Under the change of modern life style, stroke has become the second biggest killer of human health with its “four high” characteristics, namely high morbidity, mortality, disability and recurrence. Experts say that 50%-80% of patients who survive cerebrovascular disease are left with varying degrees of disabling sequelae, such as lateral paralysis, language impairment, joint stiffness, etc. This not only causes patients to lose their ability to take care of themselves, but also brings enormous pressure and burden to families and society.
Stroke rehabilitation should start 48 hours after the onset of stroke
After a brush with death, the first thing most people consider is how to recuperate. Clinically, many stroke patients can walk on crutches, but have abnormal posture and uncoordinated limb movements, with the lower limb on the affected side paddling in an arc-shaped trajectory, and the elbow, wrist and fingers on the affected side hanging stiffly from the chest in a bent position. Or the hand on the hemiplegic side is swollen and the shoulder is painful, so that the patient dares not move the upper limb on the affected side, making the limb motor function stagnant.
So, is this how stroke patients should end up after the onset of the disease? Many of the problems mentioned above may be due to the fact that the patient did not intervene in rehabilitation in a timely and standardized manner in the early stage or used inappropriate methods in the rehabilitation process, resulting in many obstacles that are not conducive to the body’s functional recovery. Many patients and their families have the misconception that rehabilitation interventions should only take place after the patient has been cured of the underlying disease and the overall physical condition has improved, and if this is the case, the patient may be dependent on family members or companions for the rest of his or her life. Pat Davies, a world-renowned expert in rehabilitation medicine, suggests that “rehabilitation should begin on the day of onset, not when you arrive at a rehabilitation center” is the most positive.
Early rehabilitation can restore the ability of 90% of patients to care for themselves
How effective is early and standardized rehabilitation treatment? According to the clinical summary of rehabilitation and a large number of studies, early and standardized rehabilitation treatment can restore 90% of patients to independent walking and self-care ability and 30% of patients to their original jobs. In contrast, without rehabilitation, the percentages of recovery in these two areas are correspondingly only 6 and 5 percent! “Early and standardized timing of rehabilitation interventions for stroke patients is very important. Early bedside care and systematic and correct rehabilitation interventions for patients are of paramount importance, and rehabilitation during the recovery and sequelae periods is even more important for improving patients’ survival and quality of life.”
When exactly can stroke rehabilitation be intervened? Generally speaking, as long as the stroke patient is conscious, his vital signs are stable and his condition is no longer developing, rehabilitation can be carried out 48 hours after the onset of the stroke. Early rehabilitation training must be carried out under the guidance of a professional doctor in a regular hospital.
Rehabilitation training, should be carried out under the guidance of a doctor
1.Early bedside rehabilitation
Suitable position placement: The patient’s bedside position can be divided into supine position, affected side position (affected side underneath) and healthy side position, and the patient needs to be placed in a suitable position for different positions with the help of pillows and towels, etc. The correct position placement can prevent premature and strong spasm, joint contracture, pressure sores and hand edema and other obstacles.
Passive joint activities: Passive movements for the joints of the upper and lower extremities require the caregiver to understand the relevant anatomical structures and protect the important joints of the patient. Avoid rapid forceful pulling or large movements during passive activities, and gradually increase the amplitude and range of passive activities.
Training on the training mat: lay the foundation for trunk and limb control in sitting and standing position, mostly trunk and limb movement control and strength training, including bridge movement, autonomous/assisted turning training, lying-sitting transfer training, sitting balance training, etc.
2.Standing balance function training
Stroke patients with paralysis and weakness of one side of trunk and limbs tend to fall to the affected side when standing, and good standing is the basis for walking, so it is crucial to use rehabilitation techniques and equipment to provide safe and effective standing balance training for patients. As for going to the hospital rehabilitation department, the BIODEX balance training system is used to assess the patient’s neuromuscular control ability and balance ability, and provide the patient with training such as lower limb weight bearing capacity, as well as the plantar pressure gait analysis system, which can intuitively understand the distribution of pressure on both feet when the patient stands, and timely shift the center of gravity to achieve standing balance, etc.
3.Walking function training
Don’t think that walking training is simple, but in fact it is necessary to focus on the key aspects of abnormal gait according to gait analysis. Weight reduction gait training system can be used to reduce the weight of the patient’s lower limbs and waist, so as to conduct safe and active walking training as early as possible; or the lower limb rehabilitation robot can assist the patient to conduct walking training in the standing position with repetitive and correct movement patterns; through the three-dimensional gait analysis system to conduct targeted analysis and correction of the patient’s abnormal gait, etc.
4.Upper limb and hand motor function training
According to the different conditions of the patients, the training is skillfully integrated into various activities, such as comprehensive training of upper limb hemiplegia and virtual game training, to expand the range of joint movement, enhance muscle strength and endurance, normalize muscle tone, improve balance and coordination and enhance the overall function of the body.
5.Language and swallowing training
Many stroke patients have different degrees of language and swallowing disorders, which are manifested as language problems such as inability to speak, slurred speech or inability to understand others’ speech, as well as swallowing problems such as choking on water and difficulty in swallowing. Swallowing disorders can affect the patient’s quality of life, and frequent mis-swallowing can lead to pneumonia.
The following rehabilitation measures can be used: targeted language training through the Aphasia Assessment and Training System and the Dysarthria Assessment and Training System; training for swallowing disorders through swallowing balloon dilation, biofeedback therapy devices for swallowing disorders, and related swallowing training techniques.
The early rehabilitation treatment tools seem to be simple and subtle, but they lay a good and solid foundation for the patient’s later rehabilitation process, reduce the occurrence of complications, spasticity and abnormal trunk posture, and induce the functional recovery of the disabled trunk and limbs in a gradual manner.