How Are Post-Stroke Rehabilitation Goals Determined?

Setting goals has a positive effect on the results to be obtained in the rehabilitation and recovery process after stroke, as in other areas of life. Participation of patients in goal setting not only ensures that the most important goals are understood for them, but also increases the feeling of satisfaction in the rehabilitation process of the person (1).

Expectations and treatment goals of paralyzed patients

People who have had a stroke want to return to their previous state and normal life. Depending on the extent and severity of the stroke, this goal may be easy or difficult. The ultimate goal of the rehabilitation team is, of course, the full recovery of the person and their return to normal work and home life. This is often a long process and it should be remembered that even the longest journeys begin with small steps. Sometimes the goals set by the physicians may not match the patient expectations. In such cases, although the process actually goes well, the patient may not be satisfied. In order to prevent this, treatment expectations and goals should be well understood by both the physician and the patient and a common language should be established.

The first step in goal setting is to determine the current situation.

While determining the rehabilitation goals after stroke, the person is first evaluated clinically and functionally. He is questioned and examined in many ways, such as positioning himself in bed, turning, sitting, swallowing, ability to move from bed to wheelchair, urination and defecation functions, communication skills, nutritional status, psychological and social factors. Health status before stroke is learned. The degree of influence in terms of mental skills, senses and balance is determined. For evaluations, internationally accepted measurement tools that have been proven to be valid for the Turkish society are used.

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The rehabilitation program is not fixed, it is constantly reviewed.

Goal determination is made to move forward from these initial values. Goals should be meaningful to the patient, focus on activity and participation, be challenging yet attainable, and include both short-term and long-term elements. Then, the evaluations are repeated at certain intervals and the process is followed. The rehabilitation process is actually an uninterrupted structure that continues every day. However, it is also beneficial for the patient, patient relatives and rehabilitation team to evaluate the distance covered at a certain time once a week and provides a more systematic progress. If the expected gains are not achieved, treatments and targets are reviewed (2).

Every patient who has had a stroke has unique circumstances. For this reason, there is no one rehabilitation program or timeline that will work for everyone. The program determined for a particular person should not contain too rigid time targets, but should be flexible. Focusing too much on dates can discourage the patient if the expected results are not achieved in a timely manner.

Post-stroke rehabilitation requires a multidisciplinary and specialized team

The best results are obtained if the patient receives treatment in a center specialized in post-stroke rehabilitation from the first days to discharge and subsequent follow-up. A multidisciplinary team work is required for the treatment of patients with paralysis after stroke, in which many different aspects such as muscle weakness, balance problems, speech difficulties, swallowing disorders, and nutrition are affected.

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