Li Sheng
Department of Physical Medicine and Rehabilitation, McGovern Medical School, University of Texas Health Science Center-Houston, Houston, TX 77025, USA.
TIRR Memorial Hermann Hospital, Houston, TX 77030, USA.
Life (Basel). 2023 Oct 15;13(10):2061. doi: 10.3390/life13102061.
Stroke recovery is a journey. Stroke survivors can face many consequences that may last the rest of their lives. Assessment of initial impairments allows reasonable prediction of biological spontaneous recovery at 3 to 6 months for a majority of survivors. In real-world clinical practice, stroke survivors continue to improve their motor function beyond the spontaneous recovery period, but management plans for maximal recovery are not well understood. A model within the international classification of functioning (ICF) theoretical framework is proposed to systematically identify opportunities and potential barriers to maximize and realize the potentials of functional recovery from the acute to chronic stages and to maintain their function in the chronic stages. Health conditions of individuals, medical and neurological complications can be optimized under the care of specialized physicians. This permits stroke survivors to participate in various therapeutic interventions. Sufficient doses of appropriate interventions at the right time is critical for stroke motor rehabilitation. It is important to highlight that combining interventions is likely to yield better clinical outcomes. Caregivers, including family members, can assist and facilitate targeted therapeutic exercises for these individuals and can help stroke survivors comply with medical plans (medications, visits), and provide emotional support. With health optimization, comprehensive rehabilitation, support from family and caregivers and a commitment to a healthy lifestyle, many stroke survivors can overcome barriers and achieve potentials of maximum recovery and maintain their motor function in chronic stages. This ICF recovery model is likely to provide a guidance through the journey to best achieve stroke recovery potentials.
中风康复是一个过程。中风幸存者可能面临许多可能伴随他们余生的后果。对初始损伤的评估能够对大多数幸存者在3至6个月时的生物学自发恢复进行合理预测。在现实世界的临床实践中，中风幸存者在自发恢复期之后仍会继续改善其运动功能，但对于实现最大程度恢复的管理计划人们还了解得不够。本文提出了一个国际功能、残疾和健康分类（ICF）理论框架内的模型，以系统地识别从急性期到慢性期实现功能恢复最大化和发挥其潜力以及在慢性期维持其功能的机会和潜在障碍。在专科医生的照料下，个人的健康状况、医学和神经学并发症能够得到优化。这使中风幸存者能够参与各种治疗干预。在正确的时间给予足够剂量的适当干预对于中风运动康复至关重要。需要强调的是，联合干预可能会产生更好的临床效果。包括家庭成员在内的照料者可以协助并促进针对这些个体的有针对性的治疗性锻炼，并且可以帮助中风幸存者遵守医疗计划（服药、就诊），并提供情感支持。通过健康优化、全面康复、家庭和照料者的支持以及对健康生活方式的坚持，许多中风幸存者能够克服障碍，实现最大程度恢复的潜力，并在慢性期维持其运动功能。这种ICF恢复模型可能会为最佳地实现中风恢复潜力的过程提供指导。
