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复旦大学:《康复医学 Rehabilitation Medicine》教学课件_脑卒中康复 STROKE REHABILITATION(英文)

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STROKE REHABILITATION 脑卒中康复 HuaDong Hospital affiliated with FuDan University 上海华东医院 □健常侧■障害侧

HuaDong Hospital affiliated with FuDan University 上海华东医院 STROKE REHABILITATION 脑卒中康复

Working pressure and psychosomatic diseases 1.2作压力与王作绩效 绩放高峰 coronary heart disease gastric ulcer 视要求为挑战 焦虑 M件动编强 庆烦 倦息urae subhealth Century disease 6 evolution of human living

coronary heart disease gastric ulcer Migrain e Century disease subhealth Working pressure and psychosomatic diseases evolution of human living

stroke A stroke is defined by the WHO as the rapid development of clinical syndrome of cerebral dysfunction, with signs lasting at least 24hrs or leading to death with no apparent cause other than that of vascular origin Stroke is the common and frequently occurring disease with high disability in the aged patients. Its complications involved motion, sensation cognition, speech and psychology dysfunctions and soon

stroke A stroke is defined by the WHO as the rapid development of clinical syndrome of cerebral dysfunction, with signs lasting at least 24hrs or leading to death with no apparent cause other than that of vascular origin. Stroke is the common and frequently occurring disease with high disability in the aged patients. Its complications involved motion, sensation, cognition, speech and psychology dysfunctions and so on

I DEFINITION. >Acute vascular origin )24hrs >Clinical dysfunctional syndrome II CLASSIFICATION >Transient ischemia >Cerebral thrombosis >Cerebral embolism >Cerebral hemorrage >Lacunar infarction >subarachnoid hemorrhage

stroke Ⅰ DEFINITION: ØAcute vascular origin Ø24hrs ØClinical dysfunctional syndrome Ⅱ CLASSIFICATION: ØTransient ischemia ØCerebral thrombosis ØCerebral embolism ØCerebral hemarrage ØLacunar infarction Øsubarachnoid hemorrhage

演血金 Diabetes 过度饮 Dyslipidemia Tobacco Cerebral vascular accident 还 60 高血压 Hypertension Overweight Sedentary unhealthy life style .metabolism syndrome Risk factor

高血糖 高血压 高血脂 高粘血症 Risk factor 60% Cerebral vascular accident 过度饮酒 •metabolism syndrome unhealthy life style

Ill. etiology 纤维蛋白 vascular wall lesions (atherosclerosis, areritis) >Blood components change abnormality e e (increased viscosity, coagulation mechanism >Hemodynamic change (hypertension, hypotension and external vascular factors) IVrisk factors > Invariable factors v age, nationality, gender and family history; >Variable factors hy pertension, cardiac disease, diabetes mellitus, hy perlipidemia etc Smoking and dietary

Ⅲ 纤维蛋白溶解 . etiology Ø vascular wall lesions ü(atherosclerosis, areritis) ØBlood components change abnormality ü(increased viscosity, coagulation mechanism ) ØHemodynamic change ü (hypertension, hypotension and external vascular factors) Ⅳrisk factors: ØInvariable factors: üage、nationality、gender and family history; ØVariable factors: ühypertension、cardiac disease、diabetes mellitus、hyperlipidemia etc. üSmoking and dietary

Damaged in automatic regulation of cerebral blood f, Infarction zone Penumbra zone Edema zone 半暗区 选择性舒张颅内痉挛血管 72

Damaged in automatic regulation of cerebral blood flow Infarction zone Penumbra zone Edema zone 选择性舒张痉挛血管 梗塞区半暗区 选择性舒张颅内痉挛血管

CL INI CAL FEATURES (1) motor dysfunction (2)sensory di sdurbance (3)advance brain dysfunction aphasia\ apraxia. agnosia i (4)compl ication Systemic: postural hypotension, decrease of physical strength and endurance, infection(pneumonia ur inary path infection, pressure ulcers) @local: joint contracture disused amyotrophy heterotopic ossification shoulder-hand syndrome i scapulohumeral periarthritis peripheral circalation disturbance i

CLINICAL FEATURES: (1)motor dysfunction; (2)sensory disdurbance; (3)advance brain dysfunction: aphasia、apraxia.、agnosia; (4) complication: ①systemic:postural hypotension 、decrease of physical strength and endurance、infection(pneumonia 、 urinary path infection、pressure ulcers); ②local:joint contracture 、disused amyotrophy 、 heterotopic ossification、shoulder-hand syndrome 、 scapulohumeral periarthritis 、peripheral circalation disturbance;

冷 Soft tissue injury 冷 spasiticity o associated reaction 冷 Synergy movement Compensatory action heterotopic ossification o genu recurvatum Hemiplegia gait

v Soft tissue injury v spasiticity v associated reaction v Synergy movement v Compensatory action v heterotopic ossification v genu recurvatum v Hemiplegia gait

三55E小GEOF5R0三 REHABLTATIO小 peripheral central paralysis paralysis (change for quantity)(change for quality 0 flaccid(I) spasticity(Il) synergy motion(III) 2345 some selective activation (Iv) selective activation (v) isolated movements (VI)

peripheral central paralysis paralysis (change for quantity) (change for quality) 0 flaccid(I) 1 spasicity(II) 2 synergy motion(III) 3 some selective activation(IV) 4 selective activation(V) 5 isolated movements(VI)

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