Neurorehabilitation following stroke

Perfectly exact truth is but rarely to be seen.The goal of stroke rehabilitation is to ensure that each person reaches the maximum physical, functional, and psychosocial recovery possible within the limits of his or her impairment. In theory, rehabilitation facilitates a degree of improvement greater than would occur spontaneously. In many regards, rehabilitation requires learning how to do things in new ways, a process that depends partially on the concentration and motivation of the patient. In some cases, the focus of rehabilitation is on adaptation and compensation for deficits. This may involve adaptive devices or training the family to compensate for deficits that are irreversible.Research in the general area of stroke rehabilitation is exploding as there is increasing demand for evidence-based approaches. During the past decade there has been a dramatic increase in knowledge regarding the potential of the brain to reorganize in response to external and/or internal demands. Functional recovery has been reported for cognitive deficits, motor deficits, and sensory and perceptual deficits such as hemineglect. The potential of the brain to reorganize is due to utilization of innate reserves that lead to functional recovery. This concept has led to rapid changes in therapeutic and rehabilitative approaches using new strategies to optimize stroke rehabilitation. Still, much of day-to-day stroke rehabilitation is based on techniques that have been helpful over many years. Therefore much of this chapter is devoted to practical aspects of current stroke rehabilitation, although newer concepts and techniques are also introduced.