Rehabilitation after stroke.

The more severely involved the stroke patient is or the greater is the pre-existing physical disability, the greater is the need for special rehabilitation services to restore him to his optimal level of performance. The availability of resources in the family and community are important factors in determining whether or not the patient will need to be treated in a rehabilitation center. There is no contraindication to early initiation of rehabilitation and those patients for whom rehabilitation is initiated immediately after the stroke have the most rapid and optimal recovery. Ninety to 95 percent of hemiplegics can learn to walk. Forty percent of hemiplegics get good return of function in their upper extremity. Sixty-five percent of hemiplegics become independent in self-care and ambulation. For the stroke patient who does not have complicating disabilities independence in self-care and ambulation can be accomplished in 4 to 8 weeks. Intellectual or emotional problems indicate the need for a carefully planned rehabilitation program. The families of stroke patients need counseling and training regarding their responsibilities and duties to the patient.