Stroke Rehabilitation

David C. Good, MD, FAAN; Kerstin Bettermann, MD, PhD; Raymond K. Reichwein, MD Neurorehabilitation p. 545-567 June 2011, Vol.17, No.3 doi: 10.1212/01.CON.0000399072.61943.38
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Despite improvements in prevention and acute management, stroke remains a common condition and a major cause of permanent disability. For patients who have had a stroke, an effective rehabilitation program is critical to maximize functional recovery and quality of life. Rehabilitation can occur in a number of different physical settings and is often coordinated by a comprehensive interdisciplinary team of professionals. Rehabilitation includes retraining to regain loss of function and teaching compensatory strategies when that is not possible. A number of interesting training approaches have been developed in recent years to supplement more traditional rehabilitation programs. A variety of adaptive devices is available to improve mobility and performance of self-cares, and these devices should be prescribed for appropriate patients. Physicians caring for patients during stroke rehabilitation must be aware of potential medical complications, as well as a number of special problems that may complicate recovery, including dysphagia, urinary incontinence, shoulder pain, spasticity, falls, and poststroke depression. Involvement of the patient and caregivers in the rehabilitation process is essential. It is important to train and educate these individuals in the physical aspects of poststroke care, the expectations for recovery, and secondary stroke prevention. Issues related to community reintegration, including driving and vocational aspects, should be addressed in appropriate patients. Stroke rehabilitation is an important part of the "stroke continuum of care," which includes prevention, acute management, rehabilitation, and secondary prevention.

Address correspondence to Dr David C. Good, Penn State Hershey Medical Center, Department of Neurology, 500 University Drive, PO Box 850, Hershey, PA 17033, [email protected].

Relationship Disclosure: Dr Good serves on a global advisory panel supported by Allergan, Inc. and receives compensation for serving on a National Institutes of Health committee and US Food and Drug Administration panels. Dr Bettermann receives personal compensation for litigation consultation and research support from the Pennsylvania Department of Health. Dr Reichwein is a member of Boehringer Ingelheim's speakers' bureau, and he receives research support from AGA Medical and Pfizer, Inc. for a stroke research trial. Dr Reichwein receives personal compensation for medical record review and depositions and receives a federal grant for outpatient stroke research.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Good discusses the unlabeled use of generic drugs. Drs Bettermann and Reichwein report no disclosures.

© 2011 American Academy of Neurology