Intracerebral Hemorrhage Rehabilitation: A Roadmap from Onset to 1 Year and the Latest Science for Maximizing Effectiveness (2025)
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Rehabilitation following Intracerebral Hemorrhage (ICH) is not just about increasing the volume of training. Conducting appropriate rehabilitation tailored to the time elapsed since onset and the brain’s recovery mechanisms is key to improving residual deficits and achieving social reintegration. Particularly, the period from 1 to 6 months after onset is the “Golden Period” when the recovery of paralyzed limbs and speech is most pronounced.
Intracerebral Hemorrhage Rehabilitation Roadmap and Effectiveness Maximization (2025)
Period
What Recovers Most
Main Rehabilitation Content (Total Daily Time)
Realistic Recovery Goal
Crucial Points Families Must Know
Onset ∼ 2 Weeks
Preserving life while waiting for brain swelling to subside
Bed mobility (rolling over), Range of Motion (ROM) exercises, Respiratory rehab (∼30–60 minutes/day)
Can roll over independently; Can eat jelly without choking
Risk of re-bleeding if forced movement occurs!Wait until the doctor gives permission.
2 Weeks ∼1 Month
Sitting →Standing improves dramatically
Bed to wheelchair transfer, Sitting balance → Walking within parallel bars (∼2–3 hours/day)
Can sit in a wheelchair for 1 hour; Can walk 10m with a walker
Do not skip daily rehab!Missing one day feels like losing a week of progress.
1 ∼ 3 Months (Recovery Hospital)
Golden Period—Paralyzed limbs recover most
PT, OT, ST total 3 hours/day (national standard) + 1–2 hours of self-training
Can walk indoors with a cane; Can self-feed and use the toilet independently
Effort put in here determines the rest of their life!
3 ∼ 6 Months
Fine hand movements and speech return
Robotic rehab, higher brain function training, swallowing training (∼2–3 hours/day)
Some can ride a bicycle; Simple conversations flow smoothly
Even if recovery feels “stalled,” improvement is often still happening.
Most Powerful Treatment/Device (Covered by Insurance)
Effectiveness (Data)
Hemiparesis (Non-functional hand)
① HAL (Robotic suit) ② ReWalk / ReoGo-J ③ Ives (Electrical stimulation)
Average 30–50% improvement in hand function in 6 months.
Severe Paralysis
Deep Brain Stimulation (DBS) + Rehabilitation (at select university hospitals)
Multiple reports of walking speed doubling.
Aphasia/Higher Brain Dysfunction
① Transcranial Magnetic Stimulation (TMS) 20 min/day×2 weeks ② Tablet AI language apps
20–40% increase in comprehension ability.
Hemi-spatial Neglect
Prism glasses + Visual search training
80% of people move from wheelchair life to walking capability.
Dysphagia(Swallowing difficulty)
① Endoscopic swallowing surgery + electrical stimulation ② Balloon dilation
Likelihood of removing PEG tube improves from 70% to 90%.
Top 3 Highly Effective Self-Training Tips for Families to Do Daily at Home
Rehabilitation Focus
Action Steps
Paralyzed Hand Rehab
* Use the unaffected hand to pull the paralyzed hand/fingers ×10 seconds hold×20 repetitions (3 sets/day). * Practice gripping a sponge from a 100-yen shop daily.
Hemi-spatial Neglect
* Place a red tape strip on the left side of the dinner plate. * Call the patient’s name from the left side to elicit a response.
Gait Training
* Tape 10 small coins (e.g., 10-yen coins) to the paralyzed foot (as a weight). * Peel off one coin for every 10m walked (use as a gamified incentive).
Lifestyle Habits to “10x Recovery Speed”
What NOT to Do
What MUST Be Done
Stay in bed all day long
Always wake up by 7 a.m.
“Not use” the paralyzed limbs
Move them 1,000 times a day (count them!)
Eat only sweet/salty foods
Adopt a Mediterranean diet (fish, vegetables, olive oil)
Simply maintaining this will more than halve the risk of cerebral hemorrhage recurrence in 5 years.
