When is a good time to rehabilitate for stroke hemiplegia

  Stroke is a common and frequent disease among the elderly, and is one of the three major diseases causing human death in the world at present. In recent years, with the widespread use of imaging technologies such as CT and MRI, the early diagnosis of stroke and the gradual improvement of medical treatment, the mortality rate of stroke patients has decreased significantly. However, due to the lack of awareness of the importance of stroke rehabilitation, many people miss the best period of rehabilitation treatment, resulting in about 75% of the survivors being disabled. This places a heavy burden on their families and society. Early, active and correct rehabilitation will result in significant functional improvement in 80% of patients, and 60% of patients can achieve self-care in daily life. It plays a positive role in improving the quality of survival of patients.  When to start rehabilitation for stroke patients? Rehabilitation is not an independent process. Rehabilitation should be started simultaneously with emergency resuscitation, and preventive rehabilitation should be done. Through preventive measures, not only can we promote the recovery of damaged functions as soon as possible, but also prevent the occurrence of various complications. This phase of rehabilitation is mainly done in the neurology department of general hospitals. Once the stroke patient is discharged from the hospital in a stable condition, the next step of rehabilitation treatment needs to be done in a professional rehabilitation treatment institution for comprehensive and systematic rehabilitation treatment.  After a sudden cerebrovascular disease causes hemiplegia, many patients are depressed and can’t take interest in anything; and for patients’ family members, they are heartbroken after their loved ones’ accidents and let the patients lie in bed all day, not allowing them to do anything. In fact, more and more clinical observations and studies have found that the earlier the rehabilitation intervention is carried out, the better the patient recovers. Generally speaking, after the occurrence of ischemic cerebrovascular accident, rehabilitation training should be carried out in time when the condition is stable for 2~3 days, while hemorrhagic cerebrovascular accident can be postponed until the condition is stable for 1 week.  In the early stage of hemiplegia, the limbs are still in the stage of weakness. At this time, with the help of the healthy limbs or relatives, there are several simple and easy exercise methods that are helpful for the recovery of hemiplegic limbs, and patients and their families must seize this golden time of rehabilitation. After a stroke patient has passed the danger period, he/she enters the rehabilitation exercise stage. At this time, the patient mainly uses exercise in certain ways to promote the functional recovery of the paralyzed limb, prevent contracture of the paralyzed limb, improve physical health, prevent complications, and make the patient treat the disease with a positive attitude and improve the patient’s mental state.  The main methods used are massage, passive exercise with the help of others, and active exercise with the patient’s own participation.  Although medical professionals advocate rehabilitation exercises as early as possible, patients and family members are often apprehensive about early exercises, especially for patients with cerebral hemorrhage, who are worried that early activities may cause rebleeding. In fact, the chance of rebleeding caused by rehabilitation exercises is very small. Medical personnel concluded that rehabilitation exercises for patients with cerebral hemorrhage will not cause rebleeding as long as the blood pressure is stable and the movements are not violent, while rehabilitation exercises start too late to prevent sequelae and complications.  Others believe that the rehabilitation of stroke patients is meaningless after six months, and the patient’s body function will not recover more from further exercise, which is also wrong. Many patients still have improved physical function 1 year after the stroke, and do not insist on exercise, the function that has been restored will often regress.  Some patients with other organ pathologies such as hypertension and coronary artery disease worry that exercise will cause blood pressure fluctuations and heart attacks. In fact, stroke rehabilitation exercises are gradual, and as long as overexertion and excessive exertion are avoided, these conditions generally do not occur.  Therefore, we advocate that once a stroke patient’s condition is stable, he or she can exercise to promote the recovery of the disease.