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Stroke

Stroke Rehabilitation

1. Stroke Rehabilitation – Early-Stage Rehabilitation Process

When the symptoms of stroke are noticed, an emergency service should be immediately consulted. After the examination made in the health institution, tomography or diffusion MR (MRG) is taken. The treatment process begins right after making the diagnosis of stroke.

  • Medications may be use in the cases caused by vascular occlusion.
  • In the cases of stroke caused by haemorrhage, sometimes it is needed to have an operation done by a brain surgeon.

During the early stage, the patients are hospitalized in the intensive care, neurology or brain surgery departments according to the severity and cause of the stroke. During this process, medical or interventional treatments are applied firstly. The cause of stroke is completely identified, and the needed medical treatments are started to prevent a repetition.

 

After this process, physical therapy and rehabilitation, either inpatient or afoot, are started. The applications of physical therapy and rehabilitation in stroke treatment can be identified as applications of neurological rehabilitation.

2. Stroke Rehabilitation - When does the physical therapy start?

Process of treatment should be started as soon as possible, and the patients should be followed lifelong. The process of physical therapy and rehabilitation should be started in the first days or in the first week after the neurological situation of the patient is stabilized. The patient with stroke and other accompanying problems should be taken under a comprehensive physical therapy program while being evaluated by a physical therapy and rehabilitation specialist in the neurology department. 

 

After the medical situation is stabilized, that is, after approximately the 3rd or 7th days, the patient should be transferred to the clinic of physical therapy and rehabilitation to start the neurological rehabilitation program. Afterwards, applications of physical therapy and rehabilitation either inpatient or afoot are continued according to the needs of patients.

3. Stroke Rehabilitation - The Significant Points while choosing a Physical Therapy Center

To have a successful stroke rehabilitation, a Neurological Rehabilitation – Robotic Rehabilitation Center under an expert physical therapy and rehabilitation specialist will be a suitable option. Stroke rehabilitation is a teamwork. This team is consisted of the specialized health workers in the field of stroke rehabilitation. The members of the rehabilitation team:

  • Physical therapy and rehabilitation specialist doctor, 
  • Physiotherapist, 
  • Occupational Therapist, 
  • Rehabilitation Nurse, 
  • Physical Therapy Technician, 
  • Robotic Rehabilitation Technician, 
  • Orthotic / Prosthetic Technician, 
  • Dietician, 
  • Speech Therapist
  • Swallowing Therapist

4. Stroke Rehabilitation – What To Do?

Following the patient in the suitable position while changing the position frequently is quite important in the stroke patients during the early stage of the physical therapy program in order to prevent the pressure sores on the patient. Apart from this, the program of physical therapy and rehabilitation is specially planned according to the needs of patients:

  • If there is no movement in the leg and arm in one side after the stroke, the passive range of motion in joint exercises are made. During these exercises, various methods of stimulation are used to increase the sense and unfold the movement. As the deliberate actions of arm and leg start, more active exercises are started.
  • Stretching exercises are made to prevent muscle shortness, joint rigidity and spasticity.

The patients are taken to the position of sitting on the edge of the bed and their body control is tried to be increased.

  • The patients are taken to the position of sitting on the edge of the bed and their body control is tried to be increased.

  • With the increase of muscle strength and body control, the exercises of standing afoot and walking are started.

  • If any balance disorder had occurred, the exercises to increase the feeling of balance are made.

  • To strengthen the breathing muscles and ensure the expectoration, respiratory physiotherapy is applied.

  • In the patients with swallowing difficulties, nutrition of the patient is regulated, and a swallowing rehabilitation is started after the evaluation of swallowing.

  • Speech therapy is applied for the patients with speaking difficulty.

  • To prevent muscle rigidity- spasticity, exercise, medicine and recreation braces may be used. If these are not enough, botulinum toxin injections may be applied. 

  • To prevent joint stiffness in the limbs whose functions are restricted and make walking easier, devices which are attached on hand and foot (orthosis) may be used.

  • Besides all these, skin care, regulation of sleeping periods, providing psychological and social support are the other points which should be noted during the stroke rehabilitation. 

     

Robotic rehabilitation devices are used during every stage of the stroke rehabilitation. With the robotic rehabilitation, participation of patients to the treatment increases. Robotic rehabilitation is quite beneficial for a more rapid healing and regaining more functions.

 

Goal in the stroke therapy: Developing the gestural functions of patients, ensuring their flawless speech, expression, self-care, self-nutrition and excretion by themselves, accelerating the return of the patients to their family, occupational and social life. 

Prof. Dr. Engin Çakar

Prof. Dr. Engin Çakar has more than 15 years of experience in the areas of Physical Therapy and Rehabilitation, Algology and Electrodiagnostic Neurology.

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