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1、StrokeRehabilitation1.SummarydefinitionRiskfactorsClinicalmanifestations:StrokepatientsspasticmodeisupperlimbflexionspasmandlowerlimbStretchspasm.associatedreactionsTheassociatedreactionsisthatinhemiplegicpatients,eventhereisnovoluntarymovementinaffectedside,theaffectedmuscleswillcontractwiththenona
2、ffectedsidemusclescontraction.Theexcitementcanspreadtotheaffectedside.Thisreactionisanabnormalreflectionwhichisdifferentfromthevoluntarymovement.Itismanifestedasalossofcontrolofandassociatedwithspasticity.2.RehabilitationAssessment(1).LevelofponderanceP151-152(A).Glasgowcomascale，（GCS）(B).Clinicalne
3、urologicaldeficitdegreescorestandards(C).NIHstrokescale,(NIHSS)(2).AssessmentofmovementP153(A)Comprehensivemotorfunction:BrunnstromAssessmentofMovementFugl-MeyerAssessmentthemaincharacteristicsofBrunnstromineachstageBrunnstromstage1:novoluntarymovements.stage2:voluntarymovementsappear,andcanleadtoth
4、eassociatedreactionsandsynergy(协同性）movement.stage3:Abnormalmuscletonesignificantlyincreased.Voluntarysynergymovementappears.stage4:Abnormalmuscletonebeginstodecrease,synergymovementpatternisbroken,theisolatedmovementbeginstoappear.stage5:Muscletonegraduallyreturnedtonormalandfinemovementappear.stage
5、6:Motorfunctionnearlyreturnstonormal,butthespeedandaccuracyofmovementisnotsogoodasthenon-affectedside.(B)Muscletoneandspasticity(C)Musclestrength(D).BalanceabilityP153(E)WalkingabilityThreelevelbalancedetectionmethodThefirstlevelofbalancereferstokeepbalanceinstaticcondition.Thesecondlevelofbalancere
6、ferstokeepbalanceduringsittingandstanding.Thethirdlevelofbalancereferstokeepbalanceunderexternaldisturbance.(4).Activitiesofdailylivingassessment(ADL)(5).Qualityoflifeassessment(QQL)3.Rehabilitation(1).RehabilitationgoalsP154(2).RehabilitationtimeP154(3).ThebasicprinciplesofrehabilitationP154(4).Acu
7、testageofrehabilitationtherapyRehabilitationgoalsP154(A).PhysicallyplacedandpositionconversionNomatterlyingdownonthehealthysideorontheaffectedside,Patientsshouldersshouldbeputinanteriorextensorandotherupperlimbjointsshouldbeputinextension。(B).PassiveactivitiesP155Todopassiveactivitieswemustslowly,ge
8、ntlely.Doproximaljointspassiveactivitiesfirst,thandodistaljointspassiveactivities.(C).ActivityinbedTheBobathhandshakeP155Thepatientclaspshishands,andwiththehemiplegiathumbplacingoverthecontralateralthumb.Withthehelpofnormallimb,thepatientcanmovebothupperlimbs.(D).PhysicalTherapy(5)Subacuterehabilita
9、tionRehabilitationgoalsP155(A)Bedandbedsideactivities(B)Sittingactivities(C)StandingactivitiesP156(D)Walkinginparallelbars(E)Indoorwalkingandoutdooractivities(F)PhysicalTherapy(G)OccupationalTherapy(H)Walkingframeandwheelchairapplications(I)Languagetheaphy(6)Medium-termrestorationrehabilitationthera
10、pyRehabilitationgoalsP156(A)TheactivitiesoftheupperlimbsandhandsP157(B)TheactivitiesoflowerextremityP157(C)OccupationalTherapy(D)CognitiveTraining(7)Post-rehabilitationtherapyRehabilitationgoalsP158(A)Theactivitiesoftheupperlimbsandhands(B)Theactivitiesoflowerextremity(C)OccupationalTherapy(D)CognitiveTraining(E)ADL(F)Languagetherapy(G)Psychotherapy(H)Bracesandtheapplicationoforthosis(8)SequelaeperiodofrehabilitationtreatmentSpecialclinicalproblemShoulderproblemThanksforlistening
