RESUMEN
This self-directed learning module highlights new advances in the understanding of co-morbid conditions and medical complications of stroke. It is part of the chapter on stroke rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article covers co-morbid conditions of stroke patients, including cardiovascular disease, diabetes, and sleep apnea. It reviews recent information on complications of stroke, including deep venous thrombosis, dysphagia and aspiration, hospital-acquired infections, depression, falls, spasticity, shoulder pain, and seizures. Treatment advances in diabetes, depression, and spasticity are highlighted. Recent information is presented regarding exercise guidelines for the stroke patient with cardiovascular disease, the relationship between stroke and sleep apnea, prophylaxis of deep venous thrombosis, the changing spectrum of hospital-acquired infections, malnutrition in stroke patients, the problem of falls during rehabilitation, the evaluation and management of poststroke shoulder pain, and the risk of seizures after stroke.
Asunto(s)
Trastornos Cerebrovasculares/complicaciones , Trastornos Cerebrovasculares/rehabilitación , Enfermedades Cardiovasculares/epidemiología , Trastornos Cerebrovasculares/epidemiología , Comorbilidad , Infección Hospitalaria/etiología , Infección Hospitalaria/terapia , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 1/epidemiología , Femenino , Humanos , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Masculino , Medicina Física y Rehabilitación/educación , Factores de Riesgo , Síndromes de la Apnea del Sueño/epidemiología , Síndromes de la Apnea del Sueño/terapiaRESUMEN
This self-directed learning module highlights new advances in the treatment of patients after stroke by means of a case study format. It is part of the chapter on stroke rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses both medical and rehabilitation issues that arise in the care of persons with strokes involving the right and left middle cerebral arteries and the vertebral artery. Cases were chosen to cover problems seen in both older and younger persons. Management of common sequelae that are typical of these stroke syndromes and identification of common co-morbidities are included.
Asunto(s)
Trastornos Cerebrovasculares/rehabilitación , Trastornos Cerebrovasculares/epidemiología , Trastornos Cerebrovasculares/fisiopatología , Comorbilidad , Femenino , Humanos , Síndrome Medular Lateral/rehabilitación , Masculino , Medicina Física y Rehabilitación/educaciónRESUMEN
The safety of a traditional Chinese exercise, Tai-Chi Chuan, on rheumatoid arthritis (RA) patients was evaluated. RA patients, who received 1 h of Tai-Chi Chuan instruction once (n = 20) and twice (n = 15) a week for 10 consecutive wk in two separate studies, showed no deterioration in their clinical disease activities compared with the corresponding controls (n = 11 and 9, respectively). Testing parameters included joint tenderness, joint swelling, time to walk 50 feet, handgrip strength and a written functional assessment. No significant exacerbation of joint symptoms using this weight-bearing form of exercise was observed. Tai-Chi Chuan exercise appears to be safe for RA patients and may serve as an alternative for their exercise therapy and part of their rehabilitation program. Weight-bearing exercises have the potential advantages of stimulating bone growth and strengthening connective tissue, but this effect needs to be documented in long-term studies.