Do you know the common misunderstandings about stroke rehabilitation?

Common misunderstandings about stroke rehabilitation

Stroke is the number one factor affecting the life and health of Chinese adults. The high incidence, disability, mortality and recurrence rates bring heavy socioeconomic burdens. Early intervention of rehabilitation can effectively improve the quality of life of patients and reduce the burden of care. However, due to the lack of popular science and people's understanding of stroke rehabilitation, there is an incorrect understanding of rehabilitation. This is not conducive to the rehabilitation of patients and even leads to worsening functional disorders. Let's talk about some common misunderstandings of stroke rehabilitation.

1. Rest for a period of time after a stroke before doing rehabilitation

Early rehabilitation training after stroke can better promote functional recovery and prevent complications such as deep vein thrombosis, muscle disuse atrophy, pressure sores, aspiration pneumonia, and joint contractures. By continuously inputting movement, sensation and other stimulations into the central nervous system, brain function recovery is promoted, the patient's motor control ability is improved, and thus the quality of life is improved [2]. According to current clinical research results, stroke patients with stable vital signs can undergo early rehabilitation training after 48 hours. The best rehabilitation period after stroke is within 3 months, known as the "golden rehabilitation period". During this period, functional recovery is faster, which is conducive to building confidence in rehabilitation.

2. Walking early will help you recover better

Hemiplegia is a common functional disorder caused by stroke. The rehabilitation of limb function is a gradual process, just like a baby learning to walk. Walking exercises can only be started when both lower limbs have the ability to bear weight and the joints can flex and extend in a coordinated manner.

Without professional rehabilitation assessment and training, standing and walking too early will cause or aggravate joint injury pain. Due to the stiffness of the lower limbs, the "length" of the affected limb relative to the healthy side increases when walking, and the affected limb can only be pulled up by lifting the pelvis, and then draw an arc outward to the front of the body, forming a typical hemiplegic gait - "circle gait". Once formed, it is difficult to correct.

3. Rehabilitation is entirely the responsibility of rehabilitation physicians and therapists

Some patients' families think that when they go to the hospital for rehabilitation treatment, they leave everything to the rehabilitation doctors and therapists, who only take care of the patients' diet and daily life. The ultimate goal of stroke rehabilitation is to allow patients to return to their daily lives, and the rehabilitation process is long-term or even lifelong. This process requires close cooperation among patients, their families, and medical and technical staff.

When rehabilitation therapists are giving rehabilitation treatment to patients, family members should watch and learn more, and master the basic methods of body positioning, turning over and sitting up, and bed-wheelchair transfer. They can also learn some simple joint movement methods, stretching methods, and strength training, etc., to facilitate the smooth progress of family rehabilitation training in the later stage. Under the guidance of rehabilitation professionals, the family environment should be transformed to strengthen family protection measures to prevent falls and fall out of bed. In addition, a warm and relaxed family atmosphere should be created to ensure the company of relatives, stimulate the patient's desire for rehabilitation, and actively cooperate with rehabilitation treatment, which is conducive to the patient's functional rehabilitation.

4. Patients undergo rehabilitation training, which will be effective quickly and can return to their pre-illness state

In clinic, family members often ask: "How long will it take to recover to the state before the disease?", or family members ask: "It has been several days since the rehabilitation, why can't I walk? I can't move my hand." The damage to nerve cells in the brain is irreversible, that is, once the nerve cells are damaged, they cannot be restored. Therefore, most patients will have residual functional disorders. Rehabilitation is a long process to stimulate the potential of the brain and compensate for the lost function of the brain tissue through repeated sensory and motor stimulation.

5. For swallowing dysfunction, the sooner oral feeding is restored, the better

After a stroke, swallowing dysfunction such as choking when eating or drinking water may occur, and nasogastric feeding is required. Some family members believe that the indwelling of a gastric tube affects the patient's appearance and comfort, and that early oral feeding can exercise the swallowing function. This behavior is very dangerous.

Patients with dysphagia lack a good throat protection mechanism, and their trachea is not completely closed when swallowing, which can easily cause food to be inhaled into the lungs through the trachea, causing aspiration pneumonia or even suffocation. Most patients have latent aspiration, that is, when aspiration occurs, they do not show obvious symptoms such as choking, coughing, and shortness of breath. When they have difficulty breathing or progress to more serious pneumonia. Therefore, for patients with dysphagia, a comprehensive swallowing dysfunction assessment should be conducted in the rehabilitation department, and targeted swallowing function training and eating methods should be developed. After a period of treatment, it is necessary to re-evaluate whether the patient has the ability to eat orally, and then gradually open up oral feeding under the guidance of a swallowing rehabilitation therapist.