Annually approx. 75 thousand Poles - also young people - suffer a stroke. Proper rehabilitation after a stroke can bring many of them back to social and professional life. The sooner it is started, the better the results can be achieved.

According to the Helsingbork Declarationpost-stroke rehabilitation( post-stroke rehabilitation ) should cover all patients. In Poland, as in the world, strokes are the third cause of death and the main cause of disability among people over 40. But strokes can also happen in younger people, especially those who have weak blood vessels due to atherosclerosis, high blood pressure, nervous life, smoking, and a lack of relaxation, as well as in people with excess blood clotting.

Specialists are making more and more efforts to limit the effects of the disease. In 2006, during the second consensus conference held in Helsingborg (Sweden), the Helsingbork Declaration was signed, containing the principles of management and medical care for patients after stroke. Poland is also among its signatories.

Rehabilitation after stroke: for whom, where and for how long

Stroke rehabilitation is very important. It significantly reduces the risk of complications after a stroke, such as, for example, pressure ulcers. It also increases the chances of the patient regaining fitness.

Early and secondary rehabilitation usually includes physical therapy, occupational therapy, speech therapy, neuropsychotherapy and nursing care. Early rehabilitation begins in the neurology or stroke unit, often on the day of admission to the hospital, and continues in the rehabilitation unit, outpatient clinic or, if necessary, at the patient's home.

Thanks to the National He alth Fund (NFZ) funds, such rehabilitation may last up to 9 to 16 weeks a year from the illness. If the patient does not recover during this time or if further rehabilitation is needed, for the years following the stroke, he or she can receive free treatment for 3 to 6 weeks a year. An insured person who does not move independently and cannot reach rehabilitation is en titled to it at home. You are en titled to this en titlement for one year from the date of the stroke.

NFZ refunds 80 treatment days, i.e. days when a physiotherapist comes to the patient's home. Referral for treatmentsrehabilitation services are provided by the doctor of the neurological, neurosurgical and trauma-orthopedic ward. However, in the case of secondary rehabilitation, referral may be obtained from a primary care physician. These forms of rehabilitation are financed by the National He alth Fund.

Rehabilitation after a stroke commissioned by ZUS

Since 1996, under the disability prevention program, ZUS may commission comprehensive rehabilitation to people who, as a result of an illness, are at risk of long-term inability to work and at the same time are likely to regain this ability after rehabilitation. In the implementation of the program, the priority is to refer the insured person to a rehabilitation center as soon as possible.

Rehabilitation (it may be applied for by the attending physician) is decided by the ZUS certifying physician, who will refer the patient to a specific rehabilitation center.

Treatment - inpatient or outpatient - usually lasts 24 days, but may be extended or shortened by the head of the center after prior consultation with ZUS, when the patient regains fitness for work earlier or when the prognosis is good, but requires longer rehabilitation. The full cost of rehabilitation, including travel to treatments and exercises (up to the price of the cheapest public transport ticket), is covered by ZUS.

Worth knowing

Stroke rehabilitation device

Dr inż. Jacek Tutak and Eng. Jacek Mucha from the Rzeszów University of Technology designed a device for stroke patients and the elderly. The apparatus helps to strengthen the overall he alth of the patient, including balance exercises and avoiding falls. It consists of a footplate with adjustable angle of inclination, a backrest with handles, an adjustable seat and an arm with a monitor. In the foot modules and in the handrails, there are pressure sensors that enable the determination of the reaction of each limb separately. The foot module facilitates the exercise of body balance and muscle strength; simulating unstable ground serves to develop in the patient a quick response to a change in balance, handrails prevent falling. The system is equipped with a diagnostics module and reporting the progress of rehabilitation. The patient can supplement balance exercises with a set of virtual reality games. The device was presented in June this year. at the 10th International Trade Fair for Inventions and Innovations INTARG 2022 in Katowice.

Stroke rehabilitation: equipment surcharge

Every person who suffered a stroke and left traces of disability is en titled to free or partially paid orthopedic equipment andauxiliaries, i.e. crutches, canes, prams, anti-bedsore mattresses, diapers. The list of these measures and price limits should be found in the provincial branches of the National He alth Fund or on the website www.nfz.gov.pl. People who do not have the money to pay the amount that is not covered by the reimbursement or need equipment that is not reimbursed by the National He alth Fund, may apply to the poviat family assistance center (PCPR) or the municipal social welfare center (MOPS) to covered the costs. But you should ask for such financial aid before purchasing the equipment you need.

Incapacity pension

It is granted only to the insured (i.e. people whose income is contributed to the Social Insurance Fund). The application for granting it is submitted to ZUS. The establishment appoints an appointment with the examining physician. The patient may be regarded as partially or completely incapable of work, and also permanently or temporarily incapable of work. This affects the amount of the pension you receive and the period for which it will be granted. The doctor's decision may be appealed against to the ZUS medical commission within 14 days from the delivery of the decision. If the commission upholds the first-instance ruling, you can pursue your rights in court.

Worth knowing

Certificate of disabilityIt allows a person after a stroke, among others benefit from reliefs in means of transport, relief for drugs, tax relief for rehabilitation or exemption from fees for radio and television license. The poviat disability adjudication teams are responsible for issuing decisions, to which the application is submitted along with a certificate from the attending physician. Medical documentation is needed - copies of test results or hospital treatment cards. After submitting the documents, the patient has an appointment before the commission, which includes specialists in various fields, including doctors, career counselors, psychologists.

Support for caregivers

People who look after a stroke patient can report to the regional social welfare center for the so-called care services. It helps in everyday activities - from washing, clothes, preparing a meal, to taking medications. The rules of payment are different in individual municipalities. Often people who do not exceed the so-called income criteria or they have reached old age, they are en titled to free assistance. A stroke survivor is en titled to home visits from a primary care physician and nurse.

Help with PCPR and MOPS

PCPR and MOPS can help with the redevelopment of the apartment (e.g. removing thresholds, widening the door, adapting the bathroom). Valueco-financing may be a maximum of 70% of the costs of services or equipment, but not more than 15 times the average salary (the average salary is PLN 4,214.14 as of January 2016). The centers can also subsidize the stay on a rehabilitation camp for a person with a significant and moderate degree of disability. Such a surcharge is due once every 2 years, and for a person with a slight degree of disability - once every 3 years.

You must do it

Respond to these symptoms immediatelyEach of us should know the symptoms of a stroke, because how quickly you get help depends on the patient's life and future. The first 4.5 hours determine his later efficiency. A stroke may be seen in:

  • weakness, lack of feeling on one side of the body
  • slight paresis of the arm, legs, tingling in the limbs
  • face contortion
  • forgetting or twisting words, difficulty understanding speech
  • no feeling on your cheek or tongue
  • visual disturbance, usually in one eye (objects appear blurry, double, out of focus, vision only to the right or left)
  • sudden, first-time vomiting and severe headaches
  • dizziness, unsteady gait, difficulties in keeping balance, even when sitting
  • falls for no reason
Where to go for help

www.poudarzemozgu.plwww.fum.info.plwww, nfz.gov.pl

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