Abstract：
OBJECTIVE: Stroke is a leading cause of disability. Occupational therapy practitioners ensure maximum participation and performance in valued occupations for stroke survivors and their caregivers.
OBJECTIVE: These Practice Guidelines are meant to support occupational therapy practitioners\' clinical decision making when working with people after stroke and their caregivers.
METHODS: Clinical recommendations were reviewed from three systematic review questions on interventions to improve performance and participation in daily activities and occupations and from one question on maintaining the caregiving role for caregivers of people after stroke.
RESULTS: The systematic reviews included 168 studies, 24 Level 1a, 90 Level 1b, and 54 Level 2b. These studies were used as the basis for the clinical recommendations in these Practice Guidelines and have strong or moderate supporting evidence.
CONCLUSIONS: Interventions with strong strength of evidence for improving performance in activities of daily living and functional mobility include mirror therapy, task-oriented training, mental imagery, balance training, self-management strategies, and a multidisciplinary three-stages-of-care rehabilitation program. Constraint-induced therapy has strong strength of evidence for improving performance of instrumental activities of daily living. Moderate strength of evidence supported cognitive-behavioral therapy (CBT) to address balance self-efficacy, long-term group intervention to improve mobility in the community, and a wearable upper extremity sensory device paired with training games in inpatient rehabilitation to improve social participation. Practitioners should incorporate problem-solving therapy in combination with CBT or with education and a family support organizer program. What This Article Adds: These Practice Guidelines provide a summary of strong and moderate evidence for effective interventions for people with stroke and for their caregivers.
OBJECTIVE: These Practice Guidelines are meant to support occupational therapy practitioners\' clinical decision making when working with people after stroke and their caregivers.
METHODS: Clinical recommendations were reviewed from three systematic review questions on interventions to improve performance and participation in daily activities and occupations and from one question on maintaining the caregiving role for caregivers of people after stroke.
RESULTS: The systematic reviews included 168 studies, 24 Level 1a, 90 Level 1b, and 54 Level 2b. These studies were used as the basis for the clinical recommendations in these Practice Guidelines and have strong or moderate supporting evidence.
CONCLUSIONS: Interventions with strong strength of evidence for improving performance in activities of daily living and functional mobility include mirror therapy, task-oriented training, mental imagery, balance training, self-management strategies, and a multidisciplinary three-stages-of-care rehabilitation program. Constraint-induced therapy has strong strength of evidence for improving performance of instrumental activities of daily living. Moderate strength of evidence supported cognitive-behavioral therapy (CBT) to address balance self-efficacy, long-term group intervention to improve mobility in the community, and a wearable upper extremity sensory device paired with training games in inpatient rehabilitation to improve social participation. Practitioners should incorporate problem-solving therapy in combination with CBT or with education and a family support organizer program. What This Article Adds: These Practice Guidelines provide a summary of strong and moderate evidence for effective interventions for people with stroke and for their caregivers.
摘要：
目的：中风是导致残疾的主要原因。职业治疗从业者确保中风幸存者及其护理人员在有价值的职业中的最大参与和表现。
目的：这些实践指南旨在支持职业治疗从业者在与卒中后患者及其护理人员一起工作时的临床决策。
方法：从关于改善日常活动和职业表现和参与的干预措施的三个系统评价问题以及关于维持卒中后患者照顾者的角色的一个问题中，对临床建议进行了综述。
结果：系统综述包括168项研究，241a级，901b级，和54级2b。这些研究被用作这些实践指南中的临床建议的基础，并具有强大或中等的支持证据。
结论：在改善日常生活活动和功能活动方面具有强大证据的干预措施包括镜像疗法，以任务为导向的培训，心理意象,平衡训练,自我管理策略,和一个多学科的三阶段护理康复计划。约束诱导疗法对于改善日常生活的工具活动具有很强的证据。中等强度的证据支持认知行为疗法（CBT）解决平衡自我效能，长期团体干预，以改善社区的流动性，以及可穿戴的上肢感觉设备与住院康复中的训练游戏配对，以提高社会参与度。从业者应将解决问题的疗法与CBT或教育和家庭支持组织者计划相结合。本文补充：这些实践指南为中风患者及其护理人员的有效干预措施提供了强有力和适度的证据。
目的：这些实践指南旨在支持职业治疗从业者在与卒中后患者及其护理人员一起工作时的临床决策。
方法：从关于改善日常活动和职业表现和参与的干预措施的三个系统评价问题以及关于维持卒中后患者照顾者的角色的一个问题中，对临床建议进行了综述。
结果：系统综述包括168项研究，241a级，901b级，和54级2b。这些研究被用作这些实践指南中的临床建议的基础，并具有强大或中等的支持证据。
结论：在改善日常生活活动和功能活动方面具有强大证据的干预措施包括镜像疗法，以任务为导向的培训，心理意象,平衡训练,自我管理策略,和一个多学科的三阶段护理康复计划。约束诱导疗法对于改善日常生活的工具活动具有很强的证据。中等强度的证据支持认知行为疗法（CBT）解决平衡自我效能，长期团体干预，以改善社区的流动性，以及可穿戴的上肢感觉设备与住院康复中的训练游戏配对，以提高社会参与度。从业者应将解决问题的疗法与CBT或教育和家庭支持组织者计划相结合。本文补充：这些实践指南为中风患者及其护理人员的有效干预措施提供了强有力和适度的证据。
