Subarachnoid Hemorrhage (SAH) Rehabilitation: The “Realistic Schedule” Where Memory and Fatigue Recovery Are Key—A Roadmap from Onset to 1 Year and the Latest Science (2025)

Treatment for Subarachnoid Hemorrhage (SAH) does not end with curative surgery for the aneurysm. Subsequent rehabilitation determines the patient’s social reintegration and Quality of Life (QOL). Unlike Intracerebral Hemorrhage, rehabilitation after SAH places critical importance on managing higher brain dysfunctions, such as memory impairment and chronic fatigability.

SAH Rehabilitation: Realistic Schedule and Effectiveness in Japan (2025)

PeriodWhat Recovers MostMain Rehabilitation Content (Total Daily Time)Realistic Goal (For most people)Crucial Points Families Must Know
Onset ∼ 1 WeekPreserving life while waiting for brain swelling to subsideBed mobility (rolling over), Range of Motion (ROM) exercises, Respiratory rehab (∼30–60 min/day)Can roll over independently; Can eat jelly without choking.
1 ∼ 4 Weeks (Acute Hospital)Sitting → Standing →Walking improves dramaticallySitting balance → Walking within parallel bars → Corridor walking (∼2–3 hours/day)Can walk 10–50m with a walker; Can go to the toilet independently.Starting rehab 1 week after coiling/clipping is the 2025 standard.
1 ∼ 3 Months (Recovery Hospital)Golden Period—Memory, attention, and fine hand movements returnPT (Gait) + OT (Hand/ADL) + ST (Memory/Language) Total 3 hours/day + Self-trainingCan walk indoors with a cane; Can do simple cooking and shopping.Effort put in here determines life 10 years later!
3 ∼ 6 MonthsFinalizing for social reintegrationOutpatient rehab + Daycare + Home visiting rehab (∼3–5 times/week)Can go out by bicycle/public transport; Light work return is possible.Fatigue peaks here →Rehab only in the morning is key.
6 Months ∼1 YearMaintenance + Incremental gainsDaycare, fitness gym, home trainingResume driving (with doctor’s OK); Full-time return to work is possible.Continue memory training even after 1 year.
Beyond 1 YearLifetime MaintenanceBrain training apps + Walking + Day serviceCan travel, enjoy hobbies.Stopping exercise leads to rapid decline.

Latest Rehabilitation “Scientifically Proven Effective” (2025)

SequelaMost Powerful Treatment/Device (Insurance Coverage)Effectiveness (Data)
Memory Impairment/Attention Deficit① Transcranial Magnetic Stimulation (TMS)20 min×10-day course  ② Computer Cognitive Training (RehaCom)20–40% improvement in memory function (Tokyo Women’s Medical Univ. 2024).
FatigabilityModafinil (100mg/day) + Part-time work systemDoubling of afternoon active time.
Hemiparesis/Gait DisorderHAL Exoskeleton Robot (Lower/Upper Limbs) 2 times/week30% increase in walking speed (in 6 months).
Higher Brain DysfunctionTablet AI App (Constant Therapy) + Speech-Language Pathologist25% improvement in comprehension/expression skills.
Chronic Headache/PhotophobiaCGRP Antibody Drug (Emgality) (Monthly subcutaneous injection)Number of headache days reduced by more than half.

Top 3 Simple, Highly Effective Self-Training Tips for Families to Do Daily at Home

Rehabilitation FocusAction Steps
Memory Training* Play “Concentration” (using ¥100 shop cards) for 10 minutes daily. * A game of recalling last night’s dinner menu the next morning.
Fatigue Management* Always take a 20-minute nap between 2 p.m. and 3 p.m. (Allows function until evening!).
Gait/Balance* Wrap a 500g weight around the affected hand/foot and walk for 10 minutes (daily). * Single-leg standing 30 seconds×10 repetitions (Fall prevention).

Lifestyle Habits to 10x Recovery Speed

What You Must NEVER DoWhat You MUST Do
Sleep until noon every dayAlways wake up by 7 a.m.
Only drink caffeine-free beveragesDrink 3–4 cups of coffee/green tea daily.
Spend all day on TV/smartphoneWalk outside for 30 minutes daily.