Rehabilitation after a stroke is not just about moving paralyzed limbs; it requires optimizing the strategy, start time, and main training content according to the type of stroke (Ischemic Stroke, Intracerebral Hemorrhage, or Subarachnoid Hemorrhage). Notably, “how early you start” is the biggest factor that dramatically changes the patient’s life one year later.
Comparison of Stroke Rehabilitation
| Feature | Ischemic Stroke (Infarction) | Intracerebral Hemorrhage | Subarachnoid Hemorrhage (SAH) |
| Rehab Start Time | Ultra-early! (Day 1 ∼ 2 post-onset) | Later (Wait 1–3 weeks until bleeding stabilizes) | Soon after surgery ∼ within 1 week (Once intracranial pressure settles) |
| Max Recovery Goal | “Walk home,” “Regain as much movement as possible.” | “Regain movement,” “Manage higher brain dysfunction.” | “Restore the brain to its original state.” |
| Most Important Rehab | Motor paralysis (Limbs) | Motor paralysis + Higher Brain Dysfunction | Cognitive function (Memory, Attention, Motivation) |
| Gait Recovery Outlook | ◎ Very good (70–90%; ≥90% with thrombectomy) | △ Poor (30–50%) | ◎ Quite good (≥80%) |
| Fine Hand Movement Recovery | △∼◯ Highly individual | × Quite difficult | ◯ Tends to recover relatively well |
| Language Rehab (Aphasia) | ◎ Extremely necessary | ◯ Necessary | △ Less necessary |
| Cognitive Rehab Needs | ◯ Needed for recurrent Lacunar cases | ◎ Highly necessary | ◎◎ Needed by 70–80% of survivors |
| Average Rehab Duration | 3–6 months (As short as 1–2 months for mild cases) | ≥6–12 months | 6–18 months (Cognitive rehab often prolonged) |
| Effectiveness of Robot/Tech | ◎ Very effective (especially for paralysis) | △ Not very effective | ◯ Sometimes used for attention training |
| Return-to-Work/Social Rate | 50–70% | 20–40% | 50–70% (But “same job as before” is only ≈30%) |
| Patient’s Biggest Distress | “My hand won’t move as I intend.” | “My body doesn’t move + my mind is dull.” | “My body moves, but my mind is foggy and I can’t concentrate.” |
| Family’s Biggest Burden | Assisting with paralysis. | Total assistance + Managing emotional outbursts. | Managing zero motivation/depression. |
One-Sentence Summary of Rehab Characteristics
- Ischemic Stroke → “Body movement rehab” → Fast and visible recovery!
- Intracerebral Hemorrhage → “Body + Brain Double Rehab” → Long and requires patience…
- Subarachnoid Hemorrhage → “Brain rehab is the main focus” → Looks healthy, but the internal function is difficult.
Recent Trends (Current as of 2025)
- Ischemic Stroke: “Miraculous recovery” is increasing with robot suits (HAL) and electrical stimulation.
- Subarachnoid Hemorrhage: Cognitive rehab using VR is rapidly increasing (brain training in a game-like setting).
The outcome of rehabilitation is drastically different depending on “how early you start” and “how much you practice daily!” Specifically, it is scientifically proven that for Ischemic Stroke, “starting even one day earlier dramatically changes life one year later.”
