Stroke rehabilitation begins during the acute hospitalization once the patient is medically and neurologically stable. Rehabilitation of the stroke patient with involvement of a multidisciplinary rehabilitation team early during the care of the stroke patient is one of the critical components of stroke unit care that results in improved outcome and shortened length of stay. While practices vary between countries and among hospitals, at our hospital and most stroke centers in the USA the major focus of rehabilitative efforts occurs after the stay in the acute stroke unit, and is beyond the scope of this book. We will focus on those aspects of rehabilitation care that are relevant to acute stroke management in the USA.

The primary goals of rehabilitation are to prevent complications, minimize impairments, and maximize function. The priorities of early stroke rehabilitation are secondary stroke prevention, management of comorbidities and prevention of complications.

The principles of rehabilitation are the same in patients with cerebral infarction and in those with hemorrhage.

TAKE-HOME MESSAGES

• Adequate secondary stroke prevention regimen.

• Prevention of medical complications.

• Early assessment of rehabilitation needs, utilizing a multidisciplinary rehabilitation team.

• Early initiation of rehabilitation therapies, and greater intensity of therapy, as tolerated by the patient.

Secondary stroke prevention

Please see Chapter 6 for detailed discussion.

Prevention of medical complications

Please see Appendix 9 for detailed discussion.

Multidisciplinary rehabilitation team

The main components of the rehabilitation team are speech therapy, physical therapy, occupational therapy, and psychosocial therapy.