"Research on Stroke Rehab on Progress in MRC"
By Dr. M. M. Ghatak
Stroke
is a peculiar disease of sudden onset having neurological dysfunction as a
result of some vascular phenomenon.
The
recovery pattern is more peculiar and does not obey the prescription of
either of a vascular doctor or a neurologist, when spontaneous neural
recovery occurs with a relatively predictable sequence of stereotype
movement events - lower extremity function recovers earliest and most completely
followed by upper extremity and hand function, tones usual returns before
voluntary movement, Volitional
control over the proximal limb before the distal limb, and mass movement
(Synergy)
patterns before specified isolated coordinated volitional motor function. Moreover,
a complex cognitive dysfunction, the aphasic communication disorder,
Spasticity, bladder, and bowel dysfunction central pain balance and
coordination problems. When recover in a peculiar way, Science
cannot explain except taking the view of cortical reorganization namingly
neuroplasticity.
The overwhelming records of recover of such
problems in
Medical Rehabilitation center in last six months has compelled us to
search for other influencing factors in this recovery pattern. We have
arranged these factors influencing stroke recovery in a newer way - (A, B,
C, D, E, F, G, H, I)
-
Associated
illness
-
Bilateral
brain damage
-
Continence (bladder & bowel) - (within 3 days
return prognosis good.) Consciousness (Less prolonged - higher recovery)
-
Depression / dementia / dysphasia
-
Elderly patient
-
Flaccid paresis more than two
months.
-
Gross perceptual deficit
-
Home and family care
-
Initiation of rehabilitation
A
total number of 40 stroke patients had entered in the multidisciplinary
rehab program for 30 to 300 days duration. Depending
on the time passed after the attack, and all other above factors the rehab
outcome was noticed with a different variability of individual results. Mostly
the uncomplicated and recent cases had very good outcome. The details of
the data will be published in the next issue after getting a one year
result.
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