Post-stroke rehabilitation

Czech version

Authors: J. Mikula
Authors‘ workplace: Rehabilitační sanatorium Karviná – Lázně Darkov, a. s.
Published in: Kardiol Rev Int Med 2008, 10(2): 66-73

Overview

It is essential that timely and permanent prevention of contractures should start from the onset of a cerebrovascular accident (CVA). The objective of rehabilitation in spastics is to provoke reciprocal relaxation of the antagonist through agonist muscle contraction, while in hemiplegics gentle tactile and proprioceptive stimulation is used carefully to increase postural activity. The article discusses a variety of procedures that can be used to infl uence spastic syndrome. Topic areas include gait training for hemiparetics, the renewal of functional knee control in limb paresis, adaptation to vertical position and leg training. A treadmill is very useful equipment in gait training. Alongside gait rehabilitation, training of the arms is another important part of the rehabilitation of such patients. Alongside gait rehabilitation, training of the arms is another important part of the rehabilitation of such patients. Another indispensable treatment is conditioning, making use of four general principles of facilitation, i.e. PNF techniques, activation of the muscles in a given movement chain, activation of the limbic system and transcallosal facilitation. Hippotheray is a practical means of applying re-education methods, in which numerous facilitatory mechanisms are activated. A modern and highly-promising approach is to combine computer technology with precise diagnosis of damage to laterolateral and anteroposterial structures and subsequent targeted vestibular habituation exercises. It involves the use of stabilometric platforms, whose basic function is the computer analysis of vestibulospinal postural refl exive actions and an analysis of the movement vectors of the centre of gravity in eight directional axes. Stabilometry and static posturography facilitate the differential diagnosis of dizziness and a great variety of defects in spatial orientation and are a component of complex modern rehabilitation for hemiparetics. The methodology for post-stroke rehabilitation as a whole is an extensive and complex discipline. This work merely identifi es its basic principles and a number of new options.

Key words:
spastic syndrome – refl ex inhibition patterns – functional knee control – gait rehabilitation – arm training –

principles of facilitation – hippotherapy – stabilometry – posturography – vestibular habituation exercises

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Cardiology Review

2008 Issue 2