Stroke Rehabilitation
Stroke Rehabilitation
Stroke Rehabilitation
พญ.พรพิมล มาศสกุลพรรณ
สถาบันประสาทวิทยา
2 / 4 / 2008
National Stroke Association
10% of stroke survivors recover almost
completely
25% recover with minimal impairment
40% experience moderate to severe
impairments that require special care
10% require care in a nursing home or other
long-term facility
15% die shortly after the stroke
Approximately 14% of stroke survivors
experience a second stroke in the first year
following a stroke
Effect of a Stroke
1. Weakness on the side of the body opposite the site
of the brain affected by the stroke
2. Spasticity, stiffness in muscles, painful muscle
spasms
3. Problems with balance and/or coordination
4. Problems using language, including having difficulty
understanding speech or writing(aphasia); and knowing
the right words but having trouble saying them
clearly (dysarthria)
5. Being unaware of or ignoring sensations on one side
of the body (bodily neglect or inattention)
6. Pain, numbness or odd sensations
Effect of a Stroke (con’t)
7. Problems with memory, thinking, attention
or learning
8. Being unaware of the effects of a stroke
9. Trouble swallowing (dysphagia)
10. Problems with bowel or bladder control
11. Fatigue
12. Difficulty controlling emotions (emotional
lability)
13. Depression
14. Difficulties with daily tasks
Rehabilitation Goal
To restore lost abilities as much as
possible
To prevent stroke-related complications
To improve the patient's quality of life
To educate the patient and family about
how to prevent recurrent strokes
Promote re-integration into family,
home, work, leisure and community
activities
Successful Rehabilitation
Depend on
- how early rehabilitation begins
- the extent of the brain injury
- the survivor’s attitude
- the rehabilitation team’s skill
- the cooperation of family and
caregiver
Basic Principles of Rehabilitation
To begin as possible early (first 24 to 48
hours)
To assess the patient systematically (first 2-
7 day)
To prepare the therapy plan carefully
To build up in stages
To include the type of rehabilitation approach
specific to deficits
To evaluate patient’s progress regularly
Multidisciplinary Team
Rehabilitation specialist
Physical, occupational and speech therapist
Social worker
Dietician
Recreational therapist
Psychologist
Vocational rehabilitation counsellor
Nurses
Orthotist
Patient, caregiver
Early Mobilisation
stability of ankle
balance
speed walking
Not enhance recovery
Ankle Foot Orthosis
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