Rehabilitation refers to the comprehensive and coordinated application of medical, educational, social, and vocational methods to restore and reconstruct lost functions as quickly and as fully as possible for individuals with illness, injury, or disability. This allows them to regain their physical, mental, social, and productive abilities, enabling them to return to life, work, and society. Rehabilitation addresses not only the disease itself but also the overall physiological, psychological, social, and economic well-being of the individual. Rehabilitation therapy aims to restore physical and mental impairments or disabilities caused by injury, disease, or developmental defects to normal or near-normal function.
Treatment methods encompass six major systems: exercise therapy (including muscle strengthening and range of motion training), physical therapy (electrotherapy, light therapy, and ultrasound therapy), occupational therapy (for restoring physical and mental function), traditional rehabilitation methods (acupuncture and massage), psychotherapy, and rehabilitation programs. Exercise therapy is widely used in neurological and skeletal injuries to prevent limb contractures, improve blood circulation, and restore physical and mental function.
Specific Methods
- Exercise Therapy:
The most important method of rehabilitation training focuses on addressing muscle strength and tone in the affected limb. It includes muscle strength training and training of various joint range of motion.
(1) Muscle strength training: The first step of rehabilitation training. The force of muscle contraction is muscle strength, which is the basis of exercise. The training methods include isometric exercise and isotonic exercise. Isometric exercise is to use the isometric contraction of muscles to carry out muscle strength training. During isometric exercise rehabilitation, the muscle contraction force is very strong, which can cause changes in heart rate and blood pressure. Patients with cardiovascular diseases should avoid high-intensity rehabilitation exercise. Isotonic exercise uses resistance above and below 1/2 of the maximum muscle force, which can increase muscle strength and muscle endurance respectively.
(2) Joint range of motion training: Muscle stretching is a functional activity training involving the range of motion to maintain flexibility. The methods include passive exercise assisted by rehabilitation technicians and active exercise actively participated by patients. In particular, passive exercise of paralyzed limbs is the main method to prevent muscle and joint contracture, limited movement, and reduce pain caused by muscle adhesion.
(3) Swallowing function therapy: Patients with dysarthria and dysphagia should undergo speech and swallowing therapy.
2. Other physical therapies:
Electrotherapy, phototherapy, magnetic field therapy, ultrasound therapy, as well as heat conduction therapy and cold therapy, all have the effects of improving blood circulation, increasing immune function, promoting inflammation absorption and swelling reduction, relieving pain and relieving muscle spasms, promoting tissue regeneration, improving tendon elasticity, and reducing joint stiffness. These multiple effects gradually restore nerve function and reconstruct limb loss function.
3. Occupational therapy:
It is training of daily living abilities. According to the recovery of the patient's hand function, a targeted occupational training program is designed for the individual to train the patient to eat, dress, defecate, and take care of themselves.
Occupational training is divided into two parts:
(1) Reducing finger flexion spasm: 97% of hand dysfunction in stroke patients is manifested as flexion spasm. During treatment, the rehabilitation therapist stretches the patient's wrist joints and interphalangeal joints of the fingers and puts them in a weight-bearing position. The five fingers with flexion spasm are then pulled by gravity. If muscle strength allows, appropriate resistance exercise can be given. For example, keep the wrist slightly flexed and perform finger stretching exercises; keep the wrist slightly extended and perform finger stretching exercises; keep the shoulder flexed and the elbow flexed at the same time and perform finger stretching exercises, etc.
(2) Use of hand orthosis: According to the wrist and finger flexion spasticity of stroke patients, static hand orthosis is equipped.
- Traditional rehabilitation treatment:
Mainly massage and acupuncture therapy, both of which can relieve limb spasms, promote qi and blood circulation, and unblock meridians. According to the patient's condition and age, special treatment is provided to effectively promote the rehabilitation of limb loss function. The combination of Western medicine rehabilitation treatment and traditional Chinese medicine acupuncture and massage and Chinese herbal decoction treatment has a significant effect.
- Psychological treatment:
The incidence of depression and anxiety in stroke patients is very high, and psychological treatment is very important for improving the quality of life.
- Rehabilitation project:
For patients with joint deformities and difficulties in self-care, orthosis training and training on the production and use of living utensils are carried out.