Aspects on rehabilitation in stroke, psychosomatic and psychomotor physiotherapy

Every year approximately 30 000 individuals suffer from stroke in Sweden. And the annual risk of stroke is 5-15% (1). In the United States more than 700 000 people suffer a stroke each year, and approximately two thirds of these survive and require rehabilitation (2). Stroke rehabilitation for milder cases is preferably conducted as home-based rehabilitation. Rehabilitation aims at helping survivors become as independent as possible and to attain the best quality of life and to facilitate return to work. In this issue of Advances in Physiotherapy, four articles deals with different aspects on stroke rehabilitation. A randomized controlled trial by Holmgren and coworkers, deals with a 5-week high intensity functional exercise (HIFE) program, implemented to real-life situations together with education on risk of falling and aspects of security. Stroke patients over 55 years of age, were randomized 3-6 months after fi rst or recurrent stroke to an intervention group or a control group. Assessments were made at baseline, postintervention, 3and 6-months follow-up. The authors suggest that the HIFE program, implemented in real life situations together with educational discussions, may improve falls effi cacy in stroke subjects with risk of falls. The authors also evaluated the benefi t of the HIFE program on health-related quality of life and on depression. The short form SF-36 and the Geriatric Depression Scale-15 were used. The authors conclude that exercise should also be complemented with discussion and education about hidden dysfunctions and not solely focused on falls and physical function, in order to obtain the best health related quality of life. Contraint-induced movement therapy (CIMT) developed by Taub and Wolf (3), is a treatment modality often used in rehabilitation of stroke patients. The treatment targets recovery of the upper limb, by limiting the use of the unaffected limb. Marklund and co-workers conducted a study where they did not focus on the upper limb, but on the lower limb CIMT. They investigated through qualitative interviews patients ’ experiences of participating in such a program. The patients reported that the exercise gave them insight into their condition;