficia Universidade Católica de São Paulo, Faculdade de Ciências Humanas e da Saúde, São Paulo SP, Brazil.
,
Karin Zazo Ortiz 
15   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Fala, Linguagem e Ciências Auditivas, São Paulo SP, Brazil.
,
Marcos Christiano Lange 
16   Universidade Federal do Paraná, Complexo Hospital de Clínicas, Curitiba PR, Brazil.
,
Priscila Watson Ribeiro 
7   Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu SP, Brazil.
,
Luciane Aparecida Pascucci Sande de Souza 
4   Universidade Federal do Triângulo Mineiro, Departamento de Fisioterapia Aplicada, Uberaba MG, Brazil.
,
Cristiano Milani 
17   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Serviço de Neurologia Vascular e Emergências Neurológicas, Ribeirão Preto SP, Brazil.
,
Daniel Marinho Cezar da Cruz 
18   Leeds Beckett University, Leeds, United Kingdom.
,
Rafael Dalle Molle da Costa 
7   Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu SP, Brazil.
,
Adriana Bastos Conforto 
19   Universidade de São Paulo, Hospital das Clínicas, Divisão de Neurologia Clínica, São Paulo SP, Brazil.
20   Hospital Israelita Albert Einstein, São Paulo SP, Brazil.
,
Fernanda Martins Maia Carvalho 
21   Universidade de Fortaleza, Programa de Pos-Graduação em Ciências Médicas, Fortaleza CE, Brazil.
,
Bruna Silva Ciarlini 
21   Universidade de Fortaleza, Programa de Pos-Graduação em Ciências Médicas, Fortaleza CE, Brazil.
,
Norberto Anizio Ferreira Frota 
21   Universidade de Fortaleza, Programa de Pos-Graduação em Ciências Médicas, Fortaleza CE, Brazil.
,
Kelson James Almeida 
22   Universidade Federal do Piauí, Departamento de Neurologia, Teresina PI, Brazil.
,
Eliane Schochat 
23   Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, São Paulo SP, Brazil.
,
Tatiana de Paula Oliveira 
23   Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, São Paulo SP, Brazil.
,
Camila Miranda 
23   Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, São Paulo SP, Brazil.
,
Maria Elisa Pimentel Piemonte 
23   Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, São Paulo SP, Brazil.
,
Laura Cardia Gomes Lopes 
24   Universidade Estadual de São Paulo, Faculdade de Medicina de Botucatu, Hospital das Clínicas, Departamento de Neurologia, Psicologia e Psiquiatria, São Paulo SP, Brazil.
,
Camila Galvão Lopes 
25   Hospital Santa Paula, São Paulo SP, Brazil.
,
Michelle Hyczy de Siqueira Tosin 
26   Universidade Federal Fluminense, Niterói RJ, Brazil.
27   Rush University, Chicago, United States.
,
Bianca Campos Oliveira 
26   Universidade Federal Fluminense, Niterói RJ, Brazil.
,
Beatriz Guitton Renaud Baptista de Oliveira 
26   Universidade Federal Fluminense, Niterói RJ, Brazil.
,
Shamyr Sulyvan de Castro 
28   Universidade Federal do Ceará, Departamento de Fisioterapia, Fortaleza CE, Brazil.
,
João Brainier Clares de Andrade 
29   Universidade Federal de São Paulo SP, São Paulo, Brazil.
,
Gisele Sampaio Silva 
20   Hospital Israelita Albert Einstein, São Paulo SP, Brazil.
29   Universidade Federal de São Paulo SP, São Paulo, Brazil.
,
Octávio Marques Pontes-Neto 
2   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.
,
João José Freitas de Carvalho 
30   Hospital Geral de Fortaleza, Faculdade de Medicina Unichristus, Fortaleza CE, Brazil.
,
Sheila C. Ouriques Martins 
31   Rede Brasil AVC, Porto Alegre RS, Brazil.
32   Hospital Moinhos de Vento, Departamento de Neurologia, Porto Alegre RS, Brazil.
33   Hospital de Clínicas de Porto Alegre, Departamento de Neurologia, Porto Alegre RS, Brazil.
,
Rodrigo Bazan 
7   Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu SP, Brazil.
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Abstract

The Brazilian Practice Guidelines for Stroke Rehabilitation – Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

Resumo

As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderência ao uso de medicamentos, cuidados paliativos, o futuro da reabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC.

Keywords

Stroke - Neurological Rehabilitation - Health Planning Guidelines - Practice Guidelines as Topic

Palavras-chave

Acidente Vascular Cerebral - Reabilitação Neurológica - Diretrizes para o Planejamento em Saúde - Guias de Prática Clínica como Assunto

Authors' Contributions

Introduction – CM, RZ: conceptualization, writing, review, editing, and validation of the original draft. Disorders of communication: aphasia, dysarthria, and apraxia of speech – LIZM, KZO: conceptualization, writing, review, editing, and validation of the original draft; MCL: participation as reviewer. Dysphagia – PWT: conceptualization, writing, review, editing, and validation of the original draft. Postural control and balance – LAPSS: conceptualization, writing, review, editing, and validation of the original draft; ROC: participation as reviewer. Ataxias – LAPSS: conceptualization, writing, review, editing, and validation of the original draft; ROC: participation as reviewer. Spasticity – CM: conceptualization, writing, review, editing, and validation of the original draft; MCL: participation as reviewer. Upper limb – CM, ABC, ROC: conceptualization, writing, review, editing, and validation of the original draft. Mobility – ROC, DMCC, RDMC, CM: conceptualization, writing, review, editing, and validation of the original draft. Cognition – FMMC, BSC, NAFF: conceptualization, writing, review, editing, and validation of the original draft; KJA: participation as reviewer. Unilateral spatial neglect – GJL: conceptualization, writing, review, editing, and validation of the original draft. Sensory impairment (hearing, vision, and touch) – ES, TPO, CM, MEPP: conceptualization, writing, review, editing, and validation of the original draft; KJA: participation as reviewer. Rehabilitation continuity: home rehabilitation, return to leisure, work, and driving – SSC, LAPSS, GJL: conceptualization, writing, review, editing, and validation of the original draft. Medication adherence – MHST, BCO, BGRBO: conceptualization, writing, review, editing and validation of the original draft. Palliative care – LON, LCGL, CGL: conceptualization, writing, review, editing, and validation of the original draft. Cerebrovascular events related to SARS-CoV-2 infection – JBCA, GSS: conceptualization, writing, review, editing, and validation of the original draft; RB: participation as reviewer. Future of stroke rehabilitation – ABC, GJL, ROC: conceptualization, writing, review, editing, and validation of the original draft. Suggested sites for patients and caregivers – LON: conceptualization, writing, review, editing, and validation of the original draft. Participation as reviwers of the entire paper: OMPN, JJFC, SCOM. CM: general coordinator; CM, RB, LON, MTP, SCSAM, ROC, GJL: coordinating group; RB: standardization and guideline coordinator; RB, CM, LON, MTP, SCSAM, ROC, GJL: standards and guidelines council; execution: Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology.


Supplementary Material



Publication History

Received: 04 February 2022

Accepted: 18 May 2022

Article published online:
29 September 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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