Stroke Rehabilitation

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Basics

Description

  • Stroke is a compromise in blood supply to an area of the nervous system, caused by hemorrhage or occlusion, which leads to infarction of nervous tissue.
  • Stroke is the fifth leading cause of death and the leading cause of long-term disability in the United States (1).
  • Stroke rehabilitation refers to the process of restoring functionality and independence after a stroke.
  • Rehabilitation is tailored to the specific deficits of the individual. This typically is accomplished through a multidisciplinary team.
  • During a stroke patient’s acute inpatient care, a formal assessment of their needs is made before discharge to aid in disposition to an inpatient rehabilitation facility (IRF), skilled nursing facility (SNF), or early supported discharge to home.
  • Rehabilitation involves continually assessing and quantifying an individual’s needs and adjusting realistic goals as needed (2).
  • Motor impairment is the most commonly recognized impairment secondary to stroke.
  • Speech/language, swallowing, vision, sensation, cognition, bladder/bowel control, activities of daily living (ADLs), and balance are also commonly impaired.

Epidemiology

Incidence
  • Each year in the United States, ~795,000 people suffer stroke; ~610,000 are first attacks, and 185,000 are recurrent attacks (3).
  • Age-adjusted incidence of initial stroke is significantly lower for whites (0.88 per 1,000) than for blacks (1.91 per 1,000) and Hispanics (1.49 per 1,000) (3).
  • Women have a higher lifetime risk of stroke compared to men (3).

Prevalence
~7.2 million Americans ≥20 years old have had a stroke (3).

Etiology and Pathophysiology

Stroke involves a compromise in blood supply to an area of the brain resulting in tissue damage seen on imaging, usually by either rupture or blockage of a blood vessel. Of all strokes, 87% are ischemic, 10% are intracerebral hemorrhage, and 3% are subarachnoid hemorrhage (3).

Risk Factors

Risk factors for stroke are discussed in the topics “Stroke, Acute (Cerebrovascular Accident [CVA])” and “Peripheral Arterial Disease.”

General Prevention

See “Stroke, Acute (Cerebrovascular Accident [CVA]).”

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Citation

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TY - ELEC T1 - Stroke Rehabilitation ID - 116572 ED - Baldor,Robert A, ED - Domino,Frank J, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116572/all/Stroke_Rehabilitation PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -