Neurorehabilitacija nakon moždanog udara

Moždani udar je naglo nastali žarišni ili globalni neurološki deficit uzrokovan cerebrovaskularnim poremećajem. Simptomi ovise o veličini oštećenja i zahvaćenog područja, te o vremenu proteklom od pojave simptoma do dijagnoze. Brzim prepoznavanjem simptoma i prijevozom bolesnika do jedinice akutnog liječenja povećava se udio bolesnika koji se mogu liječiti trombolitičkom terapijom te se na taj način smanjuje mortalitet i invaliditet. Rani početak rehabilitacije u akutnoj fazi liječenja je preventivne prirode. Ovisno o veličini oštećenja pacijenti se dalje zaprimaju na bolničko liječenje i fizikalnu terapiju ili se otpuštaju kući te terapiju nastavljaju ambulantno. Kriteriji za prijam su stabilan neurološki status, odsustvo znaĉajnijeg komorbiditeta, prisustvo značajnijeg neuromotornog deficita u najmanje dvije od pet navedenih funkcija: pokretljivost, aktivnost samozbrinjavanja, komunikacija, kontrola stolice i mokrenja, kontrola žvakanja i gutanja. Rana rehabilitacija je ključna jer je oporavak neuroloških deficita najbolji u prva 3 mjeseca nakon moždanog udara Terapijski program se individualno prilagođava svakom pacijentu i uključuje medicinsku njegu, farmakološku terapiju, fizikalnu terapiju, primjenu ortopedskih pomagala, okupacijsko – radne aktivnosti, logopedske vježbe i kognitivni trening.Stroke is characterized by a sudden development of a focal or a global neurological deficit caused by a cerebrovaskular origin. Symptoms vary from the size of the damage and the affected area, and the time elapsed from the onset of the symptoms to their diagnosis. Early recognition of the symptoms and transportation to the hospital increases the proportion of patients who can be treated with thrombolytic therapy and that way reduce the morality and disability of the patients. Early initiation of rehabilitation in acute phase of treatment has a preventive nature. Depending on the severity of their deficits, patients are admitted into further inpatient rehabilitation; or are released home and they continue their therapy as an outpatient rehabilitation. Criteria for admission are stable neurological status, the absence of significant comorbidities, the presence of significant neurodevelopmental deficits in at least two of the five functions: reduction activities in mobility, self-care activities, communication, control of stools and urine, control chewing and swallowing. Early rehabilitation is crucial because the recovery of neurological deficits is most efficent in the first 3 months after the stroke. Today's principles of neurorehabilitation are based on the theory of neuroplasticity. The therapeutic program is individually adapted to each patient and includes medical care, drug treatment, physical therapy, application of orthopedic supplies, occupational activities, speech exercises and cognitive training