Stroke Rehabilitation: Which is the Main Functional Outcome to Reach?

 You're that BLITHERINGLY STUPID that you don't know it's 100% recovery? You've never talked to survivors without pushing your tyranny of low expectations? Meaning limited recovery! Because you can't acknowledge you're a complete fucking failure of getting survivors what they want, 100% recovery!

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Telling stroke medical persons they know nothing about stroke is a no-no even if it is true. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful , I look forward to that day.

Stroke Rehabilitation: Which is the Main Functional Outcome to Reach?

By Loredana Cavalli, Rehabilitation Medicine, Physical Medicine and Rehabilitation Publisher: OMICS Publishing Grouphttps://doi.org/10.4172/2376-0281.1000293 Loredana Cavalli*, Andrea Guazzini, Bruno Rossi and Carmelo Chisari University of Florence, Italy 

 Abstract 

 Background: Stroke rehabilitation targets range from treatment of spasticity to pain reduction, gait speed gain, or autonomy amelioration. A correct evaluation of individual residual capabilities is essential to select the most appropriate rehabilitative programme; furthermore the observation of rehabilitative outcomes can provide information about gait training effects and possible compensation mechanisms. 

 Aim: To investigate the main outcome to reach in stroke rehabilitation. Methods: We examined retrospectively a heterogeneous sample of 119 subjects recovered for the treatment of stroke outcomes. Functional parameters were assessed before and after rehabilitative treatment, such as upper limbs motility impairment, lower limb sensitiveness, muscle trophism or tone, necessity of auxilium, Berg and Fugl-Meyer scale. 

 Results: A consistent improvement of standing equilibrium was reported, regardless of gender, stroke nature, hemiparetic side, type of rehabilitation performed, botulin toxin use and initial conditions, with an average increase of Berg and Fugl-Meyer scales score of 14% and 21%, respectively. The variation of equilibrium and motility across treatment resulted directly proportional and negatively correlated to lower limbs sensitivity impairment. On the contrary, initial equilibrium resulted inversely correlated with the variation of motility and vice versa. Interestingly, older subjects seem to better increase equilibrium and sensitivity as measured by Fugl-Meyer scale. 

 Conclusion: In stroke subjects any type of rehabilitation leads to a consistent improvement of standing balance. While proportional to motility and sensitivity increase, this result is inversely correlated to initial motility score, suggesting that an appropriate evaluation of the stroke patient’s functional parameters at admission contributes to select the main rehabilitation targets and the best therapeutic strategy.