Cerebrovascular accident (CVA), also known as stroke, is a general term for a group of vascular diseases of the brain caused by a variety of different etiologies, divided into two categories: hemorrhagic (cerebral hemorrhage, subarachnoid hemorrhage) and ischemic (lacunar cerebral infarction, cerebral thrombosis and cerebral embolic), characterized clinically by an acute onset and the appearance of focal neurological deficits, either cerebral hemorrhage or cerebral ischemia; its clinical manifestations are closely related to the lesion The clinical manifestations are closely related to the cerebrovascular site of the lesion. Neurological deficits of less than 24 hours are called transient ischemic attack (TIA). Clinical manifestations (1) Motor disorders: The most common is central hemiparesis of the limb contralateral to the lesioned hemisphere, including decreased or increased muscle tone, decreased or hyperactive tendon reflexes, positive pathological reflexes and possible clonus; pathological patterns or synergistic movements during limb movements, manifested by increased flexor tone in the upper limb and increased extensor tone in the lower limb. (2) Perceptual disorders: including hemianesthesia, one-sided hemianopsia and perceptual disorders; solid sensory deficits; anosognosia; dysarthria, etc. (3) Cognitive impairment: mainly manifested in dysfunction in memory, attention, orientation, thinking, problem solving and other abilities. (4) Speech disorders: ①Aphasia: common motor aphasia, sensory aphasia, naming aphasia, conductive aphasia, cortical aphasia, etc. (2) Dysarthria: manifested as abnormal articulation and unclear diction, often accompanied by swallowing dysfunction in early stage. (5) Swallowing disorder: it belongs to functional swallowing disorder or neurological swallowing disorder. (6) Mental and emotional disorders: mainly depression or anxiety disorders. (7) Impairment in activities of daily living: the ability to dress, groom, eat, bathe, and handle urine and stool is diminished. (8) Cerebral nerve palsy: including: 1) Facial nerve palsy: paralysis of the facial muscles below the orbit, often accompanied by hemiparesis and paralysis of the tongue muscles. (2) Pseudomyelination (ball) palsy: caused by damage to the bilateral motor cortex and the cortical brainstem tracts emanating from it, which are upper motor neuron lesions. (1) Indications and contraindications (1) Indications: Patients with cerebrovascular accidents without special contraindications. (2) Contraindications: Patients with unstable vital signs, such as fever (body temperature >38℃), fluctuating blood pressure, and continued progression of symptoms, may delay the start of rehabilitation or suspend rehabilitation treatment. 2. Rehabilitation purpose and principles (1) Treatment purpose The purpose of treatment in the acute phase: mainly to induce random movement of the limbs, prevent secondary damage (such as pressure sores, respiratory tract infections, deep vein thrombosis, etc.) and prevent abnormal movement patterns. The purpose of treatment during the recovery period: to promote recovery of motor function, improve selective movement of the limb, suppress abnormal joint reactions, improve walking ability, improve fine hand function and prevent possible comorbidities such as shoulder subluxation, shoulder-hand syndrome (compound regional pain syndrome), and joint stiffness. Specifically, these include: improving function, restoring or improving the patient’s motor, cognitive and speech functions to the maximum extent possible; improving self-care ability, restoring or improving the patient’s ability to perform activities of daily living and improving the patient’s self-care ability as much as possible; improving the patient’s quality of life and enabling the patient to return to society. (2) Treatment principles Early start: Treatment can be started for patients with stable vital signs, no progression of symptoms and consciousness. For comatose patients or patients staying in the intensive care unit, as long as there is no fever, no progression of paralysis, and stable blood pressure, passive activities of the limbs or intervention through physical factors can also be started. Comprehensive treatment: In addition to medication, physiotherapy, occupational therapy, speech therapy, psychotherapy, rehabilitation nursing, rehabilitation bioengineering, and Chinese medicine (including acupuncture and herbal medicine) are mainly used. Step by step: the treatment items are gradually increased from less to more, the treatment time is gradually increased, and the intensity of treatment is gradually increased; the outside help given to the patient in the treatment is gradually reduced, and the active participation of the patient is gradually increased. Persistent: from the onset of the disease, rehabilitation is intervened until the patient’s function is restored to the maximum extent.