What is the goal of rehabilitation during the acute phase of a stroke?

Written by Tang Ying
Physical Medicine and Rehabilitation
Updated on September 26, 2024
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Rehabilitation goals during the acute phase of stroke. In the acute phase, we usually can intervene with rehabilitation treatment 48 hours after the patient’s vital signs have stabilized. The main goals of rehabilitation during the acute phase are to prevent complications such as pressure ulcers, atelectasis pneumonia, urinary tract infections, deep vein thrombosis, and muscle atrophy. Additionally, it aims to improve impaired neurological functions such as sensory, motor, and speech therapies, and to enhance the patient’s ability for self-care and mobility.

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Written by Tang Bo
Neurology
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What medicine to take for a stroke?

Stroke includes ischemic stroke and hemorrhagic stroke, also known as cerebral infarction and cerebral hemorrhage. The medications used for these two diseases differ, so it is essential to identify which type of disease it is. When symptoms occur, such as slurred speech, limb weakness, or other symptoms, it is crucial to seek medical attention immediately. Perform a cranial CT scan first to rule out bleeding, and then consider cerebral infarction. If it is a cerebral infarction, thrombolytic therapy can be administered within 4.5 hours of the acute phase, followed by hospital treatment. During the acute phase of a cerebral hemorrhage, the decision on whether to proceed with surgery depends on the amount of bleeding. Regardless of the situation, these conditions are often underpinned by several underlying diseases, such as hypertension, diabetes, or hyperlipidemia, along with other risk factors. Therefore, medication needs to be personalized, and it is also necessary to check for any contraindications to determine what medication to use. (Medication use should be guided by a professional doctor.)

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Treatment of urinary retention in stroke patients

In cases of urinary retention after a stroke, some patients experience this due to psychological factors, concerns, and the sudden need to remain in bed, making it difficult to urinate in bed since they cannot stand or squat. Therefore, the first step is to alleviate psychological factors, provide patient communication and counseling, and perform massages around the navel and abdomen, along with heat treatments, to help patients urinate on their own. In a second scenario, where the patient's condition is severe or even comatose, and they have difficulty urinating, a catheter can be placed. It's important to first try to rule out a urinary tract infection, collect a midstream urine sample for analysis, and ensure the catheter is not left in longer than necessary. Once the patient's condition improves or they regain consciousness, the catheter should be removed promptly to avoid any urinary tract infections.

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Written by Zhang Hui
Neurology
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Can a stroke be cured?

Stroke is mainly divided into ischemic stroke and hemorrhagic stroke. Ischemic stroke, also known as cerebral thrombosis, can benefit many patients if they can reach a hospital quickly and receive intravenous thrombolysis within the time window, such as within 4.5 hours, leaving them with only mild neurological deficits followed by proper rehabilitation training. Some patients can be cured. However, if the stroke is severe from the onset, resulting in complete paralysis or even consciousness disorders such as drowsiness, stupor, or coma, the treatment outcomes can be significantly less effective, potentially leaving some degree of disability. Generally speaking, whether a stroke can be cured depends closely on the initial severity of the stroke, the overall condition of the patient, and the timeliness of the treatment. Some conscious patients who receive timely treatment can be cured, whereas those with severe conditions typically suffer from long-term complications.

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Written by Tang Bo
Neurology
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The difference between stroke and cerebral infarction

Stroke is divided into hemorrhagic stroke and ischemic stroke. Hemorrhagic stroke involves cerebral hemorrhage, while ischemic stroke involves cerebral infarction. Therefore, the difference is that stroke includes cerebral infarction, which is a type of ischemic stroke. In such cases, it is crucial to seek prompt hospital treatment and examine for risk factors related to cerebrovascular disease. Under the guidance of a doctor, the condition should be stabilized since the acute phase of a cerebral infarction might be unstable and could worsen. Thus, after stabilizing the condition, long-term oral medication will also be necessary to prevent future strokes.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Stroke Rehabilitation Treatment Plan

In the rehabilitation treatment of stroke patients, we first need to conduct a comprehensive rehabilitation assessment, evaluating the patient's current primary clinical symptoms, nutritional status, and rehabilitation functional impairments. Based on the results of the assessment, we determine the patient's main functional impairments, targeting a series of functional impairments such as mobility, hand function, as well as speech and swallowing disorders. We adopt a series of therapeutic interventions including exercise therapy, occupational therapy, physical therapy, swallowing therapy, speech therapy, psychological therapy, rehabilitation engineering, and rehabilitation nursing. Generally speaking, through evaluation, we develop a personalized rehabilitation treatment plan for the patient, comprehensively promoting the patient's overall recovery, improving the patient’s ability to live independently, and helping them return to their families, society, and work positions as soon as possible.