Stroke rehabilitation involves three key components: physical rehabilitation training, activities for daily living training, and speech therapy. Rehabilitation should adhere to the principles of individualization, progressing step-by-step, and beginning with simpler tasks before advancing to more complex ones.
According to the China Stroke Rehabilitation Guidelines, rehabilitation for stroke patients can begin as soon as 72 hours after their condition has stabilized. Patients should receive comprehensive rehabilitation to achieve the highest level of function possible and to minimize complications.
Rehabilitation consists of three aspects: physical rehabilitation training, training in activities of daily living, and speech training. Rehabilitation training should be conducted under the supervision of a qualified therapist, following the principles of individuality, gradual progression, and simplicity to complexity. It should primarily focus on passive training, gradually transitioning to active training.
During the process of limb rehabilitation training, the following matters should be paid attention to:
Placement of Body Position: To prevent the patient's limbs from being compressed, it is best to use the healthy side-lying position in the acute stage of the disease. Early patient position is to keep the patient's upper limb shoulder joint forward, elbow straight, wrist joint extension, rotation, and finger joint abduction; the patient's lower limb should be placed in a neutral position, the knee joint is slightly flexed, to prevent the lower limb external rotation. Overall, all joints are fully extended.
Functional Exercise of Limbs: If the condition is stable, passive exercise can be carried out to help the patient's paralysed limbs perform extension and flexion activities, promote muscle strength and joint movement, and prevent contracture and deformation of the limbs. Starting from simple movements, with the help and guidance of rehabilitation doctors. Exercise time 3 times a day, the amount of activity increases day by day, can not be too hasty.
If the patient is awake, the training of daily living ability should be carried out as early as possible, encouraging the patient to use the healthy hand to drive the affected hand to wash his face and brush his teeth, eat, change clothes, etc., and minimising the help of others. Family members should strengthen non-verbal communication with the patient at an early stage, such as smiling, hugging, and talking about the patient's most concerned issues, so that the patient has the desire to speak, and then communicate with the patient verbally, step by step, to enhance the patient's confidence in recovery.
Before a cerebrovascular patient with severe functional impairment returns home from the hospital, changes should be made in the home environment to enable the patient to perform some daily activities independently or with the help of family members.
Doorways and Stairs: Remove thresholds from doorways or stairs and install stair rails and wheelchair ramps. Make doors wider for wheelchair access.
Kitchen Adjustments: Make sure the kitchen floor is not too smooth. Purchase low-countertop tabletops to make it easier for the patient to operate.
Bathroom Safety: Non-slip mats should be installed in the toilet, bathroom and bathtub. Use a bidet in the bathroom. Install removable jets in the bathroom for easy showering. To make it easy to put the patient into the bathtub, place a plastic bench next to it. Also consider installing grab bars around the toilet, bathtub, and shower.
Bedroom Adjustments: Change to a lower bed or hospital bed to help the patient get up and down.
Additional advice: Medical devices to assist in the patient's rehabilitation might be equipped, such as exoskeleton rehabilitation robots and gait assist systems.
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