STRATEGIES FOR COMPREHENSIVE STROKE REHABILITATION – EVIDENCE-BASED REVIEW OF THERAPEUTIC METHODS

Abstract

Introduction Stroke is the leading cause of severe disability. The consequences of a stroke depend on the location and size of the brain lesions. The symptoms may include hemiparesis, swallowing disorders, speech disorders, disorders of cognitive functions, hemianopia, gait disturbances, spasticity, depression, reduction of independence in everyday life activities. Due to the multitude of impaired functions after stroke, a comprehensive approach is required in rehabilitation. Aim The aim of the study was a concise, evidence-based review of therapeutic methods that may be used in the course of rehabilitation after stroke. Material and methods Studies and systematic reviews related to a selected novel or commonly used stroke rehabilitation methods were chosen for evaluation using the PubMed search engine. The research included articles published between 2002 and 2020. Results The time to start rehabilitation is important – according to the principle, the sooner, the better. A comprehensive rehabilitation program requires an individual program of rehabilitation exercises, supported by physical modalities therapy as well as occupational therapy, speech-language therapy and neuropsychotherapy. Particular attention must be given to the methods for which there is evidence of effectiveness confirmed by scientific research, such as CIMT therapy, task-oriented training, mirror therapy, electrical stimulation, rTMS, robot-based training, and treadmill training. Conclusions The rehabilitation after stroke is effective when certain general conditions are fulfilled, such as cooperation of multidisciplinary rehabilitation teams, early start, and long and intense course. The effect of post-stroke rehabilitation may be even better when certain methods are applied, bringing improvement mostly in motor function.