Principles of Stroke Rehabilitation Treatment

Written by Tang Ying
Physical Medicine and Rehabilitation
Updated on September 28, 2024
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Principles of stroke rehabilitation treatment.

First is the issue of timing; it is crucial to choose the appropriate time for rehabilitation intervention. Rehabilitation treatment should start as early as possible when the patient's condition is stable.

Secondly, rehabilitation assessment, also known as rehabilitation evaluation, should be performed throughout the treatment process. This allows for comparability before and after treatment, clarifying the treatment results for the patient and determining if there is a need to modify the treatment plan during the process.

Thirdly, it is essential to have rehabilitation treatment goals and plans. Based on assessments, short-term and long-term rehabilitation plans must be developed for the patient to achieve certain rehabilitation objectives.

Fourth, the principle of gradual progression must be adhered to in rehabilitation treatment. It should not be rushed, and active participation from both the patient and their family members is crucial, incorporating daily life and exercise opportunities.

Fifth, rehabilitation treatment primarily involves comprehensive therapy, which includes physical exercise, speech therapy, occupational therapy, physiotherapy, and traditional rehabilitation treatments such as acupuncture and moxibustion, as well as psychological therapy, rehabilitation engineering, and assistive devices.

Sixth, conventional pharmacological treatments and necessary surgical interventions are involved. These include essential medications that must be used, and when rehabilitation methods alone cannot restore function, appropriate medical advice from relevant departments should be considered, and surgical treatment may be needed to assist the patient in better recovery.

Other Voices

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Written by Tang Bo
Neurology
1min 3sec home-news-image

The treatment goals in the early stage of stroke

Stroke includes hemorrhagic and ischemic types. Whether it is hemorrhagic or ischemic, hospitalization is necessary during the acute phase. Depending on the patient's condition, if it is hemorrhagic, the amount of bleeding should be considered to decide whether to opt for surgical treatment or conservative treatment. If it is ischemic, and the treatment is initiated within the therapeutic time window, that is within 4.5 hours, thrombolytic therapy can be administered, which may potentially reverse the symptoms of the stroke. If the time window is missed, then conservative treatment is required. Acute cerebral infarction in its acute phase can potentially worsen, so the primary goal of acute phase treatment is to stabilize the condition. After stabilization, rehabilitation and physical therapy can gradually improve the patient's symptoms.

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Written by Sheng Wang
Neurology
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Causes of Dysphagia after Stroke

The causes of dysphagia resulting from a stroke are largely related to the location of the stroke. Dysphagia mainly involves the glossopharyngeal and vagus nerves, which are distributed in the medulla oblongata of the brainstem. Therefore, if you have a brainstem stroke, specifically at the medulla oblongata, there is a significant chance of experiencing coughing due to aspiration and dysphagia. If the stroke occurs in a different area, these symptoms are unlikely to appear. A stroke in the cerebral hemisphere, since it has bilateral nerve supply, does not lead to noticeable coughing if only one side is affected. However, if one side is affected this year and the other side next year, similar symptoms of aspiration cough and dysphagia will occur. Therefore, neurologically, the location and specific site of the stroke are crucial, as each location presents different symptoms.

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Written by Liu Yan Hao
Neurology
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What are the types of strokes?

The common types of strokes include hemorrhagic stroke and ischemic stroke. Hemorrhagic strokes commonly involve subarachnoid hemorrhage and intracerebral hemorrhage. Subarachnoid hemorrhage often occurs due to the rupture of cerebral aneurysms, causing blood to enter the subarachnoid space. Intracerebral hemorrhage is commonly caused by hypertension leading to the rupture of cerebral blood vessels and subsequent bleeding into the brain parenchyma. Additionally, there is ischemic stroke, commonly presenting as cerebral infarction and cerebral embolism. Cerebral embolism occurs when a blood clot from another part of the body outside the brain, following the blood circulation, blocks a cerebral vessel. Cerebral infarction happens when cerebral arteriosclerosis narrows down to a certain extent, gradually obstructing and forming cerebral infarction. These are the common types of strokes.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Rehabilitation nursing for stroke patients

For the rehabilitation and nursing care of stroke patients, first and foremost, we need to monitor the patient's vital signs, food intake, sleep, as well as bowel and bladder function. Secondly, we should pay attention to their psychological state, checking for signs of tension, anxiety, and depressive emotional reactions. Thirdly, we encourage patients to overcome their illness and to establish confidence in their recovery. Fourthly, we guide patients to actively engage in physical function exercises, as well as daily activities such as eating and dressing to practice their daily living skills. Fifthly, we manage proper limb positioning and patient turning, prevent pressure sores, and also prevent a series of complications such as venous thrombosis and urinary tract infections.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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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.