A research on efficacy of rehabilitation for post-stroke patients in Krasnoyarsk region performed upon the programme of the ministry of health of Russia in 2016

Abstract

Krasnoyarsk Region is among the largest regions of Russia. Its population amounted 2,875,790 by January 1, 2017. A three-stage rehabilitation system for patients after stroke has been created in the region. Over 6000 patients received successive rehabilitation in 2016. The purpose of the research was to assess efficacy of complex successive post-stroke rehabilitation in Krasnoyarsk Region in 2016. A total of 163 patients after stroke (12 months), were enrolled into the unblinded study among which were 103 male and 60 female patients. The age varied from 32 to 91 years (57 ± 12.4). Ischaemic stroke was revealed in 144 patients while haemorrhagic stroke was revealed in 18. The study was conducted in the regional vascular centre at Stage I, in the Centre of neurorehabilitation of the FSSRCC of FMBA of Russia at Stage II and in the clinic of Krasnoyarsk Medical University at Stage III. Glasgow Coma Scale (Stage I only), modified ranking scale, NISSH, Ashworth spasticity, pain, dysarthria assessment scales, Wasserman test, MASA, HADS, MOCA, Rivermead Mobility Index, BBS, Hauser Ambulation Index, Frenchay Arm Test, FIM, EQ-5D were used. Statistical analysis was performed using non-parametric Wilcoxon and Mann-Whitney criteria. The patients were divided into 3 groups after examination: group I ( n = 39) included patients after only rehabilitation stage I. Group II ( n = 61) included patients after stages I and II, and group III ( n = 63) included patients after all stages. It has been found that best statistically significant results according to clinical scales were found in group III patients as manifested by disablement and neurological deficit decrease and motion activity value enhancement. In Krasnoyarsk region, the best efficacy has been shown by the complex successive rehabilitation for patients after stroke performed in stages.