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Controversial stroke guidelines are an improvement says CSP

12 June 2013 - 12:34am

The CSP has welcomed the final version of new NICE guidelines on stroke rehabilitation as an ‘improvement’ on the draft guidelines that raised ‘serious concerns’.


Dr Fiona Jones: 'Guidelines needed to be more patient-centred'

Association of Chartered Physiotherapists in Neurology (ACPIN) president, Dr Fiona Jones, speaking on behalf of the CSP said: ‘We said they needed to be more patient-centred so that stroke survivors feel they are involved in the decision-making about their rehabilitation, rather than having it dictated to them.

‘While more could still be done, there has been some movement in that direction that should help put patients in greater control.

‘There is also clear confirmation of the expertise physiotherapists provide on movement and the role we can play in developing exercise programmes for patients.’

The guidelines, which run to more than 500 pages, include evidence reviews, recommendations, and links to evidence on all aspects of stroke rehab, including: the makeup of a stroke rehab multidisciplinary team; patient goal-setting; intensity of stroke rehabilitation; fitness training; and return to work.

Dr Jones welcomed the inclusion of a recommendation that patients should be able to re-refer themselves into stroke rehab services later on, but she warned that there were some very important factors that missed the criteria to be included in these guidelines.

‘Anyone who works in this field knows the importance of building a relationship with the patient. That is not something that can be put into a controlled study, but is often critical for a successful rehabilitation,’ she said.

‘The guidelines should therefore be used as a template to design your service, but on a day to day basis, clinical reasoning and specialist skills remain absolutely essential.’

Stroke Association director of communications, Joe Korner, said acute stroke care had improved hugely in recent years, but this was not always the case for community care.

‘These guidelines set out what every stroke survivor should receive in the community and what they are entitled to,’ he said.

‘We are now calling on the new health system to adopt and implement these recommendations as soon as possible to ensure that every stroke survivor has the chance to make their best possible recovery.’

  • The first day of Physiotherapy UK 2013 will focus on how physiotherapists can implement these guidelines. Sandy Chambers, physiotherapist and member of the NICE guideline development group, will explain how the guidelines were developed and lead delegates through the most important recommendations. A member of the NICE implementation team will be on hand to talk through how guidelines can be implemented. Members of ACPIN can obtain 10% off tickets for the conference:

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