The key point here is one week and muscles start to atrophy. That to me totally invalidates the previous research suggesting starting stroke rehab 60 to 90 days later.
Rehabilitation? The earlier the better, and not just for professional athletes
"Muscle starts to shrink after about one week if a person stays in bed without any form of physical exercise," said Dr Zhang Xin, a rehabilitation therapist from Shanghai Medmotion Rehabilitation Clinic, while stressing the importance of rehabilitation.
"Many patients have asked me about the best time to start rehabilitation. My answer is the earlier the better," the doctor said. "There is a saying in China that people should rest on the bed for at least 100 days after suffering a muscles-and-bones injury. We now know that is incorrect. How well and how quickly the injury can recover largely depends on rehabilitation, which should be included in the treatment plan as early as possible."
Rehabilitation is a mature service in the West, while it is still a new concept in China. The availability of such services in the country also lags behind.
"Rehabilitation doesn't only cover post-operation service, it also involves various contents such as pain management, mobility recovery, maternal care, children's curved spine rehab and physical status renovation," Zhang said. "Professional athletes, patients and ordinary people need different and customized rehab services and guidance in line with their condition and requirements. Rehabilitation therapists can design and offer individualized direction. To improve the quality of life is the ultimate purpose of medical treatment and rehabilitation."
Shanghai has been promoting a four-tier rehabilitation network, which means patients with acute conditions can receive surgery or treatment at a city-level hospital and then be transferred to a district-level hospital for follow-up treatment and rehabilitation. They can then receive long-term rehabilitation training at community health centers and service spots in the neighborhood.
The city government set a goal of building 30 community-based rehabilitation facilities this year as role models, which offer intelligent equipment-based modern technology and skills with combination of both Western and traditional Chinese medicines.
All communities are expected to be covered by such services by 2025 through the integration of rehabilitation services into the grassroots health system, according to Shanghai Health Commission.
Therapists help a man with stroke on an AI-based rehabilitation robot for him to train walking at Dapuqiao Community Health Center.
The man is able to "walk" under the guidance of robot.
Dapuqiao Community Health Center is the first such facility that has passed evaluation. Elderly people and children, those with surgery and office workers are major patients.
With the increasing number of elderly population and the rising incidence of cerebral vascular disease, elderly with stroke, bone and joint problems and other aging problems account for the main users of community-based rehabilitation service, which is cheap, convenient and professional.
For elderly people, rehabilitation is extremely important to improve their condition, give better life quality and prevent and control other complications, doctors said.
"Rehabilitation has become increasingly important, which mainly covers post-surgery, bone and muscle injury, sports injury, post-delivery care, post-stroke and children's cerebral palsy, curved spine and improper gait," said Dr Feng Yuanyuan, director of Dapuqiao center's rehabilitation department. "We are equipped with high-end appliances and rehabilitation robots, which can help and guide elderly and stroke patients ease complications and those with sports injury regain mobility."
"Rehabilitation can effectively help patients improve their physical functions after surgery. Some patients see improvement after only one or two training courses," she said.
In addition to traditional services like tuina, acupuncture and exercise instruction, the center has introduced AI-based rehabilitation robots. They can assess each patient's condition and give therapists guidance on rehabilitation plans as well as guide patients to move through treatment.
A 69-year-old woman suffering stroke in June is receiving rehabilitation service at Dapuqiao center. Her husband escorts her for training every workday.
"My wife suffered hemiplegia due to stroke. She couldn't walk at that time. We came to Dapuqiao center, which is just minutes of walk from our home, after being discharged from the hospital. With machines and other therapies, she is able to walk a bit by herself now," said the husband.
The 69-year-old woman with stroke walks on a training machine at Dapuqiao center.
A therapist offers rehabilitation on upper limb function for the woman, who suffered hemiplegia after stroke in June.
Therapists said they guide stroke patient to develop proper standing and walking postures and help them practice on the machine.
The golden rehabilitation period for people who suffer a stroke is the first year, during which they can regain much function and mobility if they receive proper training under professional guidance, doctors said.
"For the elderly who are too old or bedridden, professionals can go to their homes with portable equipment for treatment and rehabilitation. We encourage elderly people to go to the community center or service spots, as it is a kind of practice and rehabilitation in itself," said Jin Ying, director of Dapuqiao Community Health Center.
A man does rehabilitation on mobility through equipment at Shanghai Medmotion Rehabilitation Clinic.
While community-based rehabilitation is welcomed by elderly and nearby residents, professional rehabilitation clinics in office buildings are more popular among office workers, sports fans and athletes.
Yu Junqi, an amateur American football player, is a regular client at Medmotion clinic. He said his sports passion leaves him repeated injuries and rehabilitation allows him to have better and quicker recovery.
"I fully understand the effects of rehabilitation through my own experiences. I broke my left leg years ago and it took me one year to go back to the field, since I didn't receive any professional rehabilitation or guidance. I injured my left elbow during a training afterward. Thanks to rehabilitation therapist here, I was able to play with teammates just one month later."
Dr Zhang Xin from Medmotion said rehabilitation can play different role during different stage of physical condition and injury.
"There are different solutions in line with the injury and treatment plans. We also have many patients, who complain about neck and back pain after sitting in the office for a long time. We will give guidance on proper sitting and standing gestures and teach them gestures and self-trainings they can do at home or during their spare time to ease pain and improve mobility," she said.
Yu Junqi (right), who broke his right palm bone recently, receives rehabilitation on finger mobility and function under instruction of Dr Zhang Xin at the clinic.
A therapist teaches Yu Junqi how to practice his injured hand.
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