Stroke, as the most commonly reported brain and nerve system disease of the world, develops after narrowing, coagulation or bleeding in cerebral blood vessels.
Hemiplegia means paralysis and loss of volitional acts at the right or left half of body.
It may cause such neurological disorders as loss of volitional acts or attenuation of motility, sensory losses or impairments, aside from communication (speech) disorders, loss of visual field or perception disorders at one half of the body. All of these findings may differ from one patient to the other depending on the location and severity of damages on brain.
The goals of rehabilitation are to rebuild the lost motor functions and the sensory and perception disorders and impairments, to prevent further complications, and to make the patient independent again at the highest level possible.
Stroke rehabilitation refers to assessment of patient in physical, cognitive and medical terms, and formulation of patient-oriented therapy strategies depending upon the results of all of these assessments.
Patient-oriented therapy approach;
Education of patient and his/her family members about the disease;
Joint range of motion exercises in acute period;
Protective measures for such complications as pressure sore, deep venous thrombosis and contractures;
Most appropriate care of previous injuries and wounds;
Exercises for turning (rolling over), bridging and sitting up in the bed;
Balance coordination exercises;
Mobilization exercises inside and outside parallel bar;
Therapy by such rehabilitation methods as PNF, Bobath, and Johnston;
LOKOMAT exercises aimed at regaining the walking pattern;
Balance, coordination, muscular strengthening and walking exercises under supervision of a specialist in therapy pool;
Management of spasticity by medical and physical therapy agents and ortheses;
Special applications such as modified constrained therapy and Johnston method wherein healthy and sound side of the body is precluded by a special braced orthesis, while the lost functions are intended to be regained by the sick side of the body through activities of daily living and self-care activities;
Neurogenic bladder management and treatment;
Neurogenic bowel management and treatment;
Exercises for activities of daily living through occupational therapy (ergotherapy).
During the rehabilitation process, the patient is also assessed in terms of speech, swallowing, respiratory problems and cognitive impairments, and is thus treated also by speech and swallowing therapies, pulmonary rehabilitation and cognitive rehabilitation methods.