Functional Rehabilitation & Exercise Training after Stroke (FRETS)

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The ARNI programme encourages and advances the rehabilitation of those suffering
from the effects of stroke which require progressive recovery of movement, balance,
physical strength and confidence. It does this by offering a manual-based professional development and Accreditation in Functional Training After Stroke Course for therapists and trainers.

This Level 4 course is accredited by Middlesex University at BSc Level and is also equivalent to one MSc module which may be put forward the Rehabilitation MSc at Oxford Brookes University

The course runs three times per year with 5 days at ARNI Lingfield and 1 day at the Institute of Neurology, Queen Square, UCL, with lecturers on rotation.

Stroke and ABI Charities, Local Councils and Community Centres are invited to sponsor cohorts of independent therapists and exercise s professionals… and independent therapists and exercise professionals may apply themselves.

The Course begins by outlining to candidates the fundamental principles of stroke as a diagnosis and the essential factors to be considered in stroke rehabilitation. Candidates are required to appraise the evidence base for physical activity programmes with stroke clients and how this informs practice. Candidates then demonstrate safe exercise techniques, including risk assessment for rehabilitation of the lower and upper body with volunteer examples of the cohort in question (from the ARNI Charity) and reflect on their own practice. They then assess, plan and evaluate appropriate functional training programmes with a stroke client. At the end of this course, students are required to be able to answer questions drawn from all these five topic areas: neuroplasticity & action control after stroke, acute care and neurorehabilitation in the rehab units, stroke and community stroke services, the role of the independent therapist and trainer in supporting the hospitals, and rehabilitation/training strategy planning.

Therapists, Professional Fitness Instructors

UKSF Reg. No.
16609
Is there a charge for attending this course?
£848 (no VAT required) Full insurance cover for those who qualify is available via membership of the National Register of Professional Trainers (NRPT) at a low cost of £110 joining fee with £80 annual insurance.
How is this training best described?
Multi day course
Is the course open to anyone?
MINIMUM 1. Level 3 (and Register for Exercise Professionals (REPS) Level 3) Advanced Personal Trainer or Diploma in Exercise and Physical Activity Instructor Award or NVQ Level 3 Exercise for the Older Person Advanced Instructor Award or NVQ Level 3 Exercise for Referred Populations Advanced Instructor Award or NVQ Level 3 Exercise for People with Disabilities Advanced Instructor Award= or NVQ Level 2 (REPS Level 2) Physical Activity Instructor Award with equivalent experience, usually through working with stroke patients and working in a clinical setting, supervised by a senior physiotherapist/occupational therapist or the equivalent. or BSc Physiotherapy, Occupational Therapy, Nursing, Clinical Exercise or BSc Exercise, Sports or Health Science.
Pre-requisites for attendance

MINIMUM 1. Level 3 (and Register for Exercise Professionals (REPS) Level 3) Advanced Personal Trainer or Diploma in Exercise and Physical Activity Instructor Award or NVQ Level 3 Exercise for the Older Person Advanced Instructor Award or NVQ Level 3 Exercise for Referred Populations Advanced Instructor Award or NVQ Level 3 Exercise for People with Disabilities Advanced Instructor Award= or NVQ Level 2 (REPS Level 2) Physical Activity Instructor Award with equivalent experience, usually through working with stroke patients and working in a clinical setting, supervised by a senior physiotherapist/occupational therapist or the equivalent. or BSc Physiotherapy, Occupational Therapy, Nursing, Clinical Exercise or BSc Exercise, Sports or Health Science.

Course duration

300 hours

Course location

N/A

Course Online

blended

Course leader

Dr Tom Balchin

Address

ARNI Institute, PO Box 68, Lingfield, Surrey

Postcode

RH7 6QQ

How the course is taught
  • Face-to-face - Classroom
  • Face-to-face - Work-based learning (ward mentoring)
  • Face-to-face - Tutorials / seminars
  • Resource / reference material
Exit awards
  • Module credits - 30 credits
  • Continuing Professional Development (CPD) points - 30 points
  • Certificate of attendance / completion
Who can benefit from the course?
  • Independent Services Worker
  • Junior Doctor
  • Doctor
  • Care Home Worker
  • GP
  • Medical Student
  • Occupational Therapist
  • Physician
  • Physiotherapist
  • Podiatrist\Chiropodist
  • Radiologist (General)
  • Radiologist (Neuro)
  • Therapy Assistant
  • Vascular Technician

Course breakdowns

E1Awareness raisingCourse Level
Knowledge and understanding of…
e1k_1Signs and symptoms of stroke1
e1k_2Features of less common (atypical) presentation of stroke1
e1k_3Stroke mimics and likely presentation1
e1k_4Stroke and TIA as medical emergencies2
e1k_5Emergency response, investigations, interventions and treatments for stroke and TIA1
e1k_6Timeframe for emergency investigations, interventions and treatments for stroke and TIA1
e1k_7Anatomy and physiology of the central nervous system1
e1k_8Timeframe of physiological and neurological changes during a stroke2
e1k_9Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations0
Skills and ability to…
e1s_1Initiate emergency protocol (Stroke Improvement Programme)0
e1s_2Communicate current event and need for emergency treatment0
e1s_3Know when to apply screening tests for stroke (FAST) and how to act on the results0
e1s_4Know when to apply vascular risk assessment tools for TIA (ABCD2) and how to act on the results0
e1s_5Identify emergency interventions and treatments for stroke and TIA available locally and know how to refer patients efficiently0
e1s_6Take and interpret thorough history, taking third party information where possible, and assess mental capacity0
e1s_7Identify and appropriately treat stroke mimics, e.g. hypoglycaemia, epileptic seizure0
E2Managing riskCourse Level
Knowledge and understanding of…
e2k_1Risk factors for stroke and TIA (e.g. lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities)0
e2k_2Stroke types and their aetiologies0
e2k_3Risk of stroke depending on type and aetiology0
e2k_4Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations0
e2k_5Who provides interventions for primary and secondary prevention of stroke0
e2k_6Pharmacological and non-pharmacological interventions for primary and secondary prevention of stroke, and side effects of treatment0
e2k_7Methods of changing behaviour 0
Skills and ability to…
e2s_1Take and interpret thorough history, taking third party information where possible, and assess mental capacity0
e2s_2Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information)0
e2s_3Elicit needs and aspirations of those at risk of stroke and those affected by stroke0
e2s_4Identify risk factors and apply vascular risk assessment tools0
e2s_5Communicate and discuss: current event; risk of future vascular event; need for assessments/investigations, interventions/ treatments and their timeframes; rationale for treatment and possible side effects of treatment; and provide timely information, advice and support0
e2s_6Assess services (health, social, voluntary and independent) available locally for those affected by stroke: identify the full range available; establish relevance; communicate and liaise with services; signpost service0
e2s_7Assess motivation and take steps to augment management 0
e2s_8Monitor progress and agree or change a maintenance or management plan0
e2s_9Assess and facilitate concordance0
E3InformationCourse Level
Knowledge and understanding of…
e3k_1Stroke types and their aetiologies3
e3k_2Risk factors for further vascular events (e.g. type and aetiology of current event, lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities) 3
e3k_3Pharmacological and non-pharmacological interventions for primary and secondary prevention of stroke, and side effects of treatment1
e3k_4Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations1
e3k_5Who provides interventions for primary and secondary prevention of stroke1
e3k_6Full range of services (health, social, community, voluntary and independent) available locally for those affected by stroke5
e3k_7How to assess and overcome barriers to problems: psychological and emotional; social and relationship; cognitive and communication; physical and functional; visual and sensory impairments and pain; medical5
e3k_8The impact of stroke on the individual, carer and family5
e3k_9The implications of stroke for lifestyle, driving, work and family5
e3k_10Methods of changing behaviour 3
Skills and ability to…
e3s_1Take and interpret thorough history, taking third party information where possible, and assess mental capacity3
e3s_2Elicit needs and aspirations of those affected by stroke5
e3s_3Communicate and discuss: current event; risk of future vascular event; need for assessments/investigations, interventions/ treatments and their timeframes; rationale for treatment and possible side effects of treatment; and provide timely information, advice and support3
e3s_4Identify full range of services (health, social, community, voluntary and independent) available locally for those affected by stroke5
e3s_5Assess relevance and suitability of available services for those affected by stroke; communicate and liaise with services; share information; work across agencies; signpost services for those affected by stroke5
e3s_6Implement information sharing methods and reflect on effectiveness of information sharing5
e3s_7Assess motivation and take steps to augment management 5
e3s_8Monitor progress and agree or change a maintenance or management plan in conjunction with those affected by stroke, identifying resources to facilitate participation and inclusion5
E4User involvementCourse Level
Knowledge and understanding of…
e4k_1The services relevant for stroke patients and carers5
e4k_2How to assess and overcome barriers to problems: psychological and emotional; social and relationship; cognitive and communication; physical and functional; visual and sensory impairments and pain; medical3
e4k_3Methods to empower patients; patient advocacy4
e4k_4Methods that can be used to involve stroke patients and carers in service planning2
e4k_5Methods that can be used to capture stroke patient and carer views2
e4k_6Methods for using views to influence services2
e4k_7Factors that influence people’s ability to be involved in care and service planning2
e4k_8Methods of feeding back to stroke patients and carers how their contributions have influenced services2
e4k_9How service planning and decision making processes work and how they can be influenced2
Skills and ability to…
e4s_1Assess services (health, social, voluntary and independent) available locally for those affected by stroke: identify the full range available; establish relevance; communicate and liaise with services; signpost service3
e4s_2Create an open and honest environment that is not intimidating and offers stroke patients and their carers the opportunity to freely give their views3
e4s_3Interact with people who have one or more of the following problems: communication; physical/functional; psychological; social; medical5
e4s_4Translate the views of those affected by stroke into service planning, development, delivery and monitoring3
e4s_5Identify hard-to-reach groups and ensure that their views are included1
e4s_6Overcome the factors that prevent those affected by stroke from being involved in care and service planning1
e4s_7Identify local opportunities and appropriate formats for formal and informal feedback (e.g. PALS, PPI)1
e4s_8Handle complaints to the satisfaction of all parties2
E5Assessment (TIA)Course Level
Knowledge and understanding of…
e5k_1Anatomy and physiology of the central nervous system0
e5k_2Risk factors for stroke and TIA (e.g. lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities)0
e5k_3The signs and symptoms of TIA0
e5k_4How to distinguish between stroke and TIA0
e5k_5The future risk of stroke and TIA (e.g. ABCD2 and other risk scoring methods)0
e5k_6The features of atypical presentation of TIA/stroke and mimics and how to act when they are identified0
e5k_7Investigations, interventions and treatments for TIA (e.g. imaging, vascular, medical, cardiac, surgical)0
e5k_8Implications of the Mental Capacity Act and how it applies to TIA0
e5k_9Advocates for stroke and TIA patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations0
e5k_10The timeframe for emergency and follow-on investigations, interventions and treatments for TIA0
e5k_11How to initiate emergency and ongoing treatment for TIA and vascular prevention0
e5k_12The indications, contraindications and limitations for imaging, investigations and interventions0
e5k_13Local protocols for imaging and reporting0
e5k_14Any complications of surgical procedures (e.g. stenting, carotid endarterectomy, closure of atrial septal defect (ASD) and patent foramen ovale (PFO))0
e5k_15The results of investigations0
e5k_16The implications of TIA for lifestyle, driving, work and family0
e5k_17Management options for TIA/stroke and mimics, and other conditions0
Skills and ability to…
e5s_1Take and interpret thorough history, record third party information where possible, and assess mental capacity0
e5s_2Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information)0
e5s_3Identify risk factors and apply vascular risk assessment tools for TIA (ABCD2) and screening tests for stroke (FAST)0
e5s_4Identify stroke, high risk TIA, lower risk TIA, atypical stroke and stroke mimics0
e5s_5Establish the cause of TIA0
e5s_6Recognise patients who have had a stroke rather than a TIA and to refer on for appropriate investigation and management0
e5s_7Communicate and discuss: current event; risk of future vascular event; need for assessments/investigations, interventions/ treatments and their timeframes; rationale for treatment and possible side effects of treatment; and provide timely information, advice and support0
e5s_8Identify emergency interventions and treatments for TIA available locally and know how to refer patients efficiently0
e5s_9Identify the service(s) to which the individual should be referred and to liaise effectively with those services0
e5s_10Perform a physiological assessment and assess vital signs0
e5s_11Decide on a relevant investigation and its level of urgency0
e5s_12Apply radiological knowledge for recognised investigations0
e5s_13Apply technical knowledge for recognised investigations and interventions0
e5s_14Apply surgical knowledge for recognised vascular interventions0
e5s_15Recognise and manage postoperative complications after stenting, endarterectomy, PFO and ASD closure0
e5s_16Obtain and interpret the results of investigations: this includes formulating an immediate and ongoing management plan, and initiating treatments within the relevant timelines0
e5s_17Confirm and communicate diagnosis, lifestyle advice and methods of secondary prevention to patients and carers0
e5s_18Communicate and discuss with the patient, carer, and health and social care professionals a diagnosis, results of investigations and subsequent needs and aspirations and a management plan, as well as the actions to be taken if a further vascular event occurs0
e5s_19Advise on lifestyle, driving, work and family0
e5s_20Identify local management and referral routes for TIA/stroke and mimics, and other conditions0
E6Treatment (TIA)Course Level
Knowledge and understanding of…
e6k_1The signs and symptoms of TIA0
e6k_2Atypical presentation of TIA and TIA mimics and how to act when they are identified0
e6k_3How to distinguish between stroke and TIA0
e6k_4Risk factors for further vascular events (e.g. type and aetiology of current event, lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities) 0
e6k_5Pharmacological and non-pharmacological interventions, and the level of urgency for risk factor management0
e6k_6Side effects of pharmacological and non-pharmacological interventions as well as the prevention and management of vascular events0
e6k_7Late complications of surgical procedures (e.g. stenting, carotid endarterectomy, closure of ASD and PFO) and the implications of the procedures on lifestyle0
e6k_8Implications of TIA for lifestyle, driving, work and family0
e6k_9Potential interventions for immediate and ongoing risk factor management0
e6k_10Methods of changing behaviour 0
e6k_11How QOF and community targets for risk factor management affect prevention strategies0
e6k_12Concordance: how to assess; how it is affected by individual preference; how to motivate; how to manage non-concordance0
e6k_13Likely persistent deficits or other ongoing problems0
e6k_14Why TIA/stroke review is important0
Skills and ability to…
e6s_1Recognise recurrent vascular events0
e6s_2Perform a holistic overview, including assessment of pharmacological and non-pharmacological interventions0
e6s_3Perform and interpret blood pressure measurement and ECG0
e6s_4Assess and facilitate concordance0
e6s_5Assess motivation and take steps to augment management 0
e6s_6Monitor progress and agree on or change to a maintenance or management plan0
e6s_7Use results of history and investigations to confirm a diagnosis and make an individual management plan for the patient, taking into account personal preferences0
e6s_8Identify interventions and treatments for stroke and TIA available locally and know how to refer patients efficiently0
e6s_9Communicate and discuss with the patient, carer, and health and social care professionals a diagnosis, results of investigations and subsequent needs and aspirations and a management plan, as well as the actions to be taken if a further vascular event occurs0
e6s_10Identify who provides interventions for immediate and ongoing risk factor management locally and refer0
e6s_11Identify where QOF and community targets for risk factor management may affect prevention strategies and take steps to overcome this0
e6s_12Recognise individuals with persistent deficits or other ongoing problems and arrange rehabilitation, support and management0
e6s_13Encourage people to come for review0
E7Urgent responseCourse Level
Knowledge and understanding of…
e7k_1Signs and symptoms of stroke0
e7k_2Features of less common (atypical) presentation of stroke0
e7k_3Stroke mimics and likely presentation0
e7k_4Stroke and TIA as medical emergencies0
e7k_5Emergency response, investigations, interventions and treatments for stroke and TIA0
e7k_6The timeframe for emergency investigations, interventions and treatments for stroke and TIA0
e7k_7The anatomy and physiology of the central nervous system0
e7k_8The physiological and neurological effects of stroke and their timeframe during and after a stroke0
e7k_9Monitoring and acting upon physiological and neurological changes during and after a stroke0
e7k_10How stroke can affect communication0
e7k_11Implications of the Mental Capacity Act and how it applies to TIA0
e7k_12Advocates for stroke and TIA patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations0
e7k_13Complications after stroke (e.g. aspiration, airway obstruction, hypoxia, hypotension, hypertension, hyperglycaemia, bedsores), and preventing and managing them 0
Skills and ability to…
e7s_1Take and interpret thorough history, record third party information where possible, and assess mental capacity0
e7s_2Communicate and discuss: current event; risk of future vascular event; need for assessments/investigations, interventions/ treatments and their timeframes; rationale for treatment and possible side effects of treatment; and provide timely information, advice and support0
e7s_3Identify suspected stroke, perform screening tests (e.g. FAST) and act on results0
e7s_4Perform basic neurological and physiological assessment (vital signs)0
e7s_5Perform ABCDs (airways, breathing, circulation, disability), pulse oximetry and blood glucose assessment and to act on abnormal findings0
e7s_6Identify and use methods of moving and handling the patient that are safe, depending on the individual patient or staff needs0
e7s_7Recognise stroke-related communication problems and to adapt methods of communication0
e7s_8Identify emergency investigations, and interventions for stroke and TIA patients available locally (Stroke Networks) and know where to take them0
e7s_9Identify and appropriately treat stroke mimics, e.g. hypoglycaemia, epileptic seizure0
E8Assessment (stroke)Course Level
Knowledge and understanding of…
e8k_1The signs and symptoms of stroke0
e8k_2The neurological and physiological effects of stroke and the timeframe of changes during and after a stroke0
e8k_3How to monitor, and act upon, neurological and physiological changes during and after a stroke0
e8k_4Implications of the Mental Capacity Act and how it applies to stroke and TIA0
e8k_5Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations0
e8k_6Features of atypical presentation of stroke and stroke mimics0
e8k_7Stroke types and their aetiologies0
e8k_8Different modalities to facilitate diagnosis and treatment of stroke (e.g. telemedicine)0
e8k_9Emergency investigations (e.g. imaging of brain, heart and cerebral arteries, blood tests) and interventions for stroke (e.g. intravenous and intra-arterial thrombolysis, vascular surgery, stenting, hemicraniotomy, evacuation of haematoma) and the timeframe within which they should be given0
e8k_10The indications and contraindications for investigations, interventions and treatments for stroke0
e8k_11Any complications of investigations, interventions and treatments for stroke and how to prevent and manage them0
Skills and ability to…
e8s_1Take and interpret thorough history, record third party information where possible, and assess mental capacity0
e8s_2Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information)0
e8s_3Perform neurological and physiological assessment and assess vital signs0
e8s_4Perform a standardised neurological assessment using a recognised stroke scale (e.g. NIHSS, SNSS)0
e8s_5Interpret the results of investigations (e.g. imaging, vascular, blood tests) and the actions to be taken as a result0
e8s_6Diagnose stroke using clinical information and investigations: distinguish between a stroke and a TIA; identify atypical strokes and stroke mimics; formulate and implement a management plan accordingly0
e8s_7Communicate and discuss: current event; risk of future vascular event; need for assessments/investigations, interventions/ treatments and their timeframes; rationale for treatment and possible side effects of treatment; and provide timely information, advice and support0
e8s_8Identify the need for more specialist or differing treatments when necessary0
e8s_9Monitor progress, identify complications or deteriorations and deliver treatments for complications or deteriorations0
e8s_10Identify the level of urgency for any relevant medical, surgical and radiological investigations, interventions and treatments0
e8s_11Obtain and interpret the results of investigations and formulate an immediate and ongoing management plan; initiate treatments within the relevant timescales0
E9Treatment (stroke)Course Level
Knowledge and understanding of…
e9k_1Signs and symptoms of stroke0
e9k_2Neurological and physiological effects of stroke, monitoring, and the timeframe of changes, during and after a stroke0
e9k_3The need for early mobilisation and positioning0
e9k_4Assessing swallowing and managing of dysphagia0
e9k_5Alternative methods of feeding, hydration and drug administration for patients with dysphagia0
e9k_6The interactions between enteral feeds, fluids and drug treatment0
e9k_7The effects of stopping ongoing drug treatment because of swallowing problems0
e9k_8Symptoms and effects of malnourishment0
e9k_9The importance and methods of oral hygiene0
e9k_10The importance of avoiding catheters, as well as managing retention and promoting continence0
e9k_11Assessing and managing problems: psychological and emotional; social and relationship; cognitive and communication; physical and functional; sensory impairment and pain; medical0
e9k_12Cognitive effects of the stroke and their impact on the patient’s ability to consent to treatment0
e9k_13Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations0
e9k_14The impact of the stroke on family, friends and carers0
e9k_15Assessment and management options for neurological, physiological, functional and psychological problems after stroke0
e9k_16Complications after stroke and how to prevent and manage them0
e9k_17When to refer for other specialist care (e.g. intensive care unit, hemicraniotomy, haematoma evacuation, interventional radiology, vascular surgery)0
e9k_18Any complications of investigations, interventions and treatments for stroke and how to prevent and manage them0
e9k_19The roles, level and number of health and social service professionals who should contribute to the care and support of individuals with stroke and those affected by stroke 0
e9k_20How to manage strokes that occur as a complication of another primary pathology0
Skills and ability to…
e9s_1Take and interpret thorough history, record third party information where possible, and assess mental capacity0
e9s_2Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information)0
e9s_3Perform neurological and physiological assessment and assess vital signs0
e9s_4Perform a standardised neurological assessment using a recognised stroke scale (e.g. NIHSS, SNSS)0
e9s_5Identify the need and level of urgency for the relevant medical, surgical and radiological investigations, interventions and treatments; obtain and interpret the results of investigations: formulate an immediate and ongoing management plan; initiate treatments within the relevant timescales0
e9s_6Diagnose stroke using clinical information and investigations: distinguish between a stroke and a TIA; identify atypical strokes and stroke mimics; formulate and implement a management plan accordingly0
e9s_7Communicate and discuss: current event; risk of future vascular event; need for assessments/investigations, interventions/ treatments and their timeframes; rationale for treatment and possible side effects of treatment; and provide timely information, advice and support0
e9s_8Identify the need for more specialist or differing treatments when necessary and be able to refer to those services0
e9s_9Monitor progress, identify neurological and non-neurological complications or deterioration and to deliver treatments0
e9s_10Obtain and interpret the results of investigations and formulate a management plan accordingly0
e9s_11Identify and use therapeutic methods of moving and handling the patient that are safe, depending on the individual patient or staff needs and aspirations0
e9s_12Assess and manage: oral problems including dysphagia, nutrition and hydration; cognition; psychological and emotional problems; continence; pressure areas; mobility problems etc in collaboration with members of the multidisciplinary team 0
e9s_13Deliver relevant methods of nutrition, hydration and medication in patients with dysphagia0
e9s_14Assess and discuss realistic goals with those affected by stroke, plan discharge and link to follow-up services for patients and carers0
e9s_15Recognise impending death and initiate palliative care where necessary 0
E10Specialist rehabilitationCourse Level
Knowledge and understanding of…
e10k_1The impact of stroke on the individual, carer and family5
e10k_2Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations1
e10k_3The implications of stroke for lifestyle, driving, work, family and acceptance in the community5
e10k_4MDT assessment: the principles of stroke rehabilitation and rehabilitation referral; therapy techniques and their application2
E10k_5A range of neurological treatment approaches and their applications2
e10k_6Psychological and emotional problems after stroke (e.g. depression, emotionalism, anxiety, self esteem, confidence, well-being, challenging behaviour)2
e10k_7Social and relationship problems after stroke (e.g. sex, lifestyle, work, housing, driving, transport, leisure, financial/ income, work/employment, children, family, support network, carers, respite, pets)3
e10K_8Cognitive and communication problems after stroke (e.g. spatial awareness (neglect/inattention); visual field deficits; hemianopia; memory; attention; praxis; executive function; aphasia, dysarthria, articulatory dyspraxia)3
e10k_9Physiological, physical and functional problems after stroke (e.g. rest and sleep; respiratory, mobility; balance; senses; incontinence; bladder and bowel management; swallowing; feeding, nutrition and hydration; skin integrity; sexual; motor control; ADL)2
e10k_10Neurological, visual and sensory impairments and pain problems (e.g. shoulder pain, central post-stroke pain, spasticity, seizures)3
e10k_11Medical problems (e.g. medication, comorbidities, complications)2
e10k_12The process of transfer to the community (e.g. discharge planning, long-term management, further rehabilitation, social function)3
e10k_13The causes of, and how to assess, manage and treat, problems after stroke: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical3
e10k_14The impact of problems after stroke on day-to-day and outdoor functioning: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical3
e10k_15Methods that will support those affected by stroke with their recovery and help them to cope with problems after stroke: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical3
e10k_16Risk factors for further vascular events (e.g. type and aetiology of current event, lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities) 2
e10k_17Pharmacological and non-pharmacological interventions for secondary prevention that will also help recovery after stroke, and their side effects 2
e10k_18Any support services, organisations and resources available (e.g. health, social, voluntary, independent sector; packages of care, finance and personal budgets, self-management, respite care, equipment, adaptations, rehabilitation, psychological, educational, employment, housing, transport)3
e10k_19Methods to facilitate communication with those affected by stroke2
e10k_20Therapeutic moving and handling 1
e10k_21Methods of changing behaviour 3
e10k_22The use of assessments and measures 3
e10k_23The principles of goal setting 3
e10k_24Assistive technology and other therapy interventions (e.g. functional electrical stimulation, orthotics)3
e10k_25Equipment and adaptations 3
e10k_26Concordance: how to assess; how it is affected by individual preference; how to motivate; how to manage non-concordance2
Skills and ability to…
e10s_1Take and interpret thorough history, including information from carers, relatives and other agencies where possible, and assess mental capacity3
e10s_2Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information)3
e10s_3Provide a range of neurological intervention processes and to be able to clinically reason the selection and administration of an approach3
e10s_4Communicate and discuss: current event; risk of future vascular event; need for assessments/investigations, interventions/ treatments and their timeframes; rationale for treatment and possible side effects of treatment; and provide timely information, advice and support2
e10s_5Assess, discuss and review with those affected by stroke, including client-centred goal-setting and outcomes3
e10s_6Identify rehabilitation and support services in hospital and after discharge: inform the individual about services and how to access them; check availability and agree referral2
e10s_7Identify need and when to refer for more specialist or differing treatments where necessary: also agree referral (e.g. assistive technology, major adaptations to the home, disability employment adviser)2
e10s_8Provide advice and support on driving and refer to specialist centres as required1
e10s_9Identify local services and resources (e.g. health, social, voluntary, independent sector; equipment and adaptations, rehabilitation, psychological, educational, employment, housing, transport) to overcome barriers, facilitate participation and inclusion: also identify waiting times and implications for those affected by stroke3
e10s_10Monitor progress and agree or change a maintenance or management plan3
e10s_11Identify resources to help with participation and inclusion3
e10s_12Assess motivation and take steps to augment management 2
e10s_13Assess and help with concordance 1
e10s_14Identify and use therapeutic methods of moving and handling the patient that are safe, depending on the individual patient or staff needs and aspirations, and that will help with the optimum return of functional abilities1
e10s_15Assist, encourage and facilitate post-stroke physical, social and cultural reintegration 3
e10s_16Recognise the signs, symptoms and impact of psychological and emotional problems after stroke (e.g. depression, emotionalism, anxiety, self esteem, confidence, well-being, challenging behaviour) and to help patients and their families to cope and manage; build self-esteem and confidence, encourage recovery and maximise potential2
e10s_17Recognise the signs, symptoms and impact of social and relationship problems after stroke (e.g. lifestyle, work, housing, driving, transport, leisure, financial/income, work/employment, children, family, support network, carers, relating, respite, pets) and to help patients and their families to cope and manage; encourage recovery and maximise potential1
e10s_18Recognise the signs, symptoms and impact of cognitive and communication problems after stroke (e.g. spatial awareness (neglect/inattention); visual field deficits; memory; attention; praxis; executive function; aphasia, dysarthria, articulatory dyspraxia) and to help patients and their families to cope and manage; encourage recovery and maximise potential2
e10s_19Recognise the signs, symptoms and impact of physiological, physical and functional problems after stroke (e.g. rest and sleep; respiratory, mobility; balance; senses; incontinence: bladder and bowel management; swallowing; feeding, nutrition and hydration; skin integrity; sexual; motor control; ADL) and to help patients and their families to cope and manage; encourage recovery and maximise potential2
e10s_20Recognise the signs, symptoms and impact of neurological, visual and sensory impairments and pain problems (e.g. shoulder pain; central post-stroke pain; spasticity, seizures) and to help patients and their families to cope and manage; encourage recovery and maximise potential2
e10s_21Recognise the signs, symptoms and impact of medical problems (e.g. medication, comorbidities, complications) and to help patients and their families to cope and manage; encourage recovery and maximise potential1
e10s_22Use a range of communication resources and approaches to ensure that patients and their carers are fully involved in the decision making process and their care1
e10s_23Provide a client-centred approach to care and manage any challenging behaviour3
E11End-of-life careCourse Level
Knowledge and understanding of…
e11k_1End-of-life care strategies, advanced directives, and palliative care tools in relation to stroke0
e11k_2The implications of the Mental Capacity Act for stroke patients0
e11k_3Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations0
e11k_4The range of support groups and services for those affected by stroke with palliative care needs0
e11k_5The needs and aspirations of those affected by stroke (i.e. patient, carer and family)0
e11k_6The assessment and management of problems, how they can be controlled and the implications for prognosis: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical0
e11k_7Pharmacological and non-pharmacological interventions for end-of-life care after stroke0
e11k_8The side effects of pharmacological and non-pharmacological interventions for end-of-life care after stroke0
Skills and ability to…
E11s_1Take and interpret thorough history, including information from carers, relatives and other agencies where possible, and assess mental capacity0
E11s_2Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information)0
E11s_3Communicate and discuss: current event; interventions/treatments and their timeframes; rationale for treatment; possible side effects of treatment; and provide advice and prognosis0
E11s_4Assess capacity and “best interests” according to the statutory principles0
E11s_5Provide sufficient information to enable informed choice and decision making by those affected by stroke0
E11s_6Identify need and when to refer for more specialist or differing treatments where necessary: agree referral0
E11s_7Recognise and manage symptoms taking account of individual needs and aspirations0
E11s_8Use palliative care, or other relevant tools, and care pathways0
E11s_9Identify local services and resources, including waiting times and implications for those affected by stroke0
E11s_10Use strategies to help with breaking bad news, managing emotions and obtaining information on advanced directives0
E11s_11Develop mechanisms to support the palliative care team and provide opportunities for debriefing sessions0
E12Seamless transfer of careCourse Level
Knowledge and understanding of…
e12k_1The assessment and management of problems: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical; and how to involve users and carers4
e12k_2Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations0
e12k_3The implications of stroke for lifestyle, driving, work and family4
e12k_4Methods to facilitate communication with those affected by stroke3
e12k_5Support services, organisations and resources available (e.g. health, social, voluntary, independent sector; packages of care, finance and personal budgets, self management, respite care, equipment, adaptations, rehabilitation, psychological, educational, employment, housing, transport) including exit strategies3
e12k_6The principles of good planning for transition between services or cessation of services and for transfer of care to the community, including the education of those affected by stroke2
e12k_7All agencies that are potentially involved along the whole of the Stroke Pathway5
e12k_8The principles of multi-agency working4
Skills and ability to…
e12s_1Take and interpret thorough history, including information from carers, relatives and other agencies where possible, and assess mental capacity3
e12s_2Determine, plan and initiate appropriate assessments/investigations and interventions/treatments; provide information, relevant to individual needs and aspirations (personalise information)4
e12s_3Assess, discuss and review with those affected by stroke: goal-setting, outcomes and exit strategies5
e12s_4Monitor progress and agree or change a maintenance or management plan5
e12s_5Identify need and when to refer for more specialist or differing treatments where necessary4
e12s_6Identify local services and resources (e.g. health, social, voluntary, independent sector; equipment and adaptations, rehabilitation, psychological, educational, employment, housing, transport) to facilitate participation and inclusion: check availability and waiting times; inform individual about services, identify how to access, or re-access, them and agree referral4
e12s_7Liaise with and work across agencies3
e12s_8Identify and utilise resources available locally and nationally to support those affected by stroke4
e12s_9Reflect on processes and pathways of care including mechanisms for review and exit strategies4
e12s_10Reflect on methods and effectiveness of information sharing3
E13Long-term careCourse Level
Knowledge and understanding of…
e13k_1The assessment and management of problems: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical4
e13k_2Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations0
e13k_3The needs and aspirations of those affected by stroke, particularly those related to the problems listed above, and how these needs and aspirations can be met5
e13k_4The impact of stroke on the individual, carer and family4
e13k_5The implications of stroke for lifestyle, driving, work and family5
e13k_6Risk factors for further vascular events (e.g. type and aetiology of current event, lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities) 2
e13k_7Pharmacological and non-pharmacological interventions for secondary prevention and to facilitate recovery after stroke and their side effects2
e13k_8Support services, organisations and resources available (e.g. health, social, voluntary, independent sector; packages of care, finance and personal budgets, self-management, respite care, equipment, adaptations, rehabilitation, psychological, educational, employment, housing, transport)4
e13k_9Assistive technology and other therapy interventions (e.g. functional electrical stimulation, orthotics)4
e13k_10Methods to facilitate communication with those affected by stroke3
e13k_11Concordance: how to assess; how it is affected by individual preference; how to motivate; how to manage non-concordance4
Skills and ability to…
e13s_1Take and interpret thorough history, including information from carers, relatives and other agencies where possible, and assess mental capacity3
e13s_2Communicate and discuss: current event; risk of future vascular event; need for assessments/investigations, interventions/ treatments and their timeframes; rationale for treatment and possible side effects of treatment; and provide timely information, advice and support3
e13s_3Monitor the individual’s progress and agree on or change a maintenance or management plan4
e13s_4Assess, discuss and review with those affected by stroke: goal-setting and outcomes4
e13s_5Identify need and when to refer for more specialist or differing treatments when necessary4
e13s_6Identify relevant rehabilitation and social support services after discharge: inform the individual about services and how to access them and agree referral4
e13s_7Identify the individual’s motivation and take steps to modify behaviour4
e13s_8Know of local services, their waiting times and implications for those affected by stroke and ensure that the individual is aware3
e13s_9Understand how those affected by stroke can be empowered (e.g. through self-management programmes)5
e13s_10Assess and facilitate concordance3
E14ReviewCourse Level
Knowledge and understanding of…
e14k_1The assessment and management of problems: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical0
e14k_2Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations0
e14k_3The needs and aspirations of those affected by stroke, particularly those related to the problems listed above, and how these needs and aspirations can be met0
e14k_4Support services, organisations and resources available (e.g. health, social, voluntary, independent sector; packages of care, finance and personal budgets, self-management, respite care, equipment, adaptations, rehabilitation, psychological, educational, employment, housing, transport)0
e14k_5The impact of stroke on the individual, carer and family0
e14k_6The implications of stroke for lifestyle, driving, work and family0
e14k_7Risk factors for further vascular events (e.g. type and aetiology of current event, lifestyle, socioeconomic, cultural, vascular, familial, genetic, concurrent medications, comorbidities) 0
e14k_8Pharmacological and non-pharmacological interventions for secondary prevention and how to help recovery after stroke0
e14k_9Side effects of risk factor interventions and treatments to help with recovery after stroke0
e14k_10Methods to help communication with those affected by stroke when conducting a review0
e14k_11Concordance: how to assess; how it is affected by individual preference; how to motivate; how to manage non-concordance0
Skills and ability to…
e14s_1Take and interpret thorough history, including information from carers, relatives and other agencies where possible, and assess mental capacity0
e14s_2Communicate and discuss: current event; risk of future vascular event; need for assessments/investigations, interventions/ treatments and their timeframes; rationale for treatment and possible side effects of treatment; and provide timely information, advice and support0
e14s_3Monitor the individual’s progress and agree or change a maintenance or management plan0
e14s_4Assess, discuss and review with those affected by stroke: goal-setting and outcomes0
e14s_5Plan assessments and treatments; provide information, relevant to individual needs and aspirations (personalise information)0
e14s_6Identify need and when to refer for more specialist or differing interventions/treatments where necessary0
e14s_7Review process in your area and act on the review0
e14s_8Assess and facilitate concordance0
E15Participation in communityCourse Level
Knowledge and understanding of…
e15k_1The assessment and management of problems: psychological and emotional; social and relationship; cognitive and communication; physiological, physical and functional; neurological, visual and sensory impairments and pain; medical3
e15k_2Advocates for stroke patients when there is a legal duty to instruct an IMCA, taking account of religious and cultural aspirations1
e15k_3The needs and aspirations of those affected by stroke, particularly those related to the problems listed above, and how these needs and aspirations can be met3
e15k_4Support services, organisations and resources available (e.g. health, social, voluntary, independent sector; packages of care, finance and personal budgets, self-management, respite care, equipment, adaptations, rehabilitation, psychological, educational, employment, housing, transport)2
e15k_5The impact of stroke on the individual, carer and family5
e15k_6The implications of stroke for lifestyle; driving; work, including voluntary and family4
e15k_7Methods to help communication with those affected by stroke, including when conducting a review3
Skills and ability to…
e15s_1Take and interpret thorough history, including information from carers, relatives and other agencies where possible, and assess mental capacity3
e15s_2Communicate and discuss: current event; risk of future vascular event; need for assessments/investigations, interventions/ treatments and their timeframes; rationale for treatment and possible side effects of treatment; and provide timely information, advice and support2
e15s_3Assess, discuss and review with those affected by stroke: goal-setting and outcomes3
e15s_4Monitor the individual’s progress and agree on or change a maintenance or management plan3
e15s_5Plan assessments and treatments; provide information, relevant to individual needs and aspirations (personalise information)3
e15s_6Identify need and when to refer for more specialist or differing treatments where necessary3
e15s_7Know of local services, their waiting times and implications for those affected by stroke2
E15s_8Use individual commissioning3
E16Return to workCourse Level
Knowledge and understanding of…
e16k_1The effects of stroke (cognitive, physical, sensory, visual, emotional, confidence) and how it may affect a return to work and/or education3
e16k_2Assessing the effects of stroke (cognitive, physical, sensory, visual, emotional, confidence)3
e16k_3Employment law, the Disability Discrimination Act, health and safety at work0
e16k_4The roles of healthcare and other professionals in employment-related services (occupational health, occupational psychologist, disability employment adviser)1
e16k_5The occupational therapist’s role in vocational rehabilitation3
e16k_6Jobcentre Plus, its services and its effectiveness for stroke0
e16k_7What is meant by “reasonable adjustment” in the workplace, how to adapt or instigate adaptation to the work environment and the employer’s responsibility0
e16k_8Available helpful technology for overcoming functional and activity limitations in the workplace1
e16k_9Ergonomic principles and how to overcome access issues0
e16k_10Return to work education0
e16k_11Health, work and well-being – the role of purposeful occupation and the detrimental effects of worklessness0
e16k_12The benefits system in relation to work0
e16k_13Workplace assessment including risk, job analysis, work hardening, return to work planning and job retention0
e16k_14Models of vocational rehabilitation for stroke and vocational case management0
e16k_15Vocational rehabilitation guidelines and standards for people with stroke (British Society of Rehabilitation Medicine; Vocational Rehabilitation Association; UK Rehabilitation Council)0
Skills and ability to…
e16s_1Refer to a vocational rehabilitation service0
e16s_2Assess or refer for the assessment of visual, cognitive, functional and physical deficits following stroke2
e16s_3Identify local and national services for return to work, their availability and how they can be accessed1
e16s_4Know which professionals people should be referred to for employment-related services0
e16s_5Assess for, advise on and review the need for workplace adaptation0
e16s_6Assess for, advise on and review the need for assistive technology and environmental adaptations to overcome work-related activity limitations0
e16s_7With a stroke survivor, advise, prepare and plan a return to work or education and how they can be supported on the return to work pathway1
e16s_8Advise employers/educators about stroke and its effects and negotiate a return to work of the stroke survivor0
e16s_9Communicate stroke-related deficits to employers, colleagues, educators, family members and friends 2
e16s_10Give benefits advice or refer0
e16s_11Carry out a workplace assessment and risk assessment, or refer0
e16s_12Carry out job analysis, or refer0
e16s_13Set goals for work return/retention0
e16s_14Case manage and refer to a case management service for a return to work after stroke0
e16s_15Implement guidelines in practice0
e16s_16Help the stroke survivor to remain in work, review the stroke survivor at work/in education and advise on workplace accommodations0


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