Early “toddler” after stroke

  Stroke, also known as stroke, is a group of symptoms that occur when a part of the brain tissue dies due to lack of oxygen because of a sudden interruption of blood supply to the brain cells. There are two main categories: ischemic stroke and hemorrhagic stroke. The former refers to the reduction or complete cessation of blood flow to part of the brain tissue, such as cerebral infarction. Hemorrhagic strokes are caused by compression and damage to brain tissue due to bleeding within or around the brain tissue. The most common functional impairment after a stroke is hemiparesis, others such as speech dysfunction, cognitive dysfunction, etc.  Early rehabilitation of stroke is usually started when vital signs are stable and neurological symptoms no longer progress after the onset of stroke. This includes the placement of good posture (antispastic position), massage, and passive activities. After further stabilization (generally cerebral infarction can be earlier, after about 1 week; cerebral hemorrhage later, after 2 weeks), appropriate motor training modalities are selected according to the specific situation, from bed training to sitting to standing and walking and upper limb functional training (called easy-to-use techniques, also known as neurophysiological and neurodevelopmental therapy). At a later stage, relevant occupational therapy can also be performed according to the patient’s daily life and work specifics in order to restore the ability to perform activities of daily living and work.  It is generally accepted that functional improvement after stroke is mainly within the first 3 months after the onset of stroke, with a tendency to continue to improve activities of daily living afterwards, and the degree of functional improvement is closely related to whether or not the rehabilitation therapy is carried out early. The degree of functional improvement is closely related to early rehabilitation because stroke patients can reorganize their central nervous function through timely rehabilitation, while physical activity can increase cerebral blood flow in the corresponding cortex.  Failure to move early after stroke may result in disuse syndrome, such as muscle atrophy, joint contracture, foot drop inversion deformity, and decreased cardiopulmonary function. However, inappropriate early activity and wrong rehabilitation methods can lead to another type of problem called disuse syndrome, such as joint damage and heterotopic ossification if inappropriate passive joint activity is given. Training for stroke should promote normal movement and inhibit abnormal movement. Inappropriate training can sometimes aggravate the original abnormal movement pattern of cerebrovascular patients and hinder the recovery of motor control, coordination and fine skills. For example, some family members are eager to support the patient to walk, which results in aggravating the abnormal drawing circle gait instead.  Therefore, formal rehabilitation of stroke patients is an important part of the overall treatment system, which seeks to keep the patient from becoming a disabled person, but to help more patients improve their quality of life and return to society.