The Subacute Rehabilitation of Childhood Stroke

The Subacute Rehabilitation of Childhood Stroke

CLINICAL GUIDELINE 2019

Victorian Subacute Childhood Stroke Advisory Committee

The guideline for the subacute management of childhood stroke has been developed with:

Funded by: Endorsed by:

Suggested citation: Victorian Subacute Childhood Stroke Advisory Committee. Guideline for the subacute management of childhood stroke--2019.

Copyright information: The cover image of the child may not be used or reproduced in any manner without the express written consent of the Murdoch Children's Research Institute.

Disclaimer: This document has been produced by the Murdoch Children's Research Institute for use by health professionals. The statements and recommendations are evidence-based unless labelled as consensus based. Recommendations are not to replace clinical judgement. Interpretation of this document by those without appropriate medical and/or clinical training is not recommended, unless in consultation with a relevant health professional. Despite the utmost care taken in developing this document the Murdoch Children's Research Institute cannot accept any liability, including loss or damage resulting from use of content, or for its accuracy, currency and completeness.

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CONTENTS

1. Quick reference guide

6

2. Introduction

7

3. Methodology

8

4. Framework for providing rehabilitation

10

5. Motor function

13

6. Sensory function

14

7. Pain management

15

8. Dysphagia and nutrition

16

9. Communication, speech and language function

17

10. Cognition

18

11. Psychosocial, emotional and behavioral function

20

12. Activities of daily living

21

13. Participation in recreation and leisure

22

14. Education, learning and vocation

23

15. Family function

25

16. Future research directions

26

17. References

27

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ACKNOWLEDGEMENTS

Funding

The Victorian Subacute Childhood Stroke Advisory Committee gratefully acknowledges the generous contributions of the Victorian Stroke Clinical Network, The Department of Health and Human Services, Victorian State Government, and the Murdoch Children's Research Institute.

Victorian Subacute Childhood Stroke Advisory Committee

Sincere thanks to all members of the steering committee, clinical advisory group, and expert Delphi panelists for their invaluable input to the development of this guideline.

Steering Committee

A/Prof Mark Mackay (Chair) MBBS PhD Dr Sarah Knight PhD A/Prof Adam Scheinberg MBBS MMed Prof Vicki Anderson PhD A/Prof Michael Fahey MBBS PhD Dr Jillian Rodda PhD

Project Coordinator

Dr Mardee Greenham PhD

Clinical Advisory Group

Dr Kathleen Bakker

Clinical Neuropsychologist The Royal Children's Hospital, Melbourne

Ms Janeen Bower

Music Therapist The Royal Children's Hospital, Melbourne

Ms Kim Cartwright

Education Consultant The Royal Children's Hospital, Melbourne

Ms Catherine Clancy

Physiotherapist Monash Children's

Dr Therese Clark

Clinical Neuropsychologist Barwon Health

Dr Ali Crichton

Clinical Neuropsychologist Monash Children's

Ms Anne Fulton

Speech Pathologist Goulburn Valley Health

Ms Jane Galvin

Occupational Therapist The Royal Children's Hospital, Melbourne

Dr Sue Greaves

Occupational Therapist The Royal Children's Hospital, Melbourne

Dr Lyndal Hickey

Social Worker The Royal Children's Hospital, Melbourne

Dr Brian Hoare

Occupational Therapist Monash Children's

Dr Emily Incledon

Clinical Psychologist The Royal Children's Hospital, Melbourne

Prof Angela Morgan

Speech Pathologist Murdoch Children's Research Institute

Mrs Kathryn Newton

Occupational Therapist Eastern Health

Ms Chloe Noble

Occupational Therapist The Royal Children's Hospital, Melbourne

Miss Clare O'Donnell

Physiotherapist The Royal Children's Hospital, Melbourne

Ms Jillian Steadall

Speech Therapist The Royal Children's Hospital, Melbourne

Dr Jayasri Srinivasan

Paediatric Rehabilitation Consultant and Paediatric Neurologist The Royal Children's Hospital, Melbourne

Ms Renata Winkler

Speech Therapist Eastern Health

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Delphi panelists

Vicki Anderson, Kath Bakker, Ella Barry, Sally Bletcher, Sanjay Bhate, Janeen Bower, Sarah Burney, Frances Burns, Jo Butchart, Michelle Buttler, Di Cameron, Kim Cartwright, Rachael Cavanagh, Catherine Clancy, Therese Clark, Ali Crichton, Alana Cummins, Mahek Dudhwala, Suzanne Edelmaier, Adrienne Epps, Michael Fahey, Allesha Fecondo, Michelle Fisher, Rob Forsyth, Adrienne Fosang, Anne Fulton, Jane Galvin, Vigeya Ganesan, Karen Garthwaite, Anne Gordon, Sue Greaves, Fay Guyatt, Chatwell Hababa, Monika Hasnat, Michele Hervatin, Lyndal Hickey, Brian Hoare, Deb Houston, Kate Hunter, Emily Incledon, Jacqueline Irlam, Helen Jeges, Renee Jenkins, Sonia McCall White, Angela Morgan, Tamara Moritz, Angie Morrow, Melissa Murphy, Emma Naughtin, Kathryn Newton, Chloe Noble, Jennifer Papoutsis, Barry Rawicki, Jill Rodda, Kirrily Rogers, Rita Rosa, Maree Ryan, Adam Scheinberg, Emily Schofield, Jen Sharp, Heather Sheridan, Suzie Smith, Karen Speedy, Tanja Spencer, Jayarsi Srinivasan, Jill Steadall, Michael Takagi, Wendy Taverna, Abby Thevarajah, Kelly Thompson, Lauren Thompson-Glennen, Claire Toolis, Rachel Toovey, Melanie Tozer, Joannah Tozer, Sue Tupper, Stephen Wainrib, Natalie Weekley, Kirsten Wilken, Fiona Wilkinson, Teresa Williams, Neil Wimalasundera, Renata Winkler, Felicity Wood, Bianca Worboyes, Meredith Wynter, Suzy Young.

Only names of those who consented for their names to be acknowledged in publications are printed here.

We would also like to acknowledge the guidance provided by Tanya Medley in the development of the methodology for this guideline.

Abbreviations

AIS

Arterial ischaemic stroke

CBR

Consensus-based recommendation

EBR

Evidence-based recommendation

GDC

Guideline Development Committee

mCIMT Modified constraint induced movement therapy

NHMRC National Health and Medical Research Council

PSD

Program for Students with Disabilities

PNF

Proprioceptive Neuromuscular Facilitation

rTMS Repetitive transcranial magnetic stimulation

SCD

Sickle cell disease

VPRS Victorian Paediatric Rehabilitation Service

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