Physiotherapy after stroke - a lifetime endeavour

Abstract

Recovery after stroke is influenced by both intrinsic and extrinsic factors and can be categorised as spontaneous, due to reparative processes, and due to reorganisation of neural mechanisms, plasticity. Plasticity is driven by experiences, mobility, activity, interventions and the physical features of the environment and its demands. <br> The overall aim of this research was to evaluate the effect of physiotherapy in the acute and chronic stages of stroke. <br> Physiotherapy treatment using the Motor Learning Programme was found to be preferable to that using the Bobath concept in acute rehabilitation of patients with stroke. There was no carry-over effect of gains obtained during initial physiotherapy regimes on long- term function if the exercises were not sustained.<br> There was a strong relationship between walking and dynamic and static balance in acute rehabilitation of patients with stroke, indicating that static balance and dynamic balance need to be addressed equally in early rehabilitation. Furthermore, balance was closely related to task, e.g. walking, getting up from a chair, turning, and reaching, and cannot be regarded as separate from the task.<br> A follow-up programme on a consultative basis was found to be as beneficial as a compulsory physiotherapy programme. Motor function, Activities of Daily Living and grip strength improved initially and were maintained during the first year after stroke in all patients irrespective of exercise regime. Regular controls and examinations in both groups gave probably a positive impact on compliance to and motivation for exercises in the year after stroke in both groups.