Stroke Clinical Trial
Official title:
Development of a National, Evidence Based Protocol for Stroke Rehabilitation in a Multicenter Italian no Profit Institution: Implementation and Results of a Pilot Study
Due to the importance to use standardized shared protocols in the rehabilitative setting of cerebrovascular diseases, an harmonization and redefinition of the Don Carlo Gnocchi Foundation rehabilitative model was carried out. Such process was in line with the Evidence Based approach of Cochrane Rehabilitation.
Despite progress in the treatment of cerebrovascular diseases in the acute phase, stroke
remains a catastrophic event with important public health consequences. According to the most
recent ASA/AHA guidelines, a specific and intensive rehabilitation is recommended in patients
with neurological impairments after stroke in the postacute phase.
In this regard, the use of standardized shared evaluation protocols, developed according to
the ICF model is strongly recommended to evaluate the effectiveness of rehabilitative
treatments on large populations of stroke patients affected and, possibly, to allow the
identification of biomarkers, identifiable in the acute phase and in the immediate post-acute
period, to predict prognosis and to orient rehabilitation care.
The Don Carlo Gnocchi Foundation ONLUS is one of the most important health groups in Italy,
with over 3,700 beds and 28 Centers, active in 9 Italian regions (Northern, Central and
Southern Italy). The don Gnocchi Rehabilitation Hospitals are accredited by the different
Regional Health Services all over Italy.
During 2016 and based on 60 years of experience, an harmonization and redefinition of the
Foundation rehabilitative model was carried out. Such process was in line with the Evidence
Based approach of Cochrane Rehabilitation.
The Medical Committee was the first step for the national identification of a group of health
professionals which includes, in addition to MD specialists, all health professions involved
in Interdisciplinary Rehabilitation Team.
The first objective was to develop consensus over national Rehabilitation protocols for the
most prevalent conditions addressed to in our Rehabilitation Hospitals. Given the prevalence
of neurological rehabilitation treatments and in particular Stroke, the Medical Direction
appointed a group of 6 Specialists, who entrusted the task of developing a Stroke
rehabilitation don Gnocchi Protocol.
The study describes the method and the criteria used in the development of the protocol, the
steps followed in its implementation in two Don Gnocchi Foundation Pilot Hospitals, and the
preliminary results of the pilot study, limited to the treatment of intensive post-acute
inpatient rehabilitation, with the objective of verifying the feasibility of the protocol and
comparing the outcomes for stroke inpatient rehabilitation with those of the 3 years prior to
implementation.
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