Rehabilitation for stroke: a review.

Abstract

SUMMARY Survivors of stroke are often left with severe mental and physical disabilities, which create a major social and economic burden. Many investigators have attempted to assess the role of rehabilitation in reducing such disability. Few controlled studies provide accurate assessment and documentation of benefit. Because of the presence of multiple variables and inadequate measures of outcome, it is difficult to design studies evaluating the effectiveness of rehabilitation for stroke. It is unclear bow early rehabilitation should begin and what aspects of rehabilitation are important. Intensive rehabilitation is an expensive and limited resource; thus, the ability to identify the subgroup of patients with stroke who are likely to benefit is a critical issue. Although preliminary guidelines for the selection of patients who are appropriate for rehabilitation are given, no uniform criteria reliably differentiate patients who need rehabilitation from those who will recover spontaneously or do poorly. Controlled studies in the practice of rehabilitation for stroke will provide much useful information for patient management.

Stroke outcome research.

“…(C)t FEW MAJOR ILLNESSES are treated more inconsistently than stroke, ranging from fatalistic resignation to recovery or demise at home to intensive care in specialized units. The finding of Strand and colleagues of benefits of specialised care of stroke patients, 1 raises anew the question of the value of stroke units.…”

“…In this issue of Stroke, 1 Dombovy, Sandok, and Basford, writing from the point of view of stroke rehabilitation, have provided a comprehensive review of the findings of recent stroke outcome research. They effectively emphasize the fact that, if important but controversial issues about stroke rehabilitation are to be resolved, greater attention must be given to the way in which stroke outcome studies are conducted.…”

Comparison of functional electrical stimulation associated with kinesiotherapy and kinesiotherapy alone in patients with hemiparesis during the subacute phase of ischemic cerebrovascular accident

“…Although some hemiparetic patients with ischemic CVA may show spontaneous improvement, best results occur when patients are treated with physical therapy 21,22 . The element that made up the study intervention and promoted satisfactory results was the fact that the beginning of the program did not exceed 40 days since the CVA onset.…”

“…The element that made up the study intervention and promoted satisfactory results was the fact that the beginning of the program did not exceed 40 days since the CVA onset. It has been suggested that treatment started as soon as possible is a factor to achieve more satisfactory results 22 . Some authors have inferred that the early start of therapy seems to be more important for patient evolution than the duration of the program 23 .…”

Relationship of Physical Impairment, function and Insulin Resistance in stroke patients

“…The most significant factors that affect sensory losses are reported to be gait, upper extremity recovery, balance, mobility disability, and activities of daily living [22]. An examination of the correlation between sensory losses and functions of 120 stroke patients revealed that post-stroke sensory losses were an independently negative prognostic indicator that influenced the recovery of daily activities [23]. Insufficient ankle control and tactile sensations in the lower legs result in impaired functioning.…”