Cerebrovascular disease old people called stroke, including cerebral hemorrhage, cerebral infarction, subarachnoid hemorrhage and a series of cerebrovascular disease. According to statistics, nearly 2 million new strokes occur each year in China, and about 1.5 million people die each year from cerebrovascular disease; about 6-7 million patients survive (including those who have recovered); and about 75% of those who survive are disabled, with a recurrence rate of 41% within 5 years. High mortality, disability and recurrence are the most typical features of these diseases. The most common sequelae of stroke are hemiplegia, dysphagia, language impairment, cognitive impairment, and vascular dementia; at present, the only effective treatment for these sequelae is comprehensive rehabilitation. Early, formal and comprehensive rehabilitation treatment can not only restore the patient’s physical and speech functions to the greatest extent, but also improve the patient’s daily living ability to the greatest extent, reduce the burden of family care, and restore the patient’s working ability to the greatest extent, so that the patient can return to the family and society normally. But the wrong rehabilitation treatment, not only for the patient is not useful, but also very harmful, the following are several major misconceptions of stroke rehabilitation. 1, no need to do rehabilitation treatment, injection and medicine can cure hemiplegia (wrong concept, disorderly treatment, waste of money) The best way to treat stroke hemiplegia, can not speak, can not eat is to inject and take medicine, most Chinese people basically think so, take it for granted, there is a disease must be injected and take medicine to cure, even including large hospitals neurology, emergency department, neurosurgery, etc. doctors and nurses are all of this opinion, Even doctors and nurses in neurology, emergency departments and neurosurgery departments of large hospitals think this way. In fact, in the case of cerebral infarction, if the cerebral blood vessels are blocked causing irreversible necrosis of brain cells if the ischemia lasts for more than 6 hours, there are no drugs that can save these brain cells, that is, injections and medications are not effective. The disease is effective and necessary, and thrombolytic therapy can be performed within 6 hours of the disease, which is the best way; and there is no drug to cure cerebral hemorrhage. Rehabilitation is the only effective method for stroke hemiplegia, aphasia, swallowing disorder and other sequelae, which is clinically proven and has long been popular abroad. In China, rehabilitation medicine is extremely underdeveloped, the country has no relevant policy support, most areas do not have community rehabilitation centers (reportedly Beijing, Guangzhou and other cities have been in the planning), and most hospitals do not even have a rehabilitation department, coupled with the people have no concept of rehabilitation, resulting in not going to rehabilitation training after a stroke, but just injections and medication, the result is chaotic treatment, wasted money, and not at all helpful to recovery. No. 2. 2, rehabilitation until the sequelae period to start (delayed treatment time, missed the best treatment period) Many stroke patients and their families wrongly believe that: rehabilitation treatment can only be started in the sequelae period, to wait for a month after the disease, or even three months after the rehabilitation treatment. In fact, the earlier the formal rehabilitation training starts, the better the rehabilitation effect will be, but many people miss the best time for rehabilitation (within three months of onset) because of this view. In fact, rehabilitation can be started as soon as the condition of a patient with cerebral hemorrhage or cerebral infarction is stabilized. Generally speaking, patients with cerebral infarction can be rehabilitated after 48 hours as long as their consciousness is clear, their vital signs are stable, and their condition is no longer developing. Most cerebral hemorrhage rehabilitation can be started 7 to 14 days after the disease. 3, rehabilitation is simple, that is, to move your arms and legs (self-righteousness, serious consequences) This is the most serious wrong view. Under the guidance of rehabilitation physicians, rehabilitation therapists and rehabilitation nurses, rehabilitation training must be carried out according to the specific situation of each patient, and then a targeted treatment plan is formulated. For example, many patients have shoulder dislocation, shoulder pain, shoulder-hand syndrome, etc. This is the result of not following the requirements of the rehabilitation physician and therapist, and the consequences are very serious, because once the shoulder-hand syndrome occurs, the patient’s arm and hand will be crippled. Therefore, rehabilitation should not be done on your own initiative, but according to the instructions of the doctor, therapist and nurse. 4.Joint injury caused by excessive force (wrong method, causing new injury) When the body’s sensory function and muscle tone are normal, the movement of the limb will be instinctively self-protected. For example, an elderly person, due to the aging of the ligaments and joint capsule, can only reach 150 degrees of movement in the shoulder joint when the arm is raised forward. If the arm continues to be raised upward by an external force, he or she will feel pain in the shoulder, and at the same time the muscles will reflexively contract to counteract the inappropriate movement. This is self-protection. If the protective mechanism is no longer present, and the shoulder joint is allowed to be pulled by external forces to a range of motion not normally attainable, the muscles, tendons and other tissues surrounding the joint will be injured. Patients with stroke hemiplegia are in such a state early in the disease? s muscles are flaccid and paralyzed. If the patient’s family or untrained caregivers do too much passive movement when the affected limb is unable to do various exercises out of concern for the patient’s early recovery, it is easy to cause soft tissue injury and even joint dislocation and fracture. Although some of these injuries are minor and no redness, swelling or bruising can be seen on the outside, they can unknowingly cause chronic inflammation and adhesions within the joint. This injury most often occurs in the shoulder and hip joints. 5, repeated practice spasticity aggravation (futile, a hundred harmless) Many patients know the importance of rehabilitation training, also very hard hard exercise, but we must pay attention to the method, the method is not right, only futile, or even harmful. Most patients with hemiplegia have muscle spasms on the paralyzed side of the limb, and proper rehabilitation training can relieve these spasms so that the limb movements tend to be coordinated. However, if the wrong training method is used, such as using the paralyzed side of the hand to repeatedly practice forceful grasping, the spasticity of the muscles responsible for joint flexion in the affected upper limb will increase, making it difficult to open the fingers, which will in turn create a more serious obstacle to the recovery of hand function. Hemiplegia is not only a problem of muscle weakness, but also the uncoordinated muscle contraction is an important cause of motor dysfunction. Therefore, it should not be mistaken that rehabilitation training is strength training. 6. The earlier you walk on the ground, the faster and better your recovery will be (forming a “circle” gait, which is unsightly and awkward). In normal people, the joints of both lower limbs extend and flex in a coordinated sequence according to a certain rule to alternately support the body and complete the action of stepping. If a person with hemiplegia starts walking exercises in a hurry without reasonable training, the typical hemiplegic gait will appear. A normal person can coordinate hip, knee, and ankle flexion to the proper angle when he or she needs to step forward, thus “shortening” the length of the lower extremity on that side and easily lifting the foot off the ground. In contrast, in hemiplegic patients, all joints are stiff and the toes droop, making the affected limb “longer” and difficult to lift off the ground. The magnitude of this pulling up is very limited and still does not allow the lower limb to step forward smoothly, but needs to arc outward and then fall back to the front of the body. This is the “circling” gait commonly seen in hemiplegic patients, and is a typical manifestation of the misuse syndrome. The root cause is that improper training aggravates the spasm of the muscles responsible for the extension of the joints of the lower limbs, making it difficult to complete the joint flexion movement. If regular rehabilitation training can be started at an early stage of hemiplegia and walking training can be conducted on the basis of the coordination of the movement of the affected limb, a walking posture closer to normal can be formed and the walking efficiency can be improved.