In November 2025 — The Canadian Stroke Best Practice Recommendations (CSBPR) released the 7th Edition of Rehabilitation, Recovery and Community Participation Following Stroke, marking a significant national update to stroke rehabilitation guidance across the continuum of care. The 2025 edition reflects evolving evidence, emerging therapies, and an increased emphasis on patient-centred and community-integrated care. The revised edition is structured to support clinicians, administrators, and system planners. The updated recommendations are organized into three parts:
- Part One: Stroke Rehabilitation Planning for Optimal Care Delivery
Focuses on system-level design, access, and coordination to ensure timely and equitable rehabilitation services. - Part Two: Delivery of Stroke Rehabilitation to Optimize Functional Recovery
Addresses clinical interventions and best practices to improve patient outcomes across inpatient, outpatient, and community settings. - Part Three: Optimizing Activity and Community Participation Following Stroke
Highlights long-term recovery, reintegration, and strategies that support meaningful engagement in daily life.
Together, the three sections reflect a shift from an impairment- focused model toward one that prioritizes participation, inclusion, and quality of life.
Notably, Dr. Benjamin Ritsma, Physiatrist at Providence Care Hospital and Co-Chair of the Ontario Health Stroke Rehabilitation Advisory Committee, contributed as a member of the rehabilitation writing group and co-authored the three related publications in the American Journal of Physical Medicine & Rehabilitation.
The articles can be found via the hyperlinks in the titles of the update’s parts above.
Across southeastern Ontario, clinical teams across Inpatient Rehabilitation and Community Stroke Rehabilitation programs are actively reviewing the updated recommendations. Natalie Aitken, SNSEO Rehabilitation Coordinator will be connecting with sites to highlight existing alignment with best practices and identify opportunities quality improvement and future growth.
Already the Southeast has been asked to showcase their work outside the region! On December 16, 2025, Jennifer McKenzie and Marcela Mansure represented Providence Care Hospital and Southeastern Ontario at the Central East Stroke Network’s Stroke Unit Community of Practice, presenting on use of structured family conferences by their stroke rehabilitation team. Their work aligns strongly with the updated recommendations, which emphasize formal family meetings and the inclusion of written discharge plans. We thank Jennifer and Marcela for showcasing this leading practice and for their strong representation of southeastern Ontario.
To support implementation and understanding of these best practice updates Heart and Stroke will be hosting a webinar on March 11, 2026. Click the link to register for this session.
Notable Updates in the 7th Edition
The seventh edition introduces several important enhancements to stroke rehabilitation guidance.
A key update is the strengthened emphasis on the use of validated assessment tools across rehabilitation settings. The recommendations underscore the importance of standardized, evidence-based measures to support clinical decision-making, track progress, and promote accountability across programs.
The new edition also expands representation and inclusivity within stroke care. Updated recommendations include:
- Enhanced attention to sex and gender representation, ensuring that rehabilitation approaches recognize differences in experience and outcomes.
- Inclusion of a broader range of healthcare professionals, reinforcing the interdisciplinary nature of stroke rehabilitation.
- Increased focus on family participation in rehabilitation, acknowledging the central role of caregivers in recovery and transition planning.
Emerging therapies and modern approaches are also reflected in the revisions. The guidelines now include considerations for virtual reality in rehabilitation, highlighting its growing evidence base and potential role in therapy delivery. Aquatic exercise is also newly recognized as part of comprehensive recovery programming.
Community reintegration receives heightened attention in this edition. Recommendations emphasize:
- Community engagement and participation post-discharge, reinforcing that recovery continues well beyond inpatient rehabilitation.
- Guidance on outpatient (OP) and Community Stroke Rehabilitation (CSR) processes and standards, supporting consistency across regions.
Importantly, the update broadens the scope of rehabilitation beyond traditional motor recovery. Expanded guidance addresses:
- Sensory impairments
- Bladder and bowel assessment and treatment
- Relationships, intimacy, and sexuality
These additions reflect a more holistic approach to stroke recovery, recognizing the physical, emotional, and social dimensions of rehabilitation.
Advancing Stroke Care Across Canada
The 7th Edition arrives at a time when stroke systems across Canada continue to evolve toward more integrated, patient-centred models of care. By reinforcing evidence-based practices while addressing emerging priorities such as inclusivity, family engagement, and community participation, the updated recommendations aim to promote consistent excellence while allowing flexibility for regional implementation.
As health systems adopt these updated standards, the focus remains clear: improving functional outcomes, supporting long-term recovery, and enabling individuals affected by stroke to participate fully in their communities.
The release of the 2025 rehabilitation update represents not only an evidence refresh, but a reaffirmation of Canada’s commitment to advancing comprehensive stroke care from hospital to home and beyond.