Rehabilitation after a stroke: what therapist needs to know

Announcement:

The lecture examines key aspects of post-stroke rehabilitation that are relevant for primary care physicians.

Key points:

• Epidemiology: In Russia, > 130 thousand strokes are registered annually, 90% of which are ischemic. Up to 85% of patients experience movement disorders, speech disorders and cognitive deficits.
• Economic burden: the cost of treating one case reaches 1–1.5 million rubles, including long-term care and loss of ability to work.
• The main risk factors: arterial hypertension, atherosclerosis, diabetes mellitus, obesity and smoking are the key triggers of atherothrombotic and lacunar strokes.

Modern approaches to rehabilitation:

• Three-stage model:
  • Stage 1: Early rehabilitation in hospital (first 21 days).
  • Stage 2: specialized centers (up to 3-6 months).
  • Stage 3: Outpatient observation (up to 12 months).
• The role of drug therapy: the drug Mexidol (ethylmethylhydroxypyridine succinate)
  • Improves the restoration of neurological functions.
  • Reduces the risk of recurrent stroke by 5 times in patients with hypertension.
  • Corrects cognitive and emotional disorders (depression, anxiety).
• Practical recommendations:
  • Scheme of application of Mexidol:
    • 14 days intravenously at 500 mg/day → 2 months orally (Mexidol Forte 250 mg × 3 times a day).
    • Optimally, 2 courses per year.
• The Importance of a Multidisciplinary Approach: Combination of Medication, Physical Rehabilitation and Psychological Support.

Rehabilitation after an insult: what a therapist needs to know