Northeastern Ontario Stroke Network has created a number of stroke resources to assist you in your practice. For any of these resources below, email us to obtain more information or to request the documents.
GRASP – Graded Repetitive Arm Supplementary Program
The Graded Repetitive Arm Supplementary Program (GRASP) was developed by Dr. Janice Eng and her team at the University of British Columbia and GF Strong Rehab Centre in Vancouver, Canada. It is an evidence-based program to improve upper extremity post-stroke, and has been successfully used for in-patient, as well as chronic populations. It is currently recommended as a method to improve hand and arm function in the Canadian Stroke Best Practice Recommendations. It is used in thousands of sites in over 50 countries.
Modifications of GRASP have been developed and evaluated to deliver it 1:1, in-person, in groups, by phone and by Zoom videoconferencing. The archived webinar can be found on our youtube channel.
As well, we have put together a document to assist with finding materials for the grasp kit. Please email us at strokeprogram@hsnsudbury.ca and ask for the GRASP Toolkit Items Needed document. A French version of this document is available upon request.
Webinar: Enhancing your Tool Box for Best Practice Stroke Care
More information coming soon.
Video Series: Self-management tools and resources for people recovering from stroke
An 11-episode series of free videos, exploring issues such as physical, cognitive and psychological challenges people recovering from stroke may face and aims to provide tools and resources to help.
The series delivers short sessions (most are about 10 minutes in length) on topics including memory, anxiety, fatigue, attention, stress, unilateral spatial neglect, upper extremity movement, organization and planning, resilience, leisure and functional communication.
Access the Video Series (link opens in a new widnow).
Stroke Core Competency Framework
There is Level A Evidence that Stroke Unit care reduces the likelihood of death and disability by as much as 30% for men and women of any age with mild, moderate, or severe stroke. One of the key components of Stroke Unit Care is that the core interprofessional team should consist of healthcare professional with stroke expertise. Furthermore, Quality Based Procedures for Stroke recommend that interprofessional stroke teams across the continuum receive education and training to promote stroke expertise.
The purpose of the Core Competencies Framework is to provide health care professionals working in stroke with a clear, comprehensive way to achieve the core competencies needed for evidence-based stroke care.
How to use the Stroke Core Competency Framework:
- Rate yourself on your level of expertise using Benner Stages of Clinical Competence
- Identify areas for improvement and develop professional learning plans.
- Seek professional development opportunities to fulfill professional learning plans.
- Leadership may use learning plans to support professional development reviews.
- Leadership may collate results to inform organizational priorities for stroke care that can be integrated into strategic planning.
**Steps 4 and 5 require organizational support and collaboration
Please visit the Stroke Core Competency Framework page (link opens in new window) on the CorHelath Ontario website.
Range of Motion Exercise Packages
Range of motion exercise packages have been created by the Northeastern Ontario Stroke Network which were designed to be used by a client's family/caregiver/support worker to assist in properly carrying out passive, or self-ranging, range of motion exercises with a client.
It is the intent of the authors that a regulated health professional will select the most appropriate exercises from these packages and provide them to their client. You will notice that there are separate packages for both the right and left side.
We feel it is imperative that the second page of the package entitled 'Before Getting Started...' be provided with every package handed out, whether only one or multiple exercises are being prescribed, therefore please ensure you do so.
Each package provides key points about the importance of exercise, general proper positioning tips and then specifics of each individual exercise. One exercise is provided per page, text provides the details of the positioning of the person with stroke, the hand positioning of the helper, the movement, the length of time to hold the position and the number of repetitions. Photos are also provided of the starting position and the movement involved.
Passive Range of Motion Exercises (to be performed by a care provider):
Self-Ranging Exercises (to be performed by the client themselves):
French versions of these documents are available upon request.
Self-Learning Program: Stroke Unit Orientation
Acute Stroke Unit Orientation: Created and maintained by the Southwestern Ontario Stroke Network, this is a free, online program for stroke care professionals working in acute care. It is a self-directed learning program with 11 modules, plus supplementary content and quizzes, covering a variety of topics, including NIHSS. Pages can be printed to create a hard copy binder if desired.
Acute Stroke Unit Orientation - Self Learning Program (link opens in a new window)
Stroke Rehabilitation Unit Orientation: Created and maintained by the Southwestern Ontario Stroke Network, this is a free, online program for stroke care professionals working in rehabilitation. The orientation consists of 12 modules that can be completed in any order and are arranged as separate modules, each with its own quiz. Each module should take 20-45 minutes to complete depending on the module and the clinician’s background/experience.
Stroke Rehabilitation Unit Orientation - Self Learning Program (link opens in a new window)
Posters: Stroke Care Topics
We have printable posters for these topics:
- Hemiplegic Arm and Hand - this poster outlines, in words and pictures, how to protect the hemiplegic arm and hand. It also has a picture on how to properly apply a sling.
- Neglect - this poster defines neglect and lists ways that you can help.
- Aphasia - this poster illustrates strategies to utilize when communicating with someone who has aphasia.
Please email us for copies of these posters. French versions of these posters are available upon request.
Handout: Visual Field Deficit
We have a one-page handout that can be used to educate persons with stroke and their families to better understand visual problems after stroke. The handout includes a description of visual field deficits and possible treatment options.
- Please email us for a copy of this handout.
Self-Learning Program: Mobility and Positioning to Assist a Person with Stroke
The goal of assisting a person with stroke is to maximize functional recovery and promote independence of movement in a safe manner.
How you position, mobilize and transfer is KEY in:
- preventing pain or injury
- encouraging safe active participation
- contributing to normal movement
- increasing independence
This self-learning program includes pictures, written content and a quiz.
The learning objectives are to understand:
- Unique considerations regarding persons with stroke
- General principles to follow when assisting a person with stroke
- Key principles of body mechanics for positioning, mobilizing and transferring patients
- The hemiplegic shoulder and how to prevent injury
- Positioning, bed mobility, transfer and ambulation assistance techniques
Please email us to obtain a copy of the Mobility and Positioning Self-learning Program
Posters/Handouts: Your Road to Stroke Recovery Roadmap
Displaying the continuum of stroke care in a visual form as a large, colourful "roadmap" will diminish fear of the unknown for a person with stroke before leaving the hospital. See how the team at your district stroke centre depicts the journey after stroke, currently posted on the Acute and Rehabilitation Units.
As well, handouts are available to be printed and given to your stroke patients and family members. These handouts have a picture of the Roadmap, as well as a description of some of the resources patients are referred to in that district.
Both the roadmap and the handouts are meant to be a way to start the conversation on discharge and possible referrals for your patient.
- Health Sciences North
- North Bay Regional Health Centre
- Sault Area Hospital
- Timmins and District Hospital
Please email us for copies of these posters/handouts and specify which hospital