Rehabilitation Treatment Plan for Stroke

Written by Tang Ying
Physical Medicine and Rehabilitation
Updated on September 26, 2024
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The rehabilitation treatment plan for stroke involves rehabilitation physicians and therapists who, through comprehensive assessment of the patient's overall medical condition and functional impairments, develop individualized plans. These plans focus primarily on the patient's functional impairments, and accordingly, design treatments for movement, speech, swallowing, and attention to promote the patient's overall rehabilitation and improve their ability to perform daily activities independently. Common rehabilitation treatment options include not only medication but also occupational therapy, speech therapy, physical therapy, psychological support, and traditional rehabilitation methods. Through these personalized and comprehensive rehabilitation treatments, the aim is to facilitate the patient's early recovery, allowing them to return to their family and work environment sooner.

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Written by Tang Bo
Neurology
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What department should I go to for a stroke?

Stroke is classified into ischemic stroke and hemorrhagic stroke. If symptoms of a stroke occur, such as slurred speech, limb weakness, or other neurological deficits, one should immediately seek medical attention at the emergency department of a local hospital. Emergency doctors will perform a head CT scan. If ischemia is present, the CT scan might not show changes within 24 hours, in which case a visit to the neurology department is necessary. If hemorrhage is detected, then a visit to the neurosurgery department is required. However, if the symptoms are of a chronic, old stroke, then a visit to the neurology department is needed.

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Written by Zhang Hui
Neurology
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Post-stroke depression

Recent studies have confirmed that in addition to language dysfunction, cognitive impairment, and motor dysfunction, stroke patients also exhibit many signs of depression. According to guidelines published in China in 2016, about 33% of stroke patients experience post-stroke depression, which is a very high proportion. The main symptoms of post-stroke depression include a lack of interest in anything, unwillingness to communicate with others, being quiet and reticent, non-compliance with medication, and non-cooperation with rehabilitation training. Post-stroke depression significantly affects the recovery of patients and their future quality of life. Some patients may even turn to suicide due to depression. Therefore, it is crucial to pay attention to depression after a stroke, as the incidence rate of post-stroke depression is very high, reaching up to 33%. Clinicians must carefully identify it, and family members of patients must be attentive in their care.

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Written by Tang Bo
Neurology
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What are the symptoms of a stroke?

Stroke, also commonly referred to as cerebrovascular accident, is caused by the rupture or blockage of blood vessels within the skull, leading to necrosis of brain tissue and a series of symptoms. It is divided into ischemic stroke and hemorrhagic stroke. Ischemic stroke, commonly known as cerebral infarction or stroke, while hemorrhagic stroke refers to cerebral hemorrhage. Generally, ischemic strokes account for 80% of cases. Ischemic stroke is caused by blockage of blood vessels leading to necrosis of brain tissue, presenting with a series of symptoms such as hemiplegic numbness. Cerebral hemorrhage results from rupture of brain blood vessels causing damage to brain cells and symptoms of compression, and may also present with symptoms such as hemiplegic numbness. Both types can be differentiated by their symptoms, and can also be definitively diagnosed through a CT scan.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Treatment of urinary retention in stroke patients

In cases of urinary retention after a stroke, some patients experience this due to psychological factors, concerns, and the sudden need to remain in bed, making it difficult to urinate in bed since they cannot stand or squat. Therefore, the first step is to alleviate psychological factors, provide patient communication and counseling, and perform massages around the navel and abdomen, along with heat treatments, to help patients urinate on their own. In a second scenario, where the patient's condition is severe or even comatose, and they have difficulty urinating, a catheter can be placed. It's important to first try to rule out a urinary tract infection, collect a midstream urine sample for analysis, and ensure the catheter is not left in longer than necessary. Once the patient's condition improves or they regain consciousness, the catheter should be removed promptly to avoid any urinary tract infections.

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Written by Zhang Hui
Neurology
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Nursing Care of Thrombolytic Therapy for Stroke

Thrombolytic therapy for stroke is an important tool in the treatment of cerebral thrombosis. If administered within the thrombolytic time window, which is currently within four and a half hours from onset, intravenous thrombolytic treatment can significantly save lives and improve the quality of life for patients. Post-thrombolysis care is also crucial, as there are some complications associated with thrombolytic therapy. It is essential to strictly monitor blood pressure after thrombolysis; typically, blood pressure should be checked every 15 minutes, as high blood pressure can significantly increase the tendency for bleeding. During the care process, it is also important to monitor for signs of bleeding such as nosebleeds, bleeding gums, the appearance of petechiae or ecchymosis on the skin and mucous membranes, and any bleeding in the urinary system. Additionally, changes in the patient’s consciousness and limb mobility should be noted. If the patient experiences worsening paralysis or significant headaches, a cranial CT scan must be promptly revisited. In summary, the nursing care following stroke thrombolytic treatment primarily involves monitoring blood pressure, watching for signs of bleeding, and observing changes in limb mobility and consciousness.