Cerebrovascular disease, also known as stroke, is characterized by high mortality rate, high disability rate, high recurrence rate and multiple complications. According to statistics, there are 1.5 million new stroke patients in China every year and about 7 million existing survivors, and 70% to 80% of these survivors are left with varying degrees of disability, of which hemiplegia is one of the most common symptoms.
In the opinion of rehabilitation medicine experts, the disability of many stroke patients can be avoided and reduced, and hemiplegia can be corrected through rehabilitation treatment, but misconceptions and unregulated methods have become “roadblocks” to rehabilitation for stroke patients.
Misconception 1: Seeking only rescue and neglecting rehabilitation treatment.
This situation usually occurs after the acute attack of the stroke patient, the family has not yet realized what kind of sequelae the stroke will leave to the survivor, just think that it is good to get back a life. Many stroke patients continue to receive medication in the hospital even after their condition has stabilized, and some patients are still in bed with infusion therapy even a month after their condition has stabilized.
In fact, in foreign countries, once stabilized, stroke patients soon undergo early rehabilitation. Studies have shown that the earlier the rehabilitation intervention of a stroke patient, the lower the chance of late hemiplegia. Three months after a stroke patient’s condition is stabilized belongs to the optimal rehabilitation period, and six months after the condition is stabilized, belongs to the effective rehabilitation period. Rehabilitation within this period will be more effective. Once the effective rehabilitation period is missed, it will be difficult to guarantee the effect of rehabilitation treatment.
Generally speaking, after the condition is stabilized, the stroke patient is in the soft paralysis period. During this period, the muscle contraction and nerve conduction force of the limb on the patient’s side of the disease is almost zero, and simple rehabilitation is required at this time.
This is done by ensuring that the patient’s arm is straight and the leg is properly curved, regardless of the patient’s position, whether lying down or lying on his or her side. If necessary, the patient’s elbow and knee joints can be artificially elevated. Why do the unconscious elbow and knee joints on the side of the stroke patient need to be specially positioned one by one? This is because the period of weakness only lasts for 3 to 4 weeks, after which muscle tone and neurological perception on the affected side recover for about six months. The patient’s muscles regain strength, mainly flexion strength in the upper extremity and extension strength in the lower extremity. If no attention is paid to the placement of the elbow and knee joints at this time, the inappropriate contraction of the muscles may be exacerbated during the recovery period, inducing the formation of the typical hemiplegia symptom of “the arm cannot be straightened and the leg cannot be bent”.
Misconception 2: Believing that drugs can cure everything.
The rehabilitation treatment after stroke is to combine the different conditions of each patient, to guide and stimulate the muscle tissues and nervous system that have “struck” due to cerebrovascular disease through scientific exercise, to reshape the brain function, in order to stimulate the patient’s own strength, and to achieve the purpose of the patient’s self-care and work autonomy.
However, there are quite a few patients who are overly superstitious about drugs and think that they can cure everything. Such patients always try to find a special drug and waste their precious recovery time in the process of unnecessary tossing and turning. Eventually, the effective recovery period is missed.
Myth 3: Impatient mood, excessive rehabilitation exercise.
Some patients with cerebrovascular disease or their families are so eager to recover that they make their own overly strict rehabilitation training plans, which affect the effect of recovery. Some patients’ families tie a rope to the sick side leg of the patient who can just get out of bed and pull the patient along, so that if they walk on, they will come out with a patient whose leg cannot bend. Some patients take “how far they can walk” as the standard for measuring the effectiveness of rehabilitation. Although they can walk several kilometers every day, the strength of their sick side is actually very weak and is not enough to support normal walking. Patients then experience excessive extension of the knee backwards, causing abnormal friction of the knee joint, which can seriously wear out the knee joint over time.
Patients with cerebrovascular disease must first undergo bed turn training, bed bridge training, sitting training, transfer training, and standing training before gradually transitioning to walking ability training. Any attempt to go beyond a certain stage is like a child learning to walk: it is not scientific to start running before learning to walk.
Rehabilitation training must be done scientifically under the guidance of rehabilitation professionals, otherwise it will easily cause “misuse syndrome”. After brain injury in stroke patients, often the upper limb flexor muscle tone is high, fingers, arms can not be straight, the scientific training method should train the muscle group with low muscle tone, inhibit the muscle group with high muscle tone. However, some patients do not understand the knowledge of rehabilitation, desperately practice hand grip or practice tension in various ways, the more practice fingers and elbow joints can not be straight.
Myth 4: Not understanding the principle of rehabilitation, wrong exercise affects rehabilitation.
The need for rehabilitation intervention for patients with cerebrovascular disease is something that has only emerged in China in recent years, and it is even new to patients and their families. Some patients or their families only do rehabilitation based on their own understanding, which inevitably leads to mistakes.
Some patients start with a hand that can be straightened but not bent. Patients and family members feel that a hand that cannot grasp is not useful for future self-care and should be practiced more for grasping. In fact, the palm of the patient’s previously extended hand can be restored to normal with scientific rehabilitation, but due to the patient’s wrong training, the affected hand has lost its function. If the patient and family members had more knowledge about rehabilitation, something like this would not have happened.
Misconception 5: Negative spirit, delaying the disease.
As the saying goes: the disease comes like a mountain, the disease goes like a silk. The rehabilitation of patients with cerebrovascular disease often lasts for six months or even longer. Patients in this not short time, it is easy to appear self-abandonment abnormal psychology. Especially some patients in their prime years were the pillars of their families before the onset of the disease, so they hope to get better as soon as possible, but the long rehabilitation process makes them lose all their confidence.
The rehabilitation process can only proceed to the next step when the muscle strength accumulates to a certain level, which requires a process. At the beginning, the recovery will be fast, but when the plateau stage is reached, the muscle strength needs to enter a process of accumulation, and when the plateau stage is passed, it will enter a fast recovery stage again.