The Impact of Rehabilitation Frequencies in the First Year after Stroke on the Risk of Recurrent Stroke and Mortality

My God, your fucking doctor has nothing to do here, all your recovery is based on your rehabilitation work. Nothing on stopping the neuronal cascade of death by these 5 causes in the first week. No stroke prevention diet. Nothing for any stroke medical professional to do. You are completely on your own.
http://www.sciencedirect.com/science/article/pii/S1052305717303439

• Yuan-Yang Cheng, MD, PhD^{*, †},
• Jiah-Hwang Shu, RN^{‡, §},
• Hsiu-Chuan Hsu, RN^{‡, §},
• Ying Liang, RN^{‡, §},
• Shin-Tsu Chang, MD, PhD^*,
• Chung-Lan Kao, MD, PhD^{†, ‖, ,} ,
• Hsin-Bang Leu, MD, PhD^{†, §, ,}

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https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.06.047

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Background

Rehabilitation is essential for all poststroke patients to improve self-care ability. However, whether an increased frequency of rehabilitation reduces poststroke adverse events remains undetermined.

Methods

We recruited 4899 patients with newly diagnosed ischemic stroke between January 1, 2000, and December 31, 2008, from our database and divided them into 3 groups according to their Charlson Comorbidity Index, and they were further categorized into 3 groups of different rehabilitation frequencies during their first year after stroke. Clinical adverse events including recurrent stroke, hip fracture, pneumonia, and all-cause mortality were analyzed by Cox regression analysis to investigate the protective effects of aggressive rehabilitation.

Results

We discovered that aggressive rehabilitation in the first year after stroke was significantly associated with a lower incidence of recurrent stroke and all-cause mortality despite the severity of patients' comorbidities. Further Cox regression analysis revealed decreased hazard ratios to develop recurrent stroke and all-cause mortality in patients with more intensive rehabilitation (P for trend <.05). However, no significant associations between rehabilitation frequency and pneumonia and hip fracture were identified in our study.

Conclusion

Intensive rehabilitation during the first year after stroke should be recommended to prevent detrimental adverse events for stroke survivors.