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.

Stroke in young adults has a lifelong impact on activities of daily life, including driving, leisure, and community-based activities; social participation; and reduced productivity. The needs of young people with stroke (YPwS) are likely to vary across different countries, and the development of age-adapted information and interventions is therefore critical in addressing those needs. This study aims to (1) identify the unmet needs of people with stroke aged 18 to 55 years across countries with varied income levels and cultural backgrounds and (2) determine their preferred means to access knowledge and information about stroke in the young. This international needs analysis used a phenomenologic qualitative design to gain in-depth perspectives about the experiences of YPwS. Participants were recruited from 9 countries of varied socioeconomic status. We interviewed 44 participants with stroke (men: 22; women: 21; transman: 1; mean age: 44.2 ± 8.5 years) living in the community (range of time since stroke: 0.5-10 years). The semistructured interview focused on lived stroke experience, unmet needs, helpful strategies to meet individual needs, hopes, and dreams. The interview was recorded, conducted in the participants' native language, and transcribed verbatim. Data were analyzed using inductive thematic analysis. Four main themes emerged from the interviews: (1) heterogeneity of unmet needs specific to YPwS, (2) invisible disability, (3) lack of age-specific stroke information, and (4) call for accessible information resources available in different formats. The results highlighted the need to provide long-term and contextually tailored support to YPwS, aligned with their recovery goals and age-specific needs. Initiatives such as peer-support groups, self-management or peer-mentoring programs, information resources in various formats, and participation in research projects could help address the unique needs of this population. Our results emphasize the importance of raising awareness of stroke in the young and the unique challenges of this population. Future research could focus on the development of stroke care pathways specific to YPwS.

Purpose: The purpose of this systematic scoping review was to (1) identify combined somatosensory and motor training interventions for the upper limb and their training components, and (2) review the efficacy of the combined interventions. Methods: Participants were adults post-stroke with somatosensory and/or movement deficits in the upper limb. All studies with interventions combining somatosensory and motor training and targeting the affected upper limb were included. Outcome measures were assessments of somatosensory and/or motor impairment and upper limb function. Results: Ten studies (n = 219) were included, comprising three randomized controlled trials, two pre-post studies with non-randomized comparison groups, three single-case experimental studies, and two case reports. There was heterogeneity across studies with regards to intervention contents and dosage, participant characteristics, and outcome measures. The interventions included combinations of tactile stimulation/discrimination, proprioceptive stimulation/discrimination, haptic object discrimination/recognition, movement training, and functional training. Only one group study, a non-randomized controlled study with multiple active components and the largest dose of treatment, found significant improvements in fine motor and somatosensory measures. Some improvements were found in case studies. Conclusion: There was little consistency across ‘combined somatosensory and motor training’ interventions and few have been rigorously tested for efficacy across somatosensory, motor and functional outcomes.

Background and aims: Young people with stroke (YPwS) persistently experience challenges with disability, social reintegration, employment, and financial stability to provide for themselves and their families. The aims of this scoping review are to (1) identify and collate information resources for YPwS and evidence-based self-managements programs and (2) identify gaps in age-specific resources available for YPwS after traditional rehabilitation services have ended and/or who are returning to live in the community. Methods: We will include both qualitative and quantitative studies, including all study designs. Participants will be community-dwelling adults aged between 18 and 65 years with a clinical diagnosis of stroke. We will include information resources and evidence-based self-managements programs for YPwS. Search terms will include stroke, young people, and community dwelling. We will search electronic databases such as MEDLINE. The reference lists of included studies, systematic reviews, and stroke guidelines and stroke-specific websites will also be searched. We will also contact Stroke Support Organizations and international/national allied health professional organisations to gather information resources about YPwS. We will also conduct a comprehensive environmental scan of additional resources using the search engine Google. The titles, abstracts, full-text articles, and contents of the resources identified by the search will be assessed against the inclusion and exclusion criteria to identify potentially relevant resources. Results and conclusions: Existing resources and self-management programs will be collated and categorized according to the type of needs addressed such as physical, emotions, activities of daily living, information, relationships, and social needs as well as the key gaps identified.

The 7th edition update of the Rehabilitation, Recovery and Community Participation module is presented in three parts. Part Three of the series reflects the current research evidence focused on person-centered care, optimizing an individual’s return to their community and engaging in active and meaningful participation. Emphasis is placed on regular healthcare follow-up, maximizing secondary prevention strategies, assessment, diagnosis, and management of mood disorders and cognitive status, sleep health, and post-stroke fatigue. Personal issues that are important and meaningful to individuals with stroke are addressed, including returning to driving, vocational roles, relationships, sexuality, life roles, leisure, social participation, advance care planning, and palliative care. This module highlights the need for coordinated and seamless systems of care that extend beyond the first few months after stroke, building on progress achieved during the initial recovery, to support seamless longer-term recovery. The main goal of these recommendations is to help individuals with stroke achieve as much independence as possible in meaningful life roles and leisure activities. Successful planning across transitions requires integrated and coordinated people-centered efforts by all stroke team members and the broader community. Active engagement of the individual and family at all stages of planning and goal setting is essential.