Importance of specific rehabilitation methods for patients with intracerebral hemorrage

Intracerebral hemorrhage (ICH) is a severe type of stroke which causes bleeding in the brain parenchyma, accounting for 10-15% of all strokes. Prognosis of patients with ICH remains very poor despite new advances in management strategies, and has not improved in the last decades. Disability remains important in ICH survivors, only a small proportion of patients live an independent life after ICH. Development of new strategies in rehabilitation care is expected to improve survival and outcome after intracerebral hemorrhage. The main neurological sequellae after ICH are similar to those seen after ischemic stroke. Given the clinical and pathological differences between the two types of stroke, clinical recovery is expected to be different. Comparisons between rehabilitation results in hemorrhagic versus ischemic stroke have offered mixed results, but all of them agreed that rehabilitation is highly effective after hemorrhagic strokes. There are no standard recommendations regarding the specific procedures used in the rehabilitation program of ICH patients. In the absence of clinical data to guide specific practice, the rehabilitation of ICH patients is largely based on general principles learned from ischemic stroke recovery. Physical therapy, task-specific training, sensory stimulation, use of assistive devices for upper limb or gait functions, speech and language therapy, physiotherapy and balnear therapy are methods used in rehabilitation of patients with hemorrhagic stroke, with improvement in patients functional outcome. There is a need for further development of specific rehabilitation techniques to enhance recovery in ICH patients