The Canadian Stroke Best Practice Recommendations 7 ^th edition update of the Rehabilitation, Recovery and Community Participation module is presented in three parts. This publication, Part One of the series, reflects the growing and changing body of research evidence available to guide planning, ongoing screening and assessment, management, education, and support of individuals with stroke, their families, and caregivers. This module provides guidance for the planning and delivery of coordinated and seamless systems of care from acute stroke onset to return to community settings by an interdisciplinary team of healthcare providers with expertise in stroke. These recommendations were developed with active involvement of people with lived experience of stroke at all phases. These recommendations are intended to support the progress achieved during the initial recovery stages and enable individuals with stroke to resume life roles and leisure activities as best as possible, to achieve optimal recovery goals. Evidence for effective rehabilitation therapies and support for individuals with stroke and their families continues to emerge and gaps in knowledge should drive future research.

Introduction: Telerehabilitation (TR) is a promising method for facilitating the delivery and access to post-stroke rehabilitation services. Objective: The aim of this study was to explore the acceptability of TR and factors influencing its adoption by individuals with stroke and caregivers. Methods: A qualitative descriptive approach was used. Six individuals with stroke and three caregivers participated in individual online interviews. An abductive thematic analysis was employed to analyze the qualitative data, using the Unified Theory of Acceptance and Use of Technology 2 (UTAUT-2) model. Results: Participants reported positive experiences with TR, resulting in improvements in functional abilities, such as manual dexterity, balance, and positive interactions with therapists. They found the technology easy to learn and use, facilitating engagement in TR. Participants’ prior experiences with technology, along with support from caregivers and therapists, facilitated acceptance and the use of TR. The COVID-19 pandemic also motivated participants to accept TR. However, technical issues, unstable internet connections, and lack of feedback were barriers to the use of TR. Conclusion: Despite existing obstacles, TR can be used to provide rehabilitation services for individuals with stroke. Addressing these barriers is necessary to promote the widespread and effective use of TR in the context of stroke recovery.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).

Background: Although sexuality can be affected post-stroke, few individuals receive sexual rehabilitation because of clinicians’ lack of knowledge regarding evidence-based interventions. Objective: To document and describe the best available evidence supporting interventions that target post-stroke rehabilitation of sexuality. Methods: This systematic review searched the databases Medline, Embase, Psycinfo, CINAHL, Web of science, PEDRO and OTSeeker up to 29 May 2020. Inclusion criteria were: published studies with a sample composed of ≥ 50% stroke clients and describing an intervention that could be applied by an allied health professional. Data was extracted according to the PRISMA guidelines by two independent reviewers. Interventions were described according to the Template for intervention description and replication checklist. Results: Among the 2446 articles reviewed, 8 met the inclusion criteria. Two randomized controlled trials (RCT) and one non-RCT showed improvement in sexual functioning and satisfaction following a 30–45-minute structured rehabilitation program. Two other RCT showed significant improvement in sexual functioning with physical therapy oriented toward 1) structured physical and verbal sexual counseling and 2) pelvic floor muscle training. Three studies showed that interdisciplinary sexual rehabilitation improved satisfaction and sexual functioning; implementation of an interview script for clinicians improved the proportion of clients who addressed sexuality from 0 to 80% in 10 months; and two-day couple retreats improved perceived intimacy between couples. Conclusions: This review highlights promising interventions that could orient future research and improve the access to sexual rehabilitation services for post-stroke, with structured sexual rehabilitation and pelvic floor muscle training being the most strongly supported.