New Concepts and Evidence Based Practice in Physiotherapy:Examples from Stroke Rehabilitation
New Concepts and Evidence Based Practice in Physiotherapy:Examples from Stroke Rehabilitation
摘要Objective:The purpose of this paper is to give an oveuview of new concepts and evidence based physiotherapy practice in stroke rehabilitation in the acute,post acute and chronic stage of stroke.Background:Historically physiotherapy has developed through the years from a focus on health,beauty,and equilibrium between spiritual,moral and physical powers,to a client centered service to people and populations to develop,to maintain and to restore maximum movement and functional ability throughout the lifespan.Still the health perspective is strong and divided into first,second and third prophylaxis.New concepts like Evidence Based Medicine,Evidence Based Practice,International Classification of Function and research within neurophysiology have had a deep impact on physiotherapy services.practice and education.The highest levels of documentation are Meta analyses and Randomised Controlled Trials,and today many of the physiotherapy methods used in rehabilitation of neurological conditions are tried out in different trials,bringing up-todate knowledge into practice.This paper fo-cuse8 on rehabilitation of persons with stroke and physiotherapy methods in particular.Result:Physiotherapy in the acute stage improves motor function and enhances mobility.Rehabilitative efforts within the first few weeks as opposed to later favors better recovery.Type of physiotherapy in the acutestage is task oriented training with a focus on intensity and variability.Post acute therapy-based rehabilitation services targeted towards stroke patients living at home appear to improve independence in personal activities of daily living.In the chronic stage there is good evidence that aerobic exercise is beneficial for improving aerobic capacity inpeople with mild and moderate stroke.Progressive resistance strength training programmes reduce musculoskeletal impairment after stroke,without increasing tone or spasticity.
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