Principles of rehabilitation treatment for different stages of cerebrovascular diseases

  Acute phase: A few days after the disease, emergency resuscitation is the main focus. If the patient is conscious and the condition does not progress, rehabilitation should be done as early as possible.  1.Preventing complications: measures can be taken to prevent pressure sores by turning regularly (usually once every 2h) or using turning beds and alternating inflatable air mattresses; keeping the airway open to prevent respiratory infections; moving the limbs frequently to prevent deep vein thrombosis, etc.  2. Prevention of joint contracture and deformation: massage can promote blood lymphatic return and reduce limb edema; passive movement of paralyzed limbs can maintain muscle tone and joint range of motion; placement in antispastic position can prevent the development of abnormal patterns. For example, the antispastic position in the supine position: the upper limb shoulders are slightly elevated and forward, the upper arm is externally rotated and slightly abducted, the elbow and wrist are extended, the palm is up, and the fingers are extended and separated; the lower limb pelvis and hip are forward, the thighs are slightly inward and slightly internally rotated, a pad is placed on the outside of the affected thigh to prevent lower limb external rotation, the knee is slightly padded and slightly flexed, the ankle is 90 degrees, and the toes are up.  Recovery period: After the acute phase, patients with stable vital signs and clear consciousness can carry out functional training, and the recovery period can be generally divided into delayed paralysis, spasticity and improvement period.  The treatment focuses on restoring or improving muscle tone and inducing active movement of the limbs.  The treatment focuses on relieving muscle spasm, controlling abnormal movement patterns, and promoting the emergence of dissociative movements.  The treatment focuses on further reducing muscle spasm, restoring normal muscle tone, promoting selective limb movements, and improving motor coordination and motor control. The training of motor control is carried out in the order from simple to complex and from easy to difficult according to the normal motor development, from turning over, sitting, sitting balance, double knee standing balance, single knee standing balance, sitting to standing, standing balance and walking.  Sequelae period: 2 years after the onset of the disease, enter the sequelae period.  1. Continue the rehabilitation training during the recovery period in order to further improve the function or prevent the loss of function.  2. Make full use of the residual functions, improve the patient’s surrounding environmental conditions as much as possible to adapt to the disability, and strive for self-care in daily life to the maximum extent. For those with very poor functional recovery, the focus is on the compensatory function of the healthy side of the limb.  3. For patients with work potential who have not yet retired, vocational rehabilitation training should be conducted as appropriate to enable patients to return to society as far as possible.  4.Use the necessary assistive devices (such as canes, walkers, wheelchairs, braces) to compensate for the function of the affected limb when appropriate.  5.If possible, make necessary modifications to the family and the living community environment.  6. Pay attention to vocational, social and psychological rehabilitation.