The Singapore Family Physician

Back to issue Vol 46 No. 1 - FPSC79 - Geriatric Care Update (Re-run)

Stroke Rehabilitation Principles

Dr Geoffrey Sithamparapillai Samuel
The Singapore Family Physician Vol 46 No 1 - FPSC79 - Geriatric Care Update (Re-run)
1 May 2019
0377-5305
Introduction. Stroke continues to be a major cause of mortality and disability. Besides having residual motor, sensory, or language deficits, there is a need to identify cognitive and mood related issues as well. Stroke recovery may be best defined as improvement across a variety of outcomes, beginning with biological and neurologic changes that manifest as improvement in performance and activity based behavioural measures Alternatively, the broad definition of stroke rehabilitation is: any aspect of stroke care that aims to reduce disability and promote participation in activities of daily living. The objectives of this process are: to prevent deterioration of function; improve function; achieve the highest possible level of independence within the limits of the persistent stroke impairments. The three approaches of rehabilitation are that of restoration, compensation and modification. Four phases (1.hyperacute, 2.acute, 3.subacute and 4.community reintegration phase) are recognized during stroke rehabilitation, although there is no consensus for the duration of each phase. Specific conditions such as post stroke shoulder pain, depression and spasticity should be identified and appropriate treatment rendered to improve function and quality of life for the patient. Conclusion. Post-stroke patients are more and more likely to survive and progress to the chronic phase of rehabilitation. It is useful to understand the difference between stroke recovery and rehabilitation and to be aware of pathologies that may impede rehabilitation.