Brains recovers! Stroke Rehabilitation


English 脳卒中 脳梗塞 脳出血 くも膜下出血

Research has indicated that the brain attempts to regain function, using areas other than those affected.

Recovery of functions through advanced treatments and rehabilitation.

Starting with cerebral infarctions, strokes which damage the brain, leaves the body with many forms of damage.
Here is a patient who has recently suffered a stroke.
Due to cerebral hemorrhaging, he is heavily paralyzed on the left side of his body. However, after rehabilitation...He is able to walk with smooth movements.

This is 3 months after initiating rehabilitation.
The case here is a situation in which early treatment and rehabilitation of the patient went very well. Not all patients can recover to this degree. However, the recovery of this patient is impressive.
Through research, it is now established that the brain attempts to regain lost functions after cerebral paralysis.


For example, symptoms such as loss of motion in the left hand may be present following the occurrence of a stroke on the right side of the brain.
However, a section of the brain not responsible for the affected part of the body may compensate and take over the function.


This is the plasticity of the brain.
The functions of the brain begin to recover.

Let us discuss the points of rehabilitation which are effective in the recovery of a damaged brain. The brain regains lost functions through rehabilitation. We know now that even if our brain is damaged, it attempts to recover through a function termed plasticity. The method to effectively induce plasticity in a physical manner is through rehabilitation (or rehab).
Here is the process of rehab for patients with strokes including cerebral infarctions.


Rehab for cerebral infarctions and strokes is typically performed in three stages. First, the acute stage of treatment takes place in the first 2 to 3 weeks after the incident, while the patient is admitted to an acute care hospital. Second, there is the recovery period, with a duration of approximately 3 to 6 months.
These hospitals are highly specialized utilizing extremely intensive treatments for improved effectiveness.
Generally, after 6 months, the treatments will take place at the patient's home or at long-term healthcare facilities for the elderly. In such institutions, rehabilitation to maintain and regain a level of functionality for daily life takes place. Among these, acute phase rehabilitation - taking place during the acute stage - attracts the greatest attention. This is said to be extremely effective.
The reason why is it important to perform rehabilitation during the acute phase:


Actually, research has been performed on this.
Looking at the image, the number of days are shown from 0 to 400 days.
This is traditional rehabilitation, taking place over a long period of time.
If rehab takes place during the acute phase, the recoverability that follows is greatly enhanced. It is thought that the ability to recover lost functions due to paralysis within the first 3 months is particularly high. Here, patients who have suffered a stroke due to cerebral hemorrhage or cerebral infarction undergo rehabilitation for approximately 3 weeks (acute phase rehab).
This man developed cerebral hemorrhage, resulting in heavy paralysis on the right side of his body. The fingers would not even bend...

Every day was spent training to walk. Even during the acute phase,
this is done at an especially early stage of the rehabilitation.
If movement of the legs is difficult, this kind of apparatus is used to assist the movements of the joints. The rehabilitation of the hand and arm. Taking cones from a stack and restacking them next to the original stack. To grab an object and move it. The objective is to regain lost abilities which are required in daily life.

Got it!
Got it, got it. You did it! You're getting a pretty good grip.
Yeah. Attempts at new challenges will be made.
This is a first time.
Really. Rehab which is still to be experienced. Next, back and forth or diagonal.The cones need to be moved in many directions.
I am surprised! Great! Although difficult,a new challenge was cleared.
I'm surprised that my fingers are moving this much. I'm so happy. Because of daily advances.

Actually, overcoming these new challenges and experiencing joy in doing so, is thought to be a shortcut to recovery.

After the occurrence of a stroke, the acute phase requires stimulating rehabilitation which is a novel approach, with variety while being rewarding.

Q: Patients who feel a sense of accomplishment
A: I think they will observe great improvement.
A sense of accomplishment is very important,
if they think "I cannot do it", it can hold them back.
Rather than repeatedly attempting the same thing, it would be good to challenge them with a variety of tasks.
Small steps. Doing things because they are told to do so will not result in effective rehabilitation.
I said rewarding, but I think it is important for the patient to feel a sense of accomplishment and to be empathetic towards them as the rehabilitation advances.


If the rehabilitation is accompanied by a sense of accomplishment, the extent of recovery improves greatly.

We saw it in the video, but in order to perform effective rehabilitation, there are three important key factors.
A new or novel approach.
A variety of new tasks to challenge the patient.
And with a quota system, whenever a task is completed,
a feeling of joy for the accomplishment.
These are the three key points.
This, being a great stimulus for the brain, is thought to increase the potential for the brain.
Stroke can result in severe complications or even lead to death.

Dr. Minematsu's conclusion:
Patients with stroke who would have been bed-ridden or required nursing care in the past, are now recovering.
Although, I have been dealing with stroke for several decades, I never thought we would reach this stage. I believe that in the next 5 or 10 years, further advances in this field will be achieved. For those who suffer from disabilities, please do not lose hope and keep working towards recovery.