Abstract
Rehabilitation is a crucial part of recovery for stroke survivors, and numerous studies have examined various exercises and treatments of stroke. In addition, it is very important for patients to choose the timing of rehabilitation and what kind of rehabilitation they will proceed with. The purpose of the current study is to examine research investigating the effects of rehabilitation exercise programs in recovery of physical function in patients with stroke, based on aspects of their physical function, physical strength, and daily activities, and systematically examine their effects. Therefore, through systematic review, we have investigated the effects of interventions in rehabilitation exercise programs for recovery of physical function in patients with stroke. We collected relevant publications through the databases MEDLINE/PubMed and Google scholar. Twenty-one articles were ultimately selected for the analysis. We classified the rehabilitation programs and identified the trends of treatment for stroke survivors. Our review indicated that task-oriented therapy is still dominant, but various types of combined rehabilitations have been attempted. In addition, it was identified that physical and active rehabilitation were required rather than unconditional rest, even at an early stage. Home-based treatment was used for rapid recovery and adaptation to daily life during the mid-term period.
1. Introduction
Stroke is a cerebrovascular disease that occurs when blood supply to the brain is interrupted, or when bleeding occurs in brain tissue, resulting in loss of brain function [1]. Stroke is a terrifying disease occurring every two seconds, with people dying every six seconds due to stroke worldwide, and 15 million new cases occurring yearly. Approximately 40% of patients suffer from functional impairment after stroke onset, and 15–30% experience severe motor, sensory, cognitive, perceptual, and/or language impairments [2,3]. In particular, more than 85% of patients with stroke experience hemiplegia, which results in impaired upper limb function and decreased motor ability [4]. This impairment is a major factor that affects the ability to balance, and the levels of daily and social activities [5].
Rehabilitation is vital for minimizing sequelae after stroke, and patients who undergo continuous professional and systematic rehabilitation following the acute phase tend to recover rapidly [6,7]. Drug and rehabilitation therapy are currently practiced rehabilitation treatments for stroke. Various interventions can be applied for recovery, such as bilateral training, repetitive task training, constraint-induced movement therapy, electrical stimulation, robotic therapy, and exercise [8]. Among these, exercise is crucial because it helps patients return to activities of daily life by restoring the function of impaired muscles and improving physical function. Exercise is also essential for preventing secondary complications, as was reported in a study determining that continued exercise and physical activity after a stroke reduce the risk of recurrence of cardiovascular disease and mortality [9].
Commonly used rehabilitation exercises include those for central nerve development, passive or active exercise, progressive resistance exercise, mat exercise, and balance, postural, mobility, and gait training. According to previous studies, the approaches to rehabilitation exercises are different depending on the stage of the stroke and the types of exercise (passive, isometric, isokinetic, and isotonic) [10]. In particular, studies show that applying rehabilitation exercise early after stroke is effective [11]. However, as physical or occupational rehabilitation therapy is mainly focused on the early-onset stage, essential exercise is rarely applied in the early stages of rehabilitation. In addition, rehabilitation exercise is effective if it is utilized at the appropriate time in accordance with individual functional suitability [12].
Therefore, guidelines for each type of exercise (passive/isometric/isokinetic/isotonic) are necessary, as well as programs tailored to the individual functional levels of patients, such as the time since the injury occurrence. This customized approach will help patients with stroke recover quickly even after discharge, which will save time and cost. While there are numerous studies on restoring function in patients with stroke, systematic comparative analysis studies on the effectiveness of rehabilitation exercise interventions that consider the timing of the occurrence of impairment and the type of exercise in the clinical field are difficult to find. Therefore, a systematic analysis of studies applying rehabilitation exercises for physical function recovery in patients with stroke is necessary.
This study aims to examine research investigating the effects of rehabilitation exercise programs in recovery of physical function in patients with stroke, based on aspects of their physical function, physical strength, and daily activities, and systematically examine their effects. Based on the study findings, we will present the types and programs of exercises optimized for the phase of injury in patients with stroke. […]
TBI Rehabilitation 