Department of Neurology, Johns Hopkins School of Medicine, 600 N Wolfe St; Phipps 486, Baltimore, MD, 21287, USA.
Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, USA.
Neurotherapeutics. 2023 Apr;20(3):712-720. doi: 10.1007/s13311-023-01392-2. Epub 2023 Jun 8.
Stroke remains a leading cause of adult disability. To date, hyperacute revascularization procedures reach 5-10% of stroke patients even in high resource health systems. There is a limited time window for brain repair after stroke, and therefore, the activities such as prescribed exercise in the earliest period will likely have long-term significant consequences. Clinicians who provide care for hospitalized stroke patients make treatment decisions specific to activity often without guidelines to direct these prescriptions. This requires a balanced understanding of the available evidence for early post-stroke exercise and physiological principles after stroke that drive the safety of prescribed exercise. Here, we provide a summary of these relevant concepts, identify gaps, and recommend an approach to prescribing safe and meaningful activity for all patients with stroke. The population of thrombectomy-eligible stroke patients can be used as the exemplar for conceptualization.
中风仍然是成年人残疾的主要原因。迄今为止，即使在高资源医疗体系中，也只有 5-10%的中风患者能够接受超急性期血管再通治疗。中风后大脑修复的时间窗口有限，因此，在早期进行规定的运动等活动可能会产生长期的重大影响。为住院中风患者提供护理的临床医生会根据具体情况做出治疗决策，通常没有指南来指导这些处方。这需要平衡地了解中风后早期运动和中风后驱动规定运动安全性的生理原理的可用证据。在这里，我们总结了这些相关概念，确定了差距，并为所有中风患者开出安全且有意义的活动处方提出了一种方法。接受取栓治疗的中风患者人群可以作为概念化的范例。
