Rehabilitation Medicine Issues in Acute Stroke

BACKGROUND– During the acute management of stroke, there are numerous rehabilitation medicine issues that must be addressed to maximize functional recovery. REVIEW SUMMARY– If not recognized and prevented, secondary complications related to the primary neurologic deficit after stroke can slow or limit a patient's rehabilitation and functional recovery. Prophylactic measures and management of the common complications that limit patients after acute stroke care are discussed, including venous thromboembolism, decubitus ulcers, bowel and bladder regulation, aspiration and pneumonia, and malnutrition. Facilitation of recovery includes techniques promoting mobilization, performance of self-care activities of daily living, and earlier communication in patients with aphasia. Determination of rehabilitation needs after acute stroke care is discussed in the final section. CONCLUSION– This review article gives the neurologist a better understanding of potential complications during the acute stroke period, techniques to facilitate early recovery, and guidelines for assessing rehabilitation needs after acute care.