Stroke is one of the main cause of chronic disability in industrialized
countries and, in 2010, it was among the top eighteen diseases that most frequently lead
to “years lived with disability”. All the quoted conditions decreased between 1990 and
2010, with the exception of the age-standardized rates for stroke. Caring addressed to
post-stroke patients involves multiple challenges, due to stroke causes a wide range of
impairments, among them motor skills deficits are the most common, even if should be
enumerated other areas of impairment such as sensory, visual, swallowing, cognitive
and language related. Rehabilitation provides the possibility of reducing the burden of
disability and, nowadays, one of the most exciting areas of stroke research is the
prospect to increase rehabilitation effectiveness, influence neurological recovery and,
subsequently, impact clinical outcomes. In recent years, following the spreading of
studies regarding neuroplasticity, innovative rehabilitative approaches have been based
on reasonable and intriguing theoretical assumptions. The restorative methods represent
significant tools for stroke rehabilitation; nevertheless, they become meaningless if not
integrated within the context of a rigorously personalized care plan. A comprehensive
rehabilitation plan should begin as soon as the stroke occurs. Management must be
directed toward preventing functional deterioration, restoring lost abilities and
functions, gaining compensatory strategies, suggesting environmental changes,
increasing participation and consequently achieving the highest quality of life after the
brain damage. The grade to which a rehabilitation program meets the challenge of
improving dignity and independence of stroke survivors is assessable through the
adoption of a systematic approach that relates the diseased-state and disability to
outcomes of care. The following can be considered as stroke rehabilitation strongholds:
(1) to provide a consistent rehabilitation plan throughout the acute, sub-acute, and
chronic phases: stroke rehabilitation is a dynamic pathway starting following the symptoms onset and accompanying the patient in the care pathway until his going back
to community; (2) to set goals based on the prediction of the single cases evolution
(short, medium and long-term goals) and design an appropriate pathway: the first step
for a well-conceived rehabilitation management is to establish appropriate setting
addressed to the patient; (3) to provide a comprehensive, coordinated, interdisciplinary
approach: since the strokes clinical manifestations are multidimensional, rehabilitation
is best realized through the coordinated and well harmonized actions among the whole
members of a specialized team; (4) to build up a tailored rehabilitative treatment.
Keywords: Action observation, Comprehensive approach, Individual
rehabilitation project, Multidisciplinary, Neuroplasticity, Non Invasive brain
stimulation, Prognosis, Robotic device, Setting, Tailored treatment, Task-oriented
treatment.
