Canadian Stroke Best Practice Recommendations Rehabilitation, Recovery, and Community Participation Following Stroke, Part Three: Optimizing Activity and Community Participation Following Stroke , 7th Edition Update, 2025.
Jennifer K Yao, Nancy M Salbach, M Patrice Lindsay and 59 others
PMID 41258868WHAT IT FOUND
Stroke survivors need coordinated care for mood, fatigue, cognition, driving, work, leisure and community roles.
Guidelines recommend information, support and services after discharge.
Key findings
01Stroke survivors, families and caregivers should receive information, education, training, support and access to services during transitions to community to optimize return to life roles, activities and social participation.
02Post-stroke depression is reported in 24% of individuals versus 8% in the general population, and anxiety or apathy are reported in 20%-30% of people after stroke.
03A driving trial found no significant difference in on-road scores, and the RETAKE trial found early vocational rehabilitation in addition to usual care was not associated with improved odds of return to work.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a guideline update, not a primary trial, so it does not show that a named intervention worked in a specific patient. Driving interventions are described as not well studied, and return-to-work evidence is limited and inconclusive. Palliative and advance care planning evidence comes from mixed populations, not stroke-specific trials. Recommendations rely partly on expert consensus and lived-experience review. The update is current to March 2025 and is reviewed every three to 5 years.
Declared interests
The guideline development is funded entirely by Heart & Stroke. No commercial funds are used. Writing group members and external reviewers are volunteers and complete conflict-of-interest declarations.
The easy way to misread this
Do not read the guideline's recommendations as proof that every named intervention works. The driving and return-to-work trials cited had null or limited findings, so clinicians should still judge each patient's needs and available evidence.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →