Stroke or cerebrovascular accident (CVA) refer to neurological sign/symptoms that’s result from diseases involving blood vessels in disorder of cerebral circulation include any diseases of the vascular system that causes ischamia or infarction of the brain or subarachnoid space.
Primary goal in early rehab
- To prevent secondary emotional, intellectual and physical deteriorations.
- To prepare the patient and relative for challenge ahead.
Functional motor training
Active participant from patient in rehab process to optimize performance of functional action.
Emphasize function on daily activity, such as stand up, sitting down, reaching and manipulation.
Training methods are take account of movement biomechanics, muscle characteristics, environment context and pathology of impairment.
General Principles of Training
- Anticipate and prevent soft tissues contracture, preferably by active means or passive means if necessary.
- Elicit muscles activity utilizing kinesiological principles such as elimination of gravity, eccentric/ isometric contraction using functional electrical stimulation.
- Train motor control using concrete goals by :
encourage the patient to activate muscle synergistically.
to activate muscles at a particularly length.
to sustain a muscle contraction under certain load condition.
to generate and utilize momentum.
to increase of movement.
- Increase muscles strength by increasing repetition and load relevant to specific actions (actions: standing, sitting down, stair climbing)
- Modified activity/environment to achieve of particular outcome.
- Training on balance – functional postural adjustment/balance are analyzed in sitting, standing, and performing activities (reaching forward, side way, to touch or lift up an object).
Therefore, those patient with difficulty in balance must:
training activity related to daily activities (standing up, sitting down, stair walking)
Activity can be modified gradual from simple procedure and minimum postural adjustment that need to be performed to harder task.
increase distance of objects
Increase object weight
Changing object location