Neurology enters the era of neurorehabilitation

  Rehabilitation medicine is a medical discipline on the prevention, diagnostic assessment, functional restoration, treatment and management of disabilities and functional disorders. Its purpose is to reduce or eliminate functional disorders, help the injured, sick and disabled to restore their physical, psychological, occupational and social life functions to the maximum extent possible according to their actual needs and physical potential, improve their ability to live, learn and work independently, and improve their quality of life. Rehabilitation medicine has become one of the four pillars of modern medicine alongside health care medicine, preventive medicine and therapeutic medicine. Neurological rehabilitation is an important branch of neurology, which is a new specialized discipline that is highly integrated with neurology after the development of rehabilitation medicine to a certain extent. Neurorehabilitation is a discipline that specializes in the prevention and rehabilitation of neurological disorders. The formation of neurological rehabilitation has changed the disconnect between neurology and rehabilitation, and has enabled the diagnosis and treatment of neurological and muscular diseases to reach a new overall level.  The development direction of rehabilitation medicine: 1. Scale: In western developed countries, there are large scale rehabilitation hospitals or rehabilitation centers in every region. In some economically developed regions in China, such as Guangzhou, Shenzhen and Shanghai, rehabilitation hospitals or rehabilitation centers have been emerging; 2. Specialized rehabilitation has become the best choice for general hospitals.  Stroke is one of the most common diseases in neurology, mostly seen in middle-aged and elderly people, and in recent years there is a trend of younger people. The incidence rate of stroke is 84/100,000 people, the first of all diseases, and the mortality rate is also very high. 1994 survey statistics, stroke is the first cause of death in urban areas, the third cause of death in rural areas, and in 2000 survey found that stroke has become the second cause of death in urban and rural areas. With the development of technology and medical progress, the survival rate of stroke is much higher than before, but 70%-80% of survivors have different degrees of functional impairment (motor, sensory, speech, swallowing, cognitive impairment, etc.), which becomes a heavy burden for families and society. For patients with cerebrovascular diseases, especially hemiplegia, when there is no fundamental progress in drug treatment at this stage, the way out lies in rehabilitation, rather than consuming most of the patient’s treatment cost for drug treatment, especially for patients with insufficient funds, a reasonable allocation of treatment cost is not only beneficial to the patient, but also meaningful to the patient’s family and society.  Neurological rehabilitation is a young discipline with a relative lack of talents. Neurologists have more solid basic knowledge of neuroanatomy and neurophysiology, and it is not difficult to improve the basic theory and practice of neurorehabilitation together. The future development and improvement of neurorehabilitation will be promoted by neurorehabilitation doctors who have worked in neurology.  The significance of rehabilitation intervention in neurology: 1. In the early stage of disease: participation in rehabilitation treatment can effectively prevent secondary disability due to injury or disease. For example, it can prevent shoulder pain, shoulder dislocation and joint contracture after hemiplegia; disuse muscle and joint atrophy, disuse lung function decline and vascular embolism after bed rest.  2.During the clinical recovery period: even if some diseases have caused disabilities, rehabilitation medical treatment can use comprehensive measures to bring into play their own potential, carry out functional training, functional enhancement and functional compensation to avoid complications or secondary disabilities caused by braking, which can greatly shorten the duration of hospitalization, thus changing the non-functional life state, reducing the degree of disability, reducing the cost of blind and ineffective medication, and reducing the economic and labor burden of society and families. This can reduce the economic and labor burden of the society and family, and gain social benefits, and also increase the value of their own lives.  3. At the later stage of the disease, the family community rehabilitation plan and prescriptions are formulated, and the patient and family members are taught and guided simple and effective self-rehabilitation methods. Hospital rehabilitation is the backbone of community rehabilitation, and community rehabilitation is the continuation of hospital rehabilitation.  In China, as measured by current disability standards, there are currently more than 60 million people with disabilities in China, accounting for about 5% of the total population, and about 1/5 of the families are affected and implicated. With the aging of China’s population, the number of people over 60 years old has exceeded 126 million and is growing at a rate of 3% of age, and according to the World Health Organization, it is predicted that China’s elderly population will reach more than 250 million by 2020. Relevant information shows that about 50% of geriatric patients need rehabilitation medicine services. In addition, due to the changes in the disease spectrum, old and slow disability diseases are more prominent, and there are many people with functional impairment.  Therefore, our whole society should pay attention to neurological rehabilitation, and neurology is about to enter the era of neurological rehabilitation.