(Australian) Clinical Guidelines for Stroke Management - Chapter 6 of 8: Managing complications

Published by Stroke Foundation on Jun 7, 2021

Disclaimer

These Clinical Guidelines are a general guide to appropriate practice, to be followed subject to the clinician’s judgment and the patient’s preference in each individual case. The Clinical Guideline is designed to provide information to assist decision-making and are based on the best evidence available at the time of development. The Clinical Guidelines can be viewed at www.informme.org.au - Citation: Stroke Foundation. Clinical Guidelines for Stroke Management. Melbourne Australia. © No part of this publication can be reproduced by any process without permission from the Stroke Foundation. November 2020.

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The Stroke Foundation gratefully acknowledges the financial assistance provided by the Australian Government, Medical Research Future Fund. The development of the final recommendations has not been influenced by the views or interests of the funding body.

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Abstract

This is the sixth in a series of eight guideline chapters that provide evidence-based recommendations for recovery from stroke and TIA in adults.

Language

en

PICOS

PICO 1.1

Population
Stroke patients with urinary incontinence
Intervention
Behavioural intervention
Comparator
Control
Outcomes

PICO 1.1

Population
Adults with acute stroke
Intervention
Colloid parenteral fluids
Comparator
Crystalloid parenteral fluids
Outcomes

PICO 1.1

Population
Adults with stroke
Intervention
Shoulder strapping
Comparator
No strapping
Outcomes

PICO 1.1

Population
Adults with central post-stroke pain
Intervention
Anticonvulsants
Comparator
Placebo
Outcomes

PICO 1.2

Population
Adults with acute stroke
Intervention
Parenteral fluid of 0.9% saline
Comparator
Other parenteral fluid
Outcomes

PICO 1.2

Population
Stroke patients with urinary incontinence
Intervention
Specialised professional input
Comparator
Control
Outcomes

PICO 1.2

Population
Adults with stroke
Intervention
Electrical stimulation
Comparator
Conventional therapy
Outcomes

PICO 1.2

Population
Adults with central post-stroke pain
Intervention
Tricyclic antidepressants
Comparator
Placebo
Outcomes

PICO 1.3

Population
Stroke patients with urinary incontinence
Intervention
Transcutaneous electrical nerve stimulation
Comparator
Control
Outcomes

PICO 1.3

Population
Adults with stroke with severe paresis of arm
Intervention
Combined arm stretch positioning and neuromuscular electrical stimulation
Comparator
Conventional treatment
Outcomes

PICO 1.3

Population
Adults with central post-stroke pain
Intervention
Opioid antagonists
Comparator
Placebo
Outcomes

PICO 1.4

Population
Adults with stroke with shoulder pain
Intervention
Acupuncture
Comparator
Control
Outcomes

PICO 1.4

Population
Adults with overactive bladder syndrome
Intervention
Anticholinergic drugs
Comparator
Placebo
Outcomes

PICO 1.4

Population
Adults with central post-stroke pain
Intervention
Brain or spinal cord stimulation
Comparator
Sham
Outcomes

PICO 1.5

Population
Adults with stroke with shoulder pain
Intervention
Botulinum toxin injection by any route
Comparator
Placebo injection
Outcomes

PICO 1.5

Population
Adults with suspected urinary incontinence
Intervention
Diagnostic assessment of urinary incontinence
Comparator
Multichannel urodynamics
Outcomes

PICO 1.5

Population
Adults with central post-stroke pain
Intervention
Acupuncture
Comparator
Sham
Outcomes

PICO 1.6

Population
Adults with stroke with shoulder pain
Intervention
Peripheral nerve stimulation with single implantable lead
Comparator
Usual care
Outcomes

PICO 1.7

Population
Adults with stroke with shoulder pain
Intervention
Segmental neuromyotherapy combined with standard hospital therapy
Comparator
Standard hospital therapy
Outcomes

PICO 1.8

Population
Adults with stroke with shoulder pain
Intervention
Suprascapular nerve block
Comparator
Placebo injection
Outcomes

PICO 1.9

Population
Adults with stroke with shoulder pain and with diagnosed rotator cuff syndrome (clinically and by ultrasound)
Intervention
Subacromial corticosteroid injection
Comparator
Placebo (lidocaine) injection
Outcomes

PICO 2.1

Population
Adults with stroke with emotionalism
Intervention
Pharmacotherapy
Comparator
Placebo
Outcomes

PICO 2.1

Population
Adults with stroke ,
Intervention
Percutaneous endoscopic gastrostomy feeding ,
Comparator
Nasogastric tube feeding ,
Outcomes
,

PICO 2.1

Population
Stroke patients with constipation
Intervention
Daikenchuto
Comparator
Conventional therapy
Outcomes

PICO 2.2

Population
Adults with stroke
Intervention
Continuous pump feeding
Comparator
Intermittent bolus feeding
Outcomes

PICO 2.2

Population
Stroke patients with constipation
Intervention
Daily digital stimulation
Comparator
Digital stimulation every other day
Outcomes

PICO 2.3

Population
Adults with stroke
Intervention
Nutrition support
Comparator
No nutrition support
Outcomes

PICO 2.3

Population
Stroke patients with constipation
Intervention
Morning bowel evacuation
Comparator
Evening schedule of bowel evacuation
Outcomes

PICO 2.4

Population
Adults with stroke receiving tube feeding
Intervention
Diabetes specific enteral formula
Comparator
Usual enteral formula
Outcomes

PICO 2.4

Population
Stroke patients with constipation
Intervention
Nurse-led intervention
Comparator
Routine care
Outcomes

PICO 2.5

Population
Stroke patients with constipation
Intervention
Transcutaneous electrical acustimulation
Comparator
Sham treatment
Outcomes

PICO 3.1

Population
Adults with stroke
Intervention
Pharmacotherapy for the prevention of depression
Comparator
Placebo
Outcomes

PICO 3.2

Population
Adults with stroke without depression
Intervention
Psychological therapy
Comparator
Control or attention control
Outcomes

PICO 4.1

Population
Adults with stroke with depression
Intervention
pharmacological interventions
Comparator
Placebo
Outcomes

PICO 4.2

Population
Adults with stroke with depression
Intervention
Psychological therapy
Comparator
Usual care / attention control
Outcomes

PICO 4.3

Population
Adults with stroke with depression
Intervention
Non-invasive brain stimulation
Comparator
Sham stimulation or usual care
Outcomes

PICO 4.4

Population
Adults with stroke
Intervention
Structured exercise
Comparator
Control
Outcomes

PICO 4.5

Population
Adults with stroke with depression
Intervention
Wuling capsule
Comparator
No treatment
Outcomes

PICO 4.6

Population
Adults with stroke with depression
Intervention
Acupuncture therapy
Comparator
Control
Outcomes

PICO 4.7

Population
Adults with stroke with depression
Intervention
Hyperbaric oxygen therapy
Comparator
Control
Outcomes

PICO 5.1

Population
Adults with stroke with anxiety
Intervention
Pharmacological interventions
Comparator
No control group
Outcomes

PICO 5.2

Population
Adults with stroke
Intervention
Yoga
Comparator
Control
Outcomes

PICO 6.1

Population
Adults with stroke
Intervention
Oral hygienic care intervention
Comparator
Standard care
Outcomes

PICO 7.1

Population
Adults with stroke with lower limb spasticity
Intervention
Botulinum Toxin A
Comparator
Control
Outcomes

PICO 7.2

Population
Adults with stroke with spasticity
Intervention
Acupuncture
Comparator
Control
Outcomes

PICO 7.3

Population
Adults with stroke with spasticity
Intervention
Neuromuscular electric stimulation
Comparator
Control
Outcomes

PICO 7.4

Population
Adults with stroke with spasticity
Intervention
Adjunct therapies to Botox
Comparator
Control
Outcomes

PICO 7.5

Population
Adults with stroke with spasticity
Intervention
Stretch
Comparator
Control
Outcomes

PICO 7.6

Population
Adults with stroke with spasticity
Intervention
Transcutaneuous Electrical Nerve Stimulation (TENS)
Comparator
Control
Outcomes

PICO 7.7

Population
Adults with stroke with upper limb activity
Intervention
Botulinum toxin type A plus adhesive taping
Comparator
Botulinum toxin type A plus stretching and splinting
Outcomes

PICO 7.8

Population
Adults with stroke with elbow flexor spasticity
Intervention
abobotulinumtoxinA 1000 U
Comparator
Placebo
Outcomes

PICO 7.9

Population
Adults with stroke with upper limb spasticity
Intervention
Botulinum Toxin A
Comparator
Control
Outcomes

PICO 8.1

Population
Adults with stroke
Intervention
Passive movements
Comparator
Usual care
Outcomes

PICO 8.2

Population
Adults with stroke
Intervention
Stretch plus usual care
Comparator
Usual care
Outcomes

PICO 9.1

Population
Adults with stroke
Intervention
Shoulder strapping
Comparator
No strapping
Outcomes

PICO 9.2

Population
Adults with stroke
Intervention
Shoulder orthosis / sling / support
Comparator
Conventional treatment
Outcomes

PICO 9.3

Population
Adults with stroke
Intervention
Combined arm stretch positioning and neuromuscular electrical stimulation
Comparator
Conventional treatment
Outcomes

PICO 9.4

Population
Adults with stroke
Intervention
Electrical stimulation
Comparator
Conventional therapy
Outcomes

PICO 11.1

Population
Adults with stroke ,
Intervention
Mixed interventions ,
Comparator
Usual care ,
Outcomes
,

PICO 11.2

Population
Adults with stroke
Intervention
Compression therapy
Comparator
Standard therapy
Outcomes

PICO 11.3

Population
Adults with stroke
Intervention
Passive mobilisation
Comparator
Control
Outcomes

PICO 11.4

Population
Adults with stroke with complex regional pain syndrome
Intervention
Heat therapy (various means)
Comparator
Usual care
Outcomes

PICO 11.5

Population
Adults with stroke with hand swelling ,
Intervention
Electrical stimulation ,
Comparator
Usual care ,
Outcomes
,

PICO 12.1

Population
Adults with stroke
Intervention
Interventions to treat fatigue
Comparator
Control
Outcomes

PICO 15.1

Population
Adult with ischaemic stroke
Intervention
Anticoagulation
Comparator
Control
Outcomes

PICO 15.2

Population
Adults with stroke
Intervention
Intermittent pneumatic compression
Comparator
Usual care
Outcomes

PICO 15.3

Population
Adults with stroke
Intervention
Graduated compression stockings
Comparator
Usual care
Outcomes

PICO 15.4

Population
Adults with ischaemic stroke
Intervention
Low Molecular Weight Heparin
Comparator
Unfractionated heparin
Outcomes

PICO 15.5

Population
Adults with haemorrhagic stroke
Intervention
Pharmacotherapy
Comparator
Usual care
Outcomes

PICO 16.1

Population
Adults with stroke
Intervention
Exercise
Comparator
Control
Outcomes

PICO 16.2

Population
Adults with stroke
Intervention
Single lens distance glasses
Comparator
Usual (multifocal) glasses
Outcomes

PICO 16.3

Population
Interventions for preventing falls in people after stroke
Intervention
Environment: social environment
Comparator
usual care
Outcomes

PICO 16.4

Population
Interventions for preventing falls in people after stroke
Intervention
Environment: servo-assistive rollator
Comparator
Outcomes

PICO 16.5

Population
Interventions for preventing falls in people after stroke
Intervention
Other interventions: tDCS
Comparator
Outcomes