سامانه همایش های دانشگاه آزاد اسلامی واحد نجف آباد

صفحه اصلی / اولین همایش بین المللی تحول خدمات سلامت: تلفیق مراقبت، درمان، بازتوانی و امیدبخشی

Beyond Motor Recovery: Multidimensional Stroke Rehabilitation Integrating Physical, Psychological, and Social Interventions Across the Continuum of Care

نویسندگان :

Mohammad Amin Zohourian¹ Mahdi Karimi Boroujeni² Nayereh Naseri³

1- دانشگاه آزاد اسلامی واحد نجف آباد 2- دانشگاه آزاد اسلامی واحد نجف آباد 3- دانشگاه آزاد اسلامی واحد نجف آباد

کلمات کلیدی :

stroke،rehabilitation،multidisciplinary care،physical therapy،post-stroke depression،social participation،caregiver support،telerehabilitation

چکیده :

Introduction: Stroke rehabilitation is commonly evaluated through motor recovery, yet meaningful recovery also depends on community reintegration, participation, caregiver support, cognition, and mood.(2,3,5) While physical rehabilitation remains the best-supported component of care, contemporary evidence increasingly favors a holistic approach that integrates physical, psychological, and social interventions throughout recovery.(2,3) This review summarizes the evidence for multidimensional stroke rehabilitation, identifies gaps in implementation, and outlines future priorities. Methods: We conducted a narrative review of guidelines, Cochrane reviews, systematic reviews, and other review-level literature relevant to post-stroke rehabilitation. The evidence was organized into four domains: physical rehabilitation, psychological rehabilitation, social rehabilitation, and telerehabilitation. Particular attention was given to interdisciplinary care, continuity from inpatient to community settings, and the contribution of goal-setting interventions to recovery outcomes. Results: Structured physical rehabilitation improved post-stroke function and activity, with task-specific practice identified as a central principle of effective rehabilitation.(2,3) Constraint-induced movement therapy, including modified versions, improved upper-limb activity in selected patients with residual movement.(2) Robotic-assisted upper-limb therapy and electromechanical gait training were also beneficial when used to increase training intensity and repetition.(2,3) Depression and anxiety were common after stroke and were associated with poorer recovery.(4) Psychological interventions, including cognitive behavioral therapy, supportive counseling, and coping skills training, reduced depressive symptoms, while cognitive rehabilitation improved selected cognitive and functional outcomes when added to usual care.(4,5) Social rehabilitation strategies, including caregiver education, discharge planning, participation-oriented occupational therapy, and community programs, supported daily functioning and reintegration, although the evidence was more heterogeneous.(2,3) For selected outcomes, particularly continuity of care after discharge, telerehabilitation was feasible and sometimes comparable to in-person care.(2) Discussion: Stroke recovery is inherently multidimensional, and gains in motor function alone do not necessarily translate into independence or meaningful participation.(2,3,5) A more coordinated interdisciplinary approach that combines physical, psychological, and social interventions may better address barriers encountered in real-world recovery.(2,3) The available evidence supports integrating multidimensional rehabilitation across the continuum of care into routine stroke practice.(2,3)