ASSESSMENT OF THE REHABILITATION PROGRAM FOR PATIENTS WITH STROKE - A PRELIMINARY STUDY

Authors

  • Harieta Elkova Medical Center “Hipokrat- N”, Plovdiv, Bulgaria
  • Galina Мratskova Department of Medical Rehabilitation and Ergotherapy, Physical Medicine and Sports, Medical Faculty, Trakia University, Stara Zagora, Bulgaria

Keywords:

stroke, rehabilitation, quality of life, Brunnstrom scale Bartel index

Abstract

Cerebrovascular diseases are the leading cause of morbidity and mortality around the world, and Bulgaria is on one of the first places, which determines the great social significance of the problem. Stroke is a leading cause of functional impairment and reduced daily activity. There is an increase observed in the frequency and severity of these diseases, accompanied by severe functional deficits, disorders of independence in everyday activities and quality of life. It is essential for the functional recovery of stroke patients to conduct timely, gradual, and comprehensive rehabilitation in all phases of the recovery process. Rehabilitation measures should consider the degree of damage of the central nervous system, the motor deficit and the concomitant diseases.

Objective: To study the influence of the applied rehabilitation program on the motor recovery, the daily functional activity, and the quality of life in patients who have survived a stroke.

Materials and methods: The pilot study included 39 stroke patients with a mean age of 69.90 ± (10.75). The patients were divided into three groups and inpatient rehabilitation was applied. The first group had a severe degree of motor deficit, the second group was with a moderate motor deficit and/or discoordination syndrome and the third group - with a mild deficit and/or coordination disorders. The rehabilitation program included positional treatment, breathing exercises, active and passive exercises including balance and coordination, massage, specialized techniques for neuromuscular rehabilitation, verticalization and walking training, training in daily life activities. Low-frequency current stimulations are used to reduce spasticity. For the pain syndrome - magnetic field, interference currents, therapeutic ultrasound, and thermotherapy. The achieved results were evaluated in two stages - before and after rehabilitation by: testing of motor function; Brunnstrom scale, coordination testing, locomotion, diadochokinesia, Barthel scale. SPSSv.25 was used for statistical processing. The statistical significance of the changes is p <0.05.

Results: In the beginning of the rehabilitation, 18% of the patients were in first motor deficiency group, 28% - in second group, and in third group - 54% of them. After the completion of the rehabilitation program in the first group were 15%, in the second - 5%, and in the third - 80%. Significant improvement in motor function for the upper and lower limbs after rehabilitation p <0.001 and the Brunnstrom scale for upper and lower limb p <0.001 were observed. Reduction in spasticity from 28% to 18% of patients was observed, as well as reduced coordination dysmetria. The proportion of non-vertical patients decreased from 26% to 8%. The Bartel index p <0.001 was significantly increased.

Conclusion: The application of a complex rehabilitation program leads to a reduction in the motor deficit and discoordination syndrome and improvement of the daily functional activity in the examined group of stroke patients. In order to better objectify the obtained results, it is necessary to continue the study, covering a larger number of patients.

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Published

2021-08-16

How to Cite

Elkova, H., & Мratskova G. (2021). ASSESSMENT OF THE REHABILITATION PROGRAM FOR PATIENTS WITH STROKE - A PRELIMINARY STUDY. KNOWLEDGE - International Journal , 47(4), 675–680. Retrieved from http://ikm.mk/ojs/index.php/kij/article/view/4838

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