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DOI: 10.1055/s-0045-1806924
A physiotherapy protocol* for stroke patients in acute hospital settings: expert consensus from the Brazilian early stroke rehabilitation task force
Abstract
The present protocol provides general recommendations based on the best evidence currently available for physiotherapists to use as a guide for the care of stroke patients during hospitalization. The Brazilian Early Stroke Rehabilitation Task Force, comprising physical therapy experts and researchers from different Brazilian states, was organized to develop this care protocol based on a bibliographical survey, including meta-analyses, systematic reviews, clinical trials, and other more recent and relevant scientific publications. Professionals working in stroke units were also included in the task force to ensure the practicality of the protocol in different contexts. This protocol provides guidance on assessment strategies, safety criteria for the mobilization of patients with stroke, recommendations for mobilization and proper positioning, as well as evidence-based practices for treatment during hospitalization, including preventive measures for shoulder pain and shoulder-hand syndrome. The protocol also provides information on the organization of the physiotherapy service at stroke units, guidelines for hospital discharge, and quality indicators for physiotherapy services. We have included detailed activities that can be performed during mobilization in the supplementary material, such as postural control training, sensory and perceptual stimulation, task-oriented training, and activities involving an enriched environment. The protocol was written in a user-friendly format to facilitate its application in different social and cultural contexts, utilizing resources readily available in most clinical settings.
Authors' Contributions
IM, GJL, JMAM, CFN, LAMB, EBP, FMK, RMS, PAPJ, JAOB: conceptualization, writing, review, editing, and validation of the original draft. CHCM, RB: conceptualization of the original draft and participation as reviewer. EMCR, CM, SOM: participation as reviewers. All authors reviewed and approved the final version of the manuscript.
Editor-in-Chief: Ayrton Roberto Massaro.
Associate Editor: Chien Hsin Fen.
*This protocol has been endorsed by the Brazilian Academy of Neurology and the Brazilian Association of Neurofunctional Physiotherapy.
Publication History
Received: 03 April 2024
Accepted: 03 February 2025
Article published online:
22 April 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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Iara Maso, Gustavo José Luvizutto, Jéssica Mariana de Aquino Miranda, Carla Ferreira do Nascimento, Luana Aparecida Miranda Bonome, Elen Beatriz Pinto, Fabiane Maria Klitzke, Ricardo Machado Souza, Carla Heloisa Cabral Moro, Rodrigo Bazan, Pedro Antonio Pereira de Jesus, Eduardo de Melo Carvalho Rocha, Cesar Minelli, Sheila Ouriques Martins, Jussara Almeida de Oliveira Baggio. A physiotherapy protocol* for stroke patients in acute hospital settings: expert consensus from the Brazilian early stroke rehabilitation task force. Arq Neuropsiquiatr 2025; 83: s00451806924.
DOI: 10.1055/s-0045-1806924