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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© 2011 Published by Elsevier Inc.