PHYSICAL THERAPY AND REHABILITATION FOR HEMIPLEGIC STROKE

Introduction: When should physician order rehabilitation after a stroke? This may sound a very easy question, but in reality, it is a very challenging question and continue to be one of the most controversy ones. Recent results from studies conducted on animals revealed that after ischemic injury, a consequence of genetic, molecular, cellular, and electrophysiological events is stimulated which activate neural recovery. All together, these consequences lead to cortical reorganization and regeneration, and can add the neural substrate for spontaneous recovery. Aim of work: In this review, we will discuss Physical Therapy and Rehabilitation for Hemiplegic Stroke Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1985, through February 2017. The following search terms were used: physical therapy, rehabilitation, hemiplegia, quadriplegia, neuroplasticity change. Conclusions: The best timing to start rehabilitation after a stroke is a controversial subject. After twenty-four hours, rehabilitation of diverse types appears to be a reliable and safe, however a well-defined "plastic window" in humans, during which injured brain is particularly primed for rehabilitative intervention, continues to be elusive. The optimal outcomes in the early time window have been seen in upper extremity CIMT studies. In the realms of dysphagia and neglect, early intervention has shown some promise, but the results are so limited, and the high proportion of spontaneous recovery makes it hard to evaluate the true impact of early intervention.