In Japan, there has been some concern that early ambulation may adversely affect cerebral
circulation dynamics. Consequently, an idea that patients should be kept resting in
bed during the acute phase of a stroke had been deeply rooted, and the time from onset
to the start of rehabilitation has therefore tended to be longer than the international
standard. Under such circumstances, the “JAPANESE GUIDELINES FOR THE MANAGEMENT OF
STROKE 2004” (hereinafter GL2004) was issued and specified that “for preventing disuse
syndrome and promoting the improvement of ADL and social reintegration as early as
possible, intensive rehabilitation started in the acute phase under adequate risk
control is highly recommended.” This triggered the initiation of rehabilitation in
the acute phase, and this concept has been gradually disseminated nation-wide. Furthermore,
for the first time in Japan, the GL2004 systematically organized various rehabilitation
techniques based on evidence for a variety of stroke-mediated and -related disorders.
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Article info
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2011.05.014
Copyright
© 2011 Published by Elsevier Inc.
