Post-stroke Rehabilitation

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    Stroke is caused by a cerebral embolism (ischemic) or by bleeding (hemorrhagic) within the brain. As it is essentially a vascular disease, the risk factors for stroke are similar to those for myocardial infarction, including high blood pressure (hypertension), diabetes, high blood sugar (hyperlipidemia), abnormal blood clotting, smoking, etc.

    The impact and severity of stroke depends on the scope of the brain injury. Common features of stroke include unilateral hand and foot paralysis that appear in the acute stage, difficulty swallowing (dysphagia) and speaking (dysarthria), the inability to comprehend language (aphasia), loss of bladder control (incontinence), limb spasticity, high muscle tone/spasticity (hypertonia), post-stroke depression, or vascular dementia caused by repeated episodes of stroke, as well as other problems that appear at later stages, each of which poses a great challenge to the lives of patients and their families.

    Post-stroke rehabilitation goals are based on the patient’s age, lifestyle and functional ability before stroke, severity of stroke, family expectations, and the availability of care resources, among others. All of these factors must be taken into consideration by the medical team, family members, and patient when setting goals for treatment. The main priority of rehabilitation is to help minimize future complications for the patient. For example, for patients who are unable to move on their own, safely performing transfers with assistance should be the primary goal of rehabilitation. This can greatly reduce the risk of impairments such as joint contractures, pressure sores, venous thrombosis, postural hypotension, and other complications caused by reduced physical activity. 

    Later rehabilitation focuses on practicing skills to help make everyday activities more convenient for patients and caregivers, such as putting on and taking off clothes, using utensils, and techniques for going in and out of the restroom. Changes in self-image after stroke may also affect the patient’s social and mental health. Similarly, the sudden changes after a stroke incident may have a great psychological impact on the patient’s family members. In post-stroke rehabilitation, both immediate and long-term treatment are essential. A professional medical team comprising of physical therapists, occupational therapists, and speech and psychotherapists are needed for rehabilitation, and the cooperation of the patient and their families are just as, if not more, important.