WHO/DAR99.2 Original: English Distribution: General PROMOTING INDEPENDENCE FOLLOWING A STROKE AGuidefor ionals working in Primary Health Care Therapists and Profes Disability and Rehabilitation AIFO. World Health Organization Associazione Italiana Amici di Raoul Follereau© World Health Organization 1999 ‘This document is not a formal publication of the World Health Organization (WHO), and all rights are reserved by the Organization. ‘The document may, however, be freely reviewed, abstracted, reproduced and translated, in part or in whole, but not for sale nor use in ‘conjunetion with commercial purposes. The views expressed in documents by named authors are solely the responsibility of the authors.Chapter L Section 1 1 1 1 1 1 2. 2. 2. 3 3 3 3 3 4. 4. 4. 4, 4. 4. 4. 6, 1 2 3 4 5 6 1 i 3 1 2 3 4 5 1 2 3 4 5 6 7 go CONTENTS FOREWORD ABOUT THIS GUIDE Stroke and recovery Causes of stroke Effects of stroke What happens to a person after stroke? Factors that influence the recovery Treatment guidelines Planning the rehabilitation programme Correct positioning and early handling Introduction Influence of position on muscle tone Approaching the person and other sensory inputs Lying and sitting in bed Lying on the back (supine position) Side-lying position Lying on the stomach (prone position) Sitting up in bed Sitting up with the legs out of bed Transfer from the bed and sitting on a chair Transfer from bed to chair Transfer with help Transfer without help Sitting on a chair with armrests Sitting on a chair without armrests How to correct the sitting position Getting back into bed Performing Range of Motion (ROM) activities The benefits of range of motion activities Performing range of motion activities Care of the shoulder Arm elevation with outward rotation lying on the back eCaAQnuere 10 lL Rn 12 15 7 18 19 20 20 22 22 23 24 25 26 27 27 27 28 28