REHABILITATION OF THE STROKE SURVIVOR.ppt

REHABILITATION OF THE STROKE SURVIVOR Elliot J. Roth, M.D. Rehabilitation Institute of Chicago Northwestern University Feinberg School of Medicine The brain is my second favorite organ”  -Woody Allen Stroke Third leading cause of death in U.S. Leading cause of severe disability in U.S. Estimated one-third to one-half have disability Most common reason for rehabilitation The Goals of Stroke Rehabilitation Prevent, Recognize, and Manage Comorbid Medical Conditions Maximize Functional Independence Optimize Psychosocial Adaptation of Patients and Families Facilitate Resumption of Prior Life Roles and Community Reintegration Enhance Quality of Life Rehabilitation during the Acute Phase GOALS: Prevention of Medical Complications Prevention of Deconditioning and Contractures Training of New Skills Rehabilitation during the Acute Phase TASKS: Range of Motion Stretching Exercises Frequent Position Changes Sitting in Upright Position to Improve Orthostatic Tolerance Psychological Counseling Patient and Family Education Rehabilitation during the Acute Phase TASKS: Training Personal Care Skills, Mobility, and Ambulation Training Bladder and Bowel Management Evaluation of Swallowing Function Initiate Nutrition and Hydration Identification and Treatment of Depression Medical Complications of Stroke Venous Thromboembolism Pneumonia Dysphagia Ventilatory Dysfunction Cardiac Disease Seizure Central Post-Stroke Pain Syndrome Spasticity Medical Complications of Stroke Bladder Dysfunction Bowel Dysfunction Pressure Ulcers Malnutrition and Dehydration Depression Falls and Injuries Shoulder Pain and Dysfunction Medical Complications of Stroke Recurrent Stroke Natural Recovery after Stroke MOTOR CONTROL: Flaccid Hemiplegia Increasing Tone and Spasticity Emergence of Synergy Patterns Gradually Increasing Isolated Voluntary Movements Levels of Rehabilitation Care Therapy during Acute Care Acute Comprehensive Inpatient Rehabilitation Subacute Comprehensive Inpatien