REHABILITATION IN STROKE PATIENTS

Because of the high incidence and prevalence rates of stroke, successf ul rehabilitation of patients is of considerable socioeconomic importa nce. As for diagnostics, the three levels >>impairment<<, >>disability << and >>handicap<< as defined by the WHO may be linked to standardize d tests, functional testing (ADL) and assessment of psychosocial conse quences such as quality of life. Among the rehabilitative techniques, it is possible to differentiate between restitution, compensatory stra tegies and adaptation. The efficacy of rehabilitation has been clearly proven for the majority of motor and cognitive disturbances, whereby >>tailor-made procedures<< are to be preferred. Functional outcome dep ends on various variables: as for age, its predictive value is still c ontroversial; multiple infarctions of both forebrain hemispheres, blad der incontinence, dementia, visuoconstructive disturbances and depress ion predict a poor prognosis; early initiation of rehabilitation and g ood ADL scores at admission are predictors of a beneficial outcome.