Physiotherapy in stroke treatment aims to heal the problems that occur in stroke and prevent those that may occur.
Physiotherapy is of great importance in stroke treatment, so it must be included in the treatment plan.
What is the Purpose of Physiotherapy in Stroke Treatment?
The aim of Physiotherapy in Stroke Treatment is to prevent problems that may occur, to regain controlled movement, to make the patient independent again in daily life and to ensure the patient's participation in life again in every aspect. Restoring functions to the patient
It covers all physiotherapy studies on restoration of stroke.
The most important part of the physiotherapy program in stroke treatment is the detailed evaluation of the patient. As a result of the evaluation, physiotherapists decide which rehabilitation method to apply in the light of the information obtained. As a result of interim evaluations, it should be determined whether the current rehabilitation method is effective or not in stroke. If the expected improvement is not achieved, the rehabilitation program should be changed or new methods should be added in the light of current information. In this way, the rehabilitation program tries to maximize the patient's independence. Interdisciplinary intervention is important in the success of physiotherapy in stroke treatment. In stroke rehabilitation, physiotherapy applied by physiotherapists within the team is also important. Therefore, it is necessary to get a good physiotherapy service.
When Should Physiotherapy in Stroke Treatment Start?
It is important to start physiotherapy in stroke treatment at the earliest. The duration and frequency of physiotherapy varies from patient to patient and according to the rehabilitation method to be applied. Therefore, the patient's family should be researchers on this subject and have the best possible treatments applied to their patients. The safer the Physiotherapy in Stroke Treatment to be applied to the patient, the safer it will be and the faster progress will be achieved in the patient.
How long is physiotherapy in stroke treatment?
It varies according to the patient's condition. Therefore, it would not be appropriate to say something clear for this. For this, it will be necessary to look at how much cognitive function problems the patient has in his/her body.
Why is Teamwork Important?
For physiotherapy in effective stroke treatment, it is essential that the physiotherapist and the physician work in harmony and that the patient and his/her family actively participate in rehabilitation. In order to prevent new problems that may arise in physiotherapy and for the success of rehabilitation, the individuals who make up the team must act together and exchange ideas. This is why the team is of great importance.
Rehabilitation in Stroke Treatment:
- Rehabilitation is a whole of medical treatment including acute care, reactivation and readjustment.
- The aim of rehabilitation is to maximize the physical, social and mental functions of individuals. Rehabilitation should be considered as a separate phase following diagnosis and treatment.
- Rehabilitation aims to enable patients to be self-sufficient and independent in daily life.
- The improvement of neurological functions in cerebrovascular disease can be explained by the alleviation of the effects of local harmful factors and neuronal plasticity. In the early period of stroke, local edema and local toxins lose their effect, local circulation increases and partially damaged ischemic neurons recover.
- Brain plasticity is the ability to regulate the structural and functional organization of the nervous system, which can occur early or late.
- Other possible mechanisms of plasticity include the sprouting of new synaptic connections, the unmasking of previously suppressed latent functional pathways and their recovery of function, the recruitment of previously non-functioning neural pathways without damage, and the recovery of dysfunction in the involved body region.
- In stroke patients, lower limb function recovers earlier and is close to complete, followed by upper limb and hand function; the return of tone usually precedes the return of voluntary movements.
- The degree of motor recovery varies from patient to patient, and sometimes recovery may stop at any stage.
- The rehabilitation team includes a physical medicine and rehabilitation specialist, neurologist, physiotherapist, occupational therapist, speech and language therapist, rehabilitation nurse, psychologist and social worker.
- Patients are eligible for rehabilitation when they are medically stable, able to learn, have no other uncontrolled diseases and have sufficient physical activity capacity to sit for at least one hour with support.
- First of all, it should be recognized that the need for rehabilitation varies from person to person, that the patient, not the disease, exists within the framework of rehabilitation principles, and that the goals of rehabilitation should be planned at the beginning differently from person to person.
- The patient should be given the appropriate position from the first moment; protective measures should be taken for the flaccid extremity. If necessary, a passive range of motion exercise program should be started within the first 24-48 hours. In better patients, in-bed mobility exercises, bridging exercises to help with pressure relief, dressing and toileting should be performed.
- The information obtained from the initial determination of functional level and/or rehabilitation potential is important in determining the rehabilitation process, prognosis, appropriate decision-making and continuation of rehabilitation.
- Factors that have a favorable impact on rehabilitation potential and prognosis are: young age of the patient (under 55 years), left hemiplegia (dominant hemisphere), absence of sensory deficit, early improvement in motor function, early onset of hand movements, especially in the upper extremities, little or no mental impairment and absence of progressive systemic disease (heart, kidney).
- Factors that have a negative impact on rehabilitation potential and prognosis older age of the patient (over 55 years), persistent sensory deficit and thalamic pain syndrome, persistent flaccid hemiplegia, extrapyramidal syndrome with severe rigidity, presence of mental and psychological impairment with diffuse organic brain pathology, persistent impairment of coordination and balance, and right hemiplegia, aphasia, chronic heart failure that does not respond to medical treatment, nephrosclerosis, hypertension, lack of development or absence of motor functions, late start of rehabilitation program, localized pain (such as shoulder, wrist, hip), urinary fecal incontinence and visual spatial deficit.
- After physical, neurophysiological, psychological and occupational assessment of the patient and determination of rehabilitation potential, a goal is set for each patient individually.
- The rehabilitation program to be drawn according to the determined rehabilitation potential and to be implemented by the rehabilitation team should be within the framework of rehabilitation goals.
- Rehabilitation aims to prevent deformities, to correct deformities, to train the patient to sit, stand and ambulate, to train the patient to perform IYAs with the intact limb, to train the paralyzed limb for maximal activity, to provide speech therapy to eliminate communication disorders, to treat facial paralysis, to provide maximal psychological integrity and stability, to provide the necessary environmental stimulation for social activities, to determine the vocational status and to provide vocational rehabilitation.
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