How to recover early after a stroke

  With the accelerating pace of modern life, increasing stress and unbalanced diet, the number of hemiplegia caused by brain disorders such as stroke, traumatic brain injury and brain tumor is increasing. Acute cerebrovascular accidents (stroke, stroke), including cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage, are common and frequent diseases among middle-aged and elderly people. According to the epidemiological survey in China, the annual incidence rate is 200/100,000, with more than 1.5 million new cases each year. About 75% of the survivors are disabled, 40% of whom are severely disabled, mainly with motor dysfunction, sensory impairment, speech impairment, cognitive impairment, etc. The recurrence rate is as high as 41% within 5 years, making it the first cause of disability and the first cause of death in China. In order to minimize the mortality and disability rate and improve the survival quality of patients, timely inpatient resuscitation treatment should be provided along with early active and correct rehabilitation treatment. The rehabilitation treatment of stroke includes physical therapy, occupational therapy, speech therapy, psychotherapy, hyperbaric oxygen, application of orthopedic devices and traditional rehabilitation treatment. The most important of them is the early start of movement therapy based on nerve promotion techniques. According to the survey, early and active rehabilitation treatment can restore independent walking and self-care to 90% of the surviving stroke patients and 30% of the surviving patients can resume their original jobs. In contrast, without rehabilitation, the percentages of recovery in these two areas were correspondingly only 6% and 5%! The mortality rate was also 12% lower in the rehabilitated group than in the non-rehabilitated group. However, the fact is that due to the lack of social emphasis on rehabilitation medicine and the relatively low investment in this component, many patients are discouraged when they encounter treatment that they may have to pay for themselves (exercise therapy is now covered by health insurance, but may not be fully reimbursed in some areas). The vast majority of stroke patients are now unable to take care of themselves due to the lack of rehabilitation treatment, creating a large number of disabled patients and a great social burden for society. Medicine should be the joint development of prevention, health care, treatment and rehabilitation. Rehabilitation medicine is an important discipline that is irreplaceable by neurology and neurosurgery, and is not simply equivalent to massage, massage, acupuncture, physiotherapy and simply moving the arms and legs, but has a systematic theory and many technical methods to promote the functional recovery of patients. Nowadays, the majority of medical practices are directed only at the disease and do not care about how the patient continues to live his or her life, but social progress requires that we also restore the patient’s function or compensate for his or her original function after the disease, which requires more social support for rehabilitation medicine. The ultimate goal of stroke rehabilitation is to return patients to their families and to society.  Post-stroke hemiplegia is characterized by incomplete or complete loss of random movement of one limb. Patients not only have physical dysfunction, including basic motor and sensory, cognitive impairment, primary and secondary comorbidities, but also have impairment in self-care of daily life and social participation, which puts them in an extremely difficult state physically, psychologically and mentally. Therefore, active and reasonable rehabilitation treatment is particularly important. The current consensus in rehabilitation medicine is that “for the intervention of rehabilitation therapy for hemiplegia after brain injury, the earlier the time, the better the later recovery of the patient, marked by the stabilization of the patient’s vital signs after injury and no further progression of neurological symptoms, which is generally 24 to 48 hours after the onset of the disease in clinical practice”.  Exercise therapy (PT) has a long history and profound connotations in China. In recent decades, rehabilitation medicine has developed rapidly and is increasingly valued by society, and has played a huge role in clinical medicine, and as an important part of rehabilitation medicine, exercise therapy has an irreplaceable position. Without the effective intervention of rehabilitation therapy, patients with hemiplegia after brain injury can hardly achieve the purpose of improving the quality of life through clinical treatment only, and they will have complications such as pain, muscle wasting atrophy and cognitive impairment, which will bring heavy burden to the family and society. Rehabilitation medicine starts from the perspective of obstacleology, and uses movement therapy to reconstruct motor function for patients to adapt to social life. In the past, there was a lot of confusion between lower motor neuron palsy and upper motor neuron palsy. The rehabilitation process of lower motor neuron palsy is a quantitative change of muscle strength from small to large, while the rehabilitation process of upper motor neuron palsy is a qualitative change of movement pattern. In response to the essential difference between the two, rehabilitation medicine has established a nerve promotion technology that integrates “Bobath therapy, Rood therapy and PNF therapy”, which is a leap forward in the understanding and treatment of hemiplegia. Through the Bobath technique, which relieves spasticity and improves control of the affected limb, the Rood concept, which induces a motor response and helps to establish motor memory, and the PNF technique, which uses the stimulation of proprioceptors to improve and promote muscle function, post-stroke hemiplegic patients can regain normal movement patterns, generate appropriate motor memory, and establish activity balance, thus improving their daily life. ability.