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Spasticity - The who, why, when and how

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Thursday November 15, 2018, 12:00 - 13:00 EST

Presented by:
Theodore Wein MD, FRCPC
Assistant Professor of Neurology and Neurosurgery, McGill University

About this presentation
Spasticity is a common post-stroke condition which can affect the muscles in arms, legs, hands and feet. With spasticity, muscles become stiffer and tight, with loss of voluntary movement, increased pain, and may become continuously contracted without treatment. This leads to a loss in range of motion which may impact the affected person's ability to perform activities of daily living, and may require additional caregiver support and effort. Spasticity often leads to frustration and slows recovery because it impacts active participation. Several factors need to be considered when assessing and managing people post stroke who exhibit signs of spasticity. Traditionally, spasticity is assessed and treated during rehabilitation several days after stroke onset. Current thinking is changing and assessment and treatment should occur earlier in the recovery process.

In this presentation, Dr Theodore Wein will review current literature and best practice on assessment and management of spasticity, including identification of patients who experience spasticity, how to assess them, when to treat them and how to treat them, as well as ongoing management.

Learning Objectives include:
Upon completion of this program participants will be able to:

  • Identify spasticity in the stroke population
  • Identify steps to complete the Canadian Neurological Scale.
  • Recognize that spasticity does occur in the acute setting
  • Discuss the importance of early detection and treatment

Please complete a brief evaluation for this training video, which will provide a certificate of participation.

Canadian Neurological Scale Training Video

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Presented by:
Rhonda McNicoll Whiteman, R.N. MN, CCC(c)
Stroke Best Practice Clinical Nurse Specialist – Central South Regional Stroke Network, Hamilton Health Sciences,
Part Time Assistant Clinical Professor, School of Nursing,
Faculty of Health Sciences, McMaster University, Hamilton, Ontario.
Member of Canadian Stroke Best Practice expert nursing group.

This training video is a part of the Canadian Stroke Best Practice Recommendations Acute Stroke Management module providing guidance and tools to stroke team members, clinicians, healthcare staff, hospital administrators and policymakers to advance and improve stroke services to achieve optimal inpatient stroke care delivery and patient outcomes in hospitals across Canada.

Learning Objectives include:

  • Review the background and evidence related to the Canadian Neurological Scale.
  • Identify steps to complete the Canadian Neurological Scale.
  • Apply the scoring of the Canadian Neurological Scale using Case Scenarios.
  • Describe the tools available to support staff in utilizing the Canadian Neurological Scale.

Please complete a brief evaluation for this training video, which will provide a certificate of participation.

Lives disrupted: The impact of stroke on women Highlights from Stroke Report 2018

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Presented by:
Dr. Patrice Lindsay
Director, Stroke
Heart and Stroke Foundation

Dr. Thalia Field
Assistant Professor
CSBPR Webinar Archive
CSBPR Last Updated June 7, 2018 Page 2 of 9
Faculty of Medicine, University of British Columbia
Stroke Neurologist and Fellowship Program Director
Vancouver Stroke Program.
Dr. Anita Mountain
Assistant Professor, Dalhousie University
Division of Physical Medicine and Rehabilitation
Medical Lead Acquired Brain Injury Program
Queen Elizabeth II Health Sciences Centre
Nova Scotia Rehabilitation Centre Site

Overview
This webinar discusses the highlights from Stroke Report 2018 - Lives disrupted: The impact of stroke on women. To access the full report click here.

Please complete a brief evaluation for this session.

Resumption of life roles and activities following stroke webinar - Driving rehabilitation

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Presented by:
Michael Cammarata OT, Ph.D. student Nellemarie Hyde, OT, CDRS, Saint Elizabeth Health Care

Brief Description
The Heart & Stroke Canadian Stroke Best Practice Rehabilitation and Managing Transitions of Stroke Care Recommendations provide specific guidance for healthcare professionals on the recovery and resumption of life roles after stroke. Stroke survivors often experience motor, cognitive and psychosocial changes that impact their ability to resume pre stroke pursuits. Return to driving, return to work and vocational pursuits, sexual activity and leisure activities have each been cited as important rehabilitation goals for patients and evidence indicates that the resumption of these activities are associated with increased quality of life. During this webinar participants will learn more about the recommendations, research, and practical approaches for returning to driving.

Upon completion of this program participants will be able to:

  • Describe stroke best practice recommendations related to return to driving following a stroke from both the Canadian Stroke Best Practice Recommendations Rehabilitation and Managing Transitions of Stroke Care modules.
  • State issues related to provincial regulations regarding driving after stroke.
  • Discuss practical approaches to rehabilitation and recovery related to return to driving following stroke and access to driving assessments.

Please complete a brief evaluation for this session.

Resumption of life roles following stroke - Intimacy after stroke

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Presented by:
Shawna McCusker, RSW, MSW
Trauma and Bariatric Centre of Excellence
The Ottawa Hospital – Civic Campus
Tracy Palmer, RN, CRRN, BA SEXOLOGY
Ottawa Hospital Rehabilitation Centre

Brief Description
The Heart & Stroke Canadian Stroke Best Practice Rehabilitation and Managing Transitions of Stroke Care Recommendations provide specific guidance for healthcare professionals on the recovery and resumption of life roles after stroke. Stroke survivors often experience motor, cognitive and psychosocial changes that impact their ability to resume pre stroke pursuits. Return to driving, return to work and vocational pursuits, sexual activity and leisure activities have each been cited as important rehabilitation goals for patients and evidence indicates that the resumption of these activities are associated with increased quality of life. During this three part webinar series participants will learn more about the recommendations, research, and practical approaches for returning to driving, return to work and vocational pursuits, and sexual activity during recovery after stroke. Participants will hear directly from experts in these areas.

Learning objectives:

  • Describe the Canadian Stroke Best Practice Recommendations from the Rehabilitation and Managing Transitions of Stroke Care modules on sexuality.
  • Identify relevant issues around intimacy/sexuality with people who have experienced stroke and their partners.
  • Engage in meaningful discussions with people who have experienced stroke and their partners regarding intimacy sexual relationships.
  • Explain where to find more information about intimacy/sexuality, for knowledge, and to share with patients and families.

Please complete a brief evaluation for this session.

Incidence and secondary prevention of stroke during pregnancy

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Presented by:
Dr. Rick Swartz
Medical Director North East GTA Regional Stroke Program
Director, University of Toronto Stroke Program
Assistant Professor, Department of Medicine (Neurology),
University of Toronto

Dr. Noor Ladhani
Associate Scientist, Evaluative Clinical Sciences,
Women & Babies Research Program,
Sunnybrook Research Institute
Staff physician, maternal-fetal medicine,
Sunnybrook Health Sciences Centre
Assistant professor,
Department of Obstetrics and Gynaecology
University of Toronto

Overview
The Heart & Stroke Canadian Stroke Best Practice Consensus Statement: Secondary Stroke Prevention during Pregnancy provides the first broad-based, stroke-specific guidance around secondary stroke prevention in pregnancy. The first part of a two part series, this statement focuses on unique aspects of secondary stroke prevention in a woman with a prior history of stroke or transient ischemic attack who is, or is planning to become, pregnant. During this webinar participants will learn more about the current rates of stroke occurring in pregnancy, and secondary prevention of stroke management considerations and strategies during pregnancy as addressed in the consensus statement. Some highlights of the acute stroke management during pregnancy consensus statement will also be presented. Participants will hear directly from the writing group Chairs, and engage in a question and answer period with them.

Learning Objectives:
Participants of this program will be able to:

  • State the importance of an interdisciplinary team approach to management of stroke in pregnancy.
  • Describe counseling and risk factor screening considerations for a woman who has a history of stroke and is now pregnant or planning a pregnancy.
  • Develop a specifically-tailored management approach to secondary stroke prevention during pregnancy.
  • Discuss options for pharmacotherapy for antithrombotics and management of blood pressure.

Please complete a brief evaluation for this session.

Hot topics in secondary stroke prevention

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Presented by: Dr. Ted Wein
Assistant Professor of Neurology and Neurosurgery
McGill University Stroke Prevention Clinic
Montreal General Hospital

Overview
The Sixth Edition of the CSBPR Secondary Prevention of Stroke Guidelines have been published. Recent trial releases have impacted changes to the guidelines which include lipid management, diabetes and stroke, and patent foramen ovale (PFO) and stroke management. During this webinar the evidence and changes to the guidelines related to these topics will be discussed.

Learning Objectives include:
Participants of this program will be able to:

  • Explain lipid management and diabetes and stroke CSBPR guideline changes from recent clinical trial releases.
  • Describe the evidence from the Close and Reduce trial, discussing PFO management and stroke, and the revised recommendations due to the trial’s results.
  • Discuss challenges and approaches to secondary prevention of stroke in complex patients with multimorbidities.
  • Engage participants in the webinar through a question and answer session at the end of the presentation.

Please complete a brief evaluation for this session.

Stroke report 2017: Triumphs and challenges after stroke – helping patients and families to Keep moving forward

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Presented by Dr. Patrice Lindsay, Dr. Jill Cameron, and Heather Purvis

Overview
This webinar will discuss the key messages from the Heart and Stroke 2017 Stroke Report.

Learning objectives include:

  • Compare the common and unique needs of people who experience stroke at different ages across the lifespan.
  • Describe the core areas of support needed by people impacted by stroke.
  • Discuss the healthcare professional’s role and strategies in supporting people impacted by stroke.
  • Discuss current service availability and solutions to gaps in service for people impacted by stroke.

Please complete a brief evaluation for this session.

Learning to mobilize your community after stroke

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Presented by Dr. Patrice Lindsay, Dr. Maureen Markle-Reid, Rebecca Fleck OT Reg. (Ont.), and Luis Rivas

Overview
This webinar will provide people who have experienced a stroke and care partners with information about how to be engaged in their recovery including concepts related to self-management, and how to manage transitions to the community including accessing resources to improve and support recovery once they have left the hospital.

Learning objectives include:
Participants of this program will be able to:

  • Understand their role in their own recovery and that of the family caregiver
  • Understand the concept of self-management, and identify self-management strategies.
  • Transition from hospital to community. Navigate and identify resources and supports available in their community.
  • Access resources available from the Heart and Stroke Foundation.

Please complete a brief evaluation for this session.

CSBPR: Palliative and end of life care for stroke patients

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Presented by Dr. Jeff Myers MSEd, CCFP(PC), and Julie Wilding OT

Overview
This webinar will provide Canadian Stroke Best Practice Recommendations information on palliative and end of life care. At the end of this webinar participants will be able to:

  • Define palliative and end of life care
  • Discuss the Canadian Stroke Best Practice Recommendations for palliative and end of life care.
  • Describe the different roles interprofessional team members play, along with their knowledge and skills, in the management of palliative and end of life care situations.
  • Identify strategies to work with patients and families who are dealing with palliative and end of life care.

Please complete a brief evaluation for this session.

Improve your compliance with stroke best practice across settings and professions: Practical methods for reducing language barriers for patients with aphasia

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Presented by Aura Kagan

Overview
You are a busy stroke care provider/researcher/educator – why add aphasia and communication to the mix? This webinar will cover the following:

  • Thinking differently about aphasia and why this is relevant to most aspects of stroke recovery and stroke education from Day One
  • The benefits and impact of reducing language barriers to Best Practice in stroke care
  • Practical, evidence-based methods and resources to reduce language barriers and increase communicative access - with video illustration
  • A new free online tool (Communicative Access Measure for Stroke – CAMS) that can be used for quality improvement in hospitals and other settings
  • Suggested first steps for individuals and/or organizations

Please complete a brief evaluation for this session.

Integration and application of telestroke across the continuum

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Presented by Dr. Dylan Blacquiere and Dr. Gail Eskes

Overview
This webinar will discuss updates to the Canadian Stroke Best Practice Recommendations, Telestroke module; practical advice and tips on providing telestroke services; and lessons learned from a cognitive deficit telerehabilitation research project.

Please complete a brief evaluation for this session

Canadian stoke best practice recommendations secondary prevention webinar

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Presented by Dr. Patrice Lindsay and Dr. Ashkan Shoamanesh on November 17, 2016

Overview:

  • Dr. Patrice Lindsay discusses the core elements of stroke prevention services and application across Canada, along with strategies to use to increase access, including Geoinformatics to support decision-making.
  • Dr. Ashkan Shoamanesh provides new updates to secondary stroke prevention best practices for intracerebral hemorrhage.

Please complete a brief evaluation for this session

Stroke Report 2016: the stroke and dementia connection

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Presented by Dr. Eric Smith and Dr. Patrice Lindsay on June 9, 2016

Overview:

  • Dr. Patrice Lindsay discusses The Heart and Stroke Foundation’s Stroke Report. The focus of the report is the relationship between stroke and vascular dementia; preventing stroke will help prevent dementia.
  • Dr. Eric Smith’s presents trials of treatments for patients with VCI (Vascular Cognitive Impairment). The link between stroke and dementia is stronger than we think.
    • PURE-MIND study.
    • Canadian Alliance for Healthy Hearts and Minds.
    • Treating Symptomatic VCI. Systematic Review by the Canadian Consortium on Neurodegeneration and Aging Vascular Team.

Please complete a brief evaluation for this session.

Emerging practices in stroke rehabilitation: Are they ready for prime time?

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Presented by Dr. Robert Teasell and Debbie Hebert on May 19, 2016

Overview:

  • Optimizing outpatient and community rehabilitation, including Early Supported Discharge
  • What is the new evidence for management of impairment in the lower and upper limb?
  • What’s new in the assessment and management of dysphagia?
  • What implications could the results of the AVERT trial have on rehabilitation practices?
  • An overview of the integration of pediatric recommendations into the CSBPR

Please complete a brief evaluation for this session.

Turning best practice into the practical: Post-stroke depression

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Presented by Dr. Elizabeth Gilchrist on March 10, 2016

Overview:

  • Understand post-stroke depression (PSD)
  • Learn how to best screen for PSD
  • Learn how PSD is treated once identified
  • A Case Study of Best Practice into the Practical

Please complete a brief evaluation for this session

Practical Approaches for Taking Action for Optimal Community and Long-Term Stroke Care (TACLS)

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Presented by Patrice Lindsay, Margo Collver and Trudy Taylor on December 14, 2016

Objectives:

  • Development of ‘Taking Action in Long-Term Stroke Care: A Resource for Healthcare Providers’ (TACLS)
  • Organization of stroke care in the community
  • The team approach to community stroke care
  • Practical solutions to challenges in community stroke care:
    • Communication
    • Positioning, Transfers and Mobility
    • Vision, visual perception, and neglect
    • Promoting ongoing rehabilitation and recovery

Please complete a brief evaluation for this session

Acute inpatient stroke care: an update on the evidence

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Presented by Dawn Tymianski and Melanie Penn on December 10, 2015

Objectives:

  • Describe care for the stroke patient after endovascular therapy
  • Review best practices for care of the patient with intracerebral hemorrhage
  • Identify care of the patient post-hemicraniectomy
  • Explain DVT prophylaxis in the hemorrhagic stroke patient
  • Identify the goal of acute inpatient stroke care within the stroke care continuum
  • Review the components of acute inpatient stroke care based on the Canadian Stroke Best Practice Recommendations
  • Identify what is NEW with the 2015 Update
  • Focus on assessment and new evidence in cardiovascular investigations, DVT prophylaxis and early mobilization

Please complete a brief evaluation for this session

Vascular cognitive assessment: When, where and how?

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Presented by Dr. Gail Eskes on November 12, 2015

Learning Objectives:

  • To understand the concept of Vascular Cognitive Impairment (VCI)
  • To be aware of the Best Practice Recommendations for cognitive screening in VCI
  • To become familiar with the practical aspects of cognitive assessment: the Montreal Cognitive Assessment (MoCA) test
  • Supplementary information: Montreal Cognitive Assessment Demonstration Video

Please complete a brief evaluation for this session.

Stroke Resources