Rehabilitation in stroke syndromes

Moždani udar je klinički sindrom karakteriziran naglim razvojem žarišnog neurološkog deficita, vaskularne geneze (infarkt ili hemoragija), a simptomi koreliraju s veličinom i mjestom oštećenja mozga, ali i s vremenom proteklim od nastanka moždanog udara do trenutka procjene. Rehabilitacija osoba s moždanim udarom treba početi tijekom akutnog liječenja u jedinicama za moždani udar. Po završetku akutnog liječenja potrebno je započeti s početnom rehabilitacijom u bolnici, ambulantno ili u domu bolesnika. Indikacije za neurološku rehabilitaciju su: smanjenje aktivnosti u pokretljivosti, smanjenje u aktivnostima samozbrinjavanja, komunikaciji, kontroli stolice i mokrenja, kontroli žvakanja i gutanja. Kontraindikacije za neurološku rehabilitaciju su: febrilna stanja, akutne zarazne bolesti, teški psihički poremećaji, patološka trudnoća, imobilizacija kod koje nije moguće provoditi rehabilitaciju, komplicirani tijek koronarne bolesti, kardijalna dekompenzacija, teški poremećaji srčanog ritma, kardiovaskularne aneurizme, kavuma lijeve klijetke preko 6 cm, teška oštećenja jetre i bubrega, zloćudne bolesti u stanjima egzacerbacije i dekompenzacije. Rehabilitacijskom intervencijom koja uključuje dijagnostiku, medikamentoznu terapiju, fizikalnu terapiju, primjenu ortopedskih i drugih medicinskih pomagala, radnu terapiju, logopedske vježbe, kognitivni trening, medicinsku njegu, prehranu i smještaj, realno je očekivati poboljšanje funkcionalnosti bolesnika i njihovo kvalitetnije uključivanje u obitelj, radnu i širu društvenu zajednicu.Stroke is a clinical syndrome characterized by the sudden development of focal neurologic deficit of vascular origin (infarct or hemorrhage), and symptoms correlate size and site (s) of brain damage and the time elapsed from stroke onset to the moment of assessment. Rehabilitation of people with stroke should begin during acute treatment for cerebral stroke. Upon completion of acute treatment with presence indication: reduction activities in mobility, self-care activities, communication, control of stools and urine, control chewing and swallowing with absent contraindications: febrile conditions, acute infectious disease, severe mental disorders, pathological pregnancy, immobilization, where it is not possible implement rehabilitation, complicated course of coronary artery disease, cardiac decompensation, severe heart rhythm disorders, cardiovascular aneurysms, increased left ventricular cavity than 6 cm, severe damage to the liver and kidney, malignant disease exacerbations and decompensation, start with an inpatient rehabilitation, or as outpatient rehabilitation or community based rehabilitation. Rehabilitation intervention that includes diagnosis, medical therapy, physical therapy, application of orthopedic and other medical supplies, occupational therapy, speech exercise, cognitive training, medical care, food and shelter, it is realistic to expect patients to improve the functionality and quality of their participation in family, work and the wider community