Basic Principles of Stroke Rehabilitation Treatment

Written by Li Chao Jin Zi
Neurorehabilitation
Updated on August 31, 2024
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There are several key principles for stroke rehabilitation. The first emphasizes that rehabilitation should start as early as possible. In cases of ischemic stroke, generally when the patient is conscious and vital signs are stable, rehabilitation can begin after 48 hours. For patients with high blood pressure or cerebral hemorrhage, it is generally recommended to start rehabilitation after seven days. The second principle emphasizes the active participation of the patient, encouraging patients to actively engage in rehabilitation training and communicate with therapists to achieve functional improvement. The third point emphasizes comprehensive rehabilitation; stroke patients often have issues in multiple areas such as language, cognition, swallowing, limb movement, and functional balance, so it is suggested that patients undergo comprehensive rehabilitation rather than focusing on just one aspect. The fourth point stresses the continuity of rehabilitation, as rehabilitation therapy is an ongoing process.

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Can a stroke be detected through a physical examination?

Patients who have suffered a stroke can definitely be diagnosed if they undergo a head CT scan or MRI during a physical examination. Stroke is classified into hemorrhagic stroke, ischemic stroke, and tumor-induced stroke. A tumor-induced stroke is caused by a tumor, and hemorrhagic stroke includes cerebral hemorrhage and subarachnoid hemorrhage. Ischemic stroke refers to diseases such as cerebral embolism and cerebral infarction. Whether it is a hemorrhagic or ischemic lesion, over time, they tend to form a softening focus. These lesions are difficult to eliminate, and regardless of how many years have passed, these old lesions can still be seen in a head CT scan or MRI. In cases of stroke caused by brain tumors, the changes in size and location of the lesion can also be clearly seen on a head CT scan. Therefore, strokes can be diagnosed during a physical examination of the patients.

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The soft paralysis phase of a stroke refers to a few weeks after the onset.

The recovery of stroke patients is generally divided into four phases: the flaccid phase, also known as the hypotonic phase, the spastic phase, the recovery phase, and the sequelae phase. The symptoms of the flaccid phase mainly include muscle relaxation, low muscle tone, and lack of autonomous movement. The majority of patients maintain the flaccid phase for about one to three weeks, and depending on the individual's condition, they generally begin to enter the spastic phase after one to three weeks. A small portion of patients with severe conditions and poor initiative, who have not undergone formal rehabilitation training, may extend their flaccid phase to more than a month or even longer. Therefore, receiving early formal rehabilitation training to improve muscle strength and spasticity treatment can allow patients to smoothly transition through the flaccid phase and gradually enter the spastic phase. Good management of spasticity is even more beneficial for the patient’s recovery. Rehabilitation training can help stroke patients recover sooner and faster.

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What are the symptoms of a stroke?

Symptoms of stroke vary greatly, and it is crucial to judge based on the circumstances. The symptoms are mainly divided into two major categories: hemorrhagic stroke and ischemic stroke. The most common symptoms of hemorrhagic stroke are severe headaches, projectile vomiting, and the gradual onset of consciousness disorders. Some people might also experience limb numbness, weakness, speech impediments, and other conditions. The most common symptoms of ischemic stroke include dizziness, limb numbness, and speech impediments; sometimes, these symptoms alternate, so it is essential to pay attention to clinical observations and focus on differential diagnosis. There are also other types of symptoms, such as cognitive decline, urinary and fecal incontinence, unstable gait, swallowing difficulties, and coughing while swallowing. Therefore, it is imperative to visit a hospital in a timely manner for testing to clearly understand the specific changes in the patient's condition at that time, thus better facilitating the patient’s recovery.

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What department should I go to for a stroke?

Stroke is classified into ischemic stroke and hemorrhagic stroke. If symptoms of a stroke occur, such as slurred speech, limb weakness, or other neurological deficits, one should immediately seek medical attention at the emergency department of a local hospital. Emergency doctors will perform a head CT scan. If ischemia is present, the CT scan might not show changes within 24 hours, in which case a visit to the neurology department is necessary. If hemorrhage is detected, then a visit to the neurosurgery department is required. However, if the symptoms are of a chronic, old stroke, then a visit to the neurology department is needed.

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What are the symptoms of a stroke?

Stroke, also commonly referred to as cerebrovascular accident, is caused by the rupture or blockage of blood vessels within the skull, leading to necrosis of brain tissue and a series of symptoms. It is divided into ischemic stroke and hemorrhagic stroke. Ischemic stroke, commonly known as cerebral infarction or stroke, while hemorrhagic stroke refers to cerebral hemorrhage. Generally, ischemic strokes account for 80% of cases. Ischemic stroke is caused by blockage of blood vessels leading to necrosis of brain tissue, presenting with a series of symptoms such as hemiplegic numbness. Cerebral hemorrhage results from rupture of brain blood vessels causing damage to brain cells and symptoms of compression, and may also present with symptoms such as hemiplegic numbness. Both types can be differentiated by their symptoms, and can also be definitively diagnosed through a CT scan.