Stroke Rehabilitation: Synopsis of the 2024 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines

作者：Blessen C. Eapen, Johanna Tran, Jennifer Ballard‐Hernandez, Andrew Buelt, Carrie W. Hoppes, Christine Matthews, Svetlana Pundik, James Reston, Zahari Tchopev, Lisa Wayman, Tyler Koehn · 发表于：Annals of Internal Medicine · 年份：2025 · DOI：10.7326/annals-24-02205 · 被引用次数：28 · 研究领域：Stroke Rehabilitation and Recovery、Botulinum Toxin and Related Neurological Disorders、Dysphagia Assessment and Management

DESCRIPTION: In July 2024, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DOD) released a joint update of their 2019 clinical practice guideline (CPG) for the management of stroke rehabilitation. This synopsis is a condensed version of the 2024 CPG, highlighting the key aspects of the guideline development process and describing the major recommendations. METHODS: The VA/DOD Evidence-Based Practice Work Group convened a joint VA/DOD guideline development work group (WG) that included clinical stakeholders and conformed to the Institute of Medicine's tenets for trustworthy CPGs. The guideline WG conducted a patient focus group, developed key questions, and systematically searched and evaluated the literature (English-language publications from 1 July 2018 to 2 May 2023). The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was used to evaluate the evidence. The WG developed 47 recommendations along with algorithms for stroke rehabilitation in the inpatient and outpatient settings. Stakeholders outside the WG reviewed the CPG before approval by the VA/DOD Evidence-Based Practice Work Group. RECOMMENDATIONS: This synopsis summarizes where evidence is strongest to support guidelines in crucial areas relevant to primary care physicians: transition to community (case management, psychosocial or behavioral interventions); motor therapy (task-specific practice, mirror therapy, rhythmic auditory stimulation, electrical stim...