Treatment of urinary incontinence after stroke in adults

Thomas, Lois H; Cross, Stephen; Barrett, James; French, Beverley; Leathley, Michael J; Sutton, Chris J; Watkins, Caroline

doi:10.1002/14651858.cd004462.pub3

Cited by 90 publications

(81 citation statements)

References 28 publications

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“…At 1 year, 15% will remain incontinent of urine. 90 Age, cognition, and motor impairments are risk factors for bladder incontinence. Fecal incontinence prevalence is ≈40% acutely but diminishes to 20% by discharge from rehabilitation.…”

Section: Treatment Of Bowel and Bladder Incontinencementioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,068

840

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e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

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Section: Treatment Of Bowel and Bladder Incontinencementioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,068

840

View full text Add to dashboard Cite

show abstract

“…19 The cause of incontinence should be sought, eg pre-existing stress incontinence, urinary tract infection, immobility. Regular toileting can significantly reduce incontinence for patients with cognitive, communication or mobility problems.…”

Section: Bladder Bowels and Skinmentioning

confidence: 99%

Stroke unit care, inpatient rehabilitation and early supported discharge

Rodgers

Price

2017

Clinical Medicine

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Stroke units reduce death and disability through the provision of specialist multidisciplinary care for diagnosis, emergency treatments, normalisation of homeostasis, prevention of complications, rehabilitation and secondary prevention. All stroke patients can benefit from provision of high-quality basic medical care and some need high impact specific treatments, such as thrombolysis, that are often time dependent. A standard patient pathway should include assessment of neurological impairment, vascular risk factors, swallowing, fluid balance and nutrition, cognitive function, communication, mood disorders, continence, activities of daily living and rehabilitation goals. Good communication and shared decision making with patients and their families are key to high-quality stroke care. Patients with mild or moderate disability, who are medically stable, can continue rehabilitation at home with early supported discharge teams rather than needing a prolonged stay in hospital. National clinical guidelines and prospective audits are integral to monitoring and developing stroke services in the UK. Stroke unitsEach year 152,000 people in the UK have a stroke.1 Randomised controlled trials and subsequent meta-analyses have clearly shown that care in a multidisciplinary stroke unit reduces death, disability and the need for institutionalisation when compared with general medical wards.2 These benefits are seen regardless of the patient's age, gender, stroke type (ie infarct or haemorrhage) or stroke severity (Fig 1 ).2 Based on a number needed to treat of 18, stroke units prevent death or dependency for 8,400 stroke patients per year.3 All acute stroke patients should be treated on a stroke unit (a ward that cares almost exclusively for stroke patients) throughout their inpatient stay unless stroke is not their predominant medical problem. Recently, stroke services in many areas have been reorganised to improve the quality and efficiency of care.5 Hyperacute stroke units (HASUs) provide > rapid specialist assessment and diagnosis on the HASU or in the associated accident and emergency department > hyperacute treatment, eg thrombolysis > physiological and neurological monitoring > early rehabilitation.Stroke patients usually remain on a HASU for up to 72 hours and are then transferred to an acute stroke unit or stroke rehabilitation unit. Some stroke services have a comprehensive

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“…Incontinence after stroke is not always central in origin but may be the result of immobility and impaired ability to communicate. Although there is insufficient evidence regarding the treatment of incontinence after stroke, 207 general continence care includes early removal of indwelling catheters to…”

Section: Incontinencementioning

confidence: 99%

Palliative and End-of-Life Care in Stroke

Holloway¹,

Arnold²,

Creutzfeldt³

et al. 2014

Stroke

236

131

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Background and Purpose-The purpose of this statement is to delineate basic expectations regarding primary palliative care competencies and skills to be considered, learned, and practiced by providers and healthcare services across hospitals and community settings when caring for patients and families with stroke. Methods-Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were chosen to reflect the diversity and expertise of professional roles in delivering optimal palliative care. Writing group members were assigned topics relevant to their areas of expertise, reviewed the appropriate literature, and drafted manuscript content and recommendations in accordance with the American Heart Association's framework for defining classes and level of evidence and recommendations. Results-The palliative care needs of patients with serious or life-threatening stroke and their families are enormous: complex decision making, aligning treatment with goals, and symptom control. Primary palliative care should be available to all patients with serious or life-threatening stroke and their families throughout the entire course of illness. To optimally deliver primary palliative care, stroke systems of care and provider teams should (1) promote and practice patient-and family-centered care; (2) effectively estimate prognosis; (3) develop appropriate goals of care; (4) be familiar with the evidence for common stroke decisions with end-of-life implications; (5) assess and effectively manage emerging stroke symptoms; (6) possess experience with palliative treatments at the end of life; (7) assist with care coordination, including referral to a palliative care specialist or hospice if necessary; (8) provide the patient and family the opportunity for personal growth and make bereavement resources available if death is anticipated; and (9) actively participate in continuous quality improvement and research. Conclusions-Addressing the palliative care needs of patients and families throughout the course of illness can complement

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Treatment of urinary incontinence after stroke in adults

Cited by 90 publications

References 28 publications

Guidelines for Adult Stroke Rehabilitation and Recovery

Guidelines for Adult Stroke Rehabilitation and Recovery

Stroke unit care, inpatient rehabilitation and early supported discharge

Palliative and End-of-Life Care in Stroke

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