Stroke and Neuro Physiotherapy: How, When and Why

Stroke leaves a significant number of individuals with disabling motor, cognitive, or language deficits. 36% are disabled 5 years post stroke. ⁽³⁾The financial burden of stroke on health services is enormous. In Europe, it is estimated that informal care amounted to €1.3 billion, the cost for health care was €27 billion, while the cost due to lost productivity following stroke was €12 billion in 2017.⁽⁴⁾

Regaining motor function is critical for independence in activities of daily living, which goes hand in hand with a satisfactory quality of life.⁽¹⁾ In 2017, 32 European countries spent €60 billion on stroke care, of which 45 % was spent on health care, 8 % on social care and 47 % on direct and indirect productivity losses. Of the €27 billion spent on stroke healthcare, only 18% was spent on rehabilitation. ⁽⁵⁾

Rehabilitation has been defined in accordance with the WHO as “a set of measures that assist individuals, who experience or are likely to experience disability, to achieve and maintain optimal functioning in interaction with their environments.” ⁽¹⁾ However, post-stroke care is considered disorganized and fragmented even in the best healthcare systems. ⁽⁶⁾ The literature describes that stroke survivors generally receive minimal rehabilitation support after discharge to the community. ⁽³⁾

This data shows that more emphasis should be placed on rehabilitation and the importance of physiotherapy after a stroke. Ideally, stroke rehabilitation should be intensive, timely, and multidisciplinary, with coordinated transfers between settings, and effective interfacing with social and community. The physiotherapist creates a personalized intervention plan, aiming to achieve maximum autonomy and functional independence, avoiding the development of pathological synergies and optimizing the patient’s motor capacity. The neuro physiotherapist uses several tools for intervention, as, facilitating motor strategies, external instruments (such as treadmills, dumbbells, etc.) and modification of the environment (higher seat, surface base unstable, etc.). The neurological physiotherapist plays a crucial role in gait training, in enabling the patient to carry out activities of daily living as well as to participate in social life again.

In summary, rehabilitation after a stroke is critical for optimizing recovery, enhancing independence, and improving the overall well-being of stroke survivors. It involves a multidisciplinary approach to address the comprehensive needs of individuals affected by stroke. It is further important to understand that healthcare systems need to be optimized, considering the socioeconomic impact of strokes if they are not adequately treated by a neurological rehabilitation team with a focus on physiotherapy.

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References:

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