Abstract

Objective. The purpose is to increase the efficiency of medical and physical rehabilitation in patients who suffered from cerebral ischemic stroke (CIS) with the help of differentiated use of rehabilitation measures depending on the severity of neurological disorders and comorbid states.Materials and methods. In the clinic of nerve diseases of Zaporizhzhia State Medical University we observed 305 patients (213 men and 92 women, average age is 57.93 ± 0.43 years old) in the recovery period of CIS. All patients were clinically and neurologically examined according to a specially designed protocol using modern scales – NIHSS, mRS on the 10th, 30th, 90th and 180th day of the disease and differentiated treatment in accordance with standards and protocols for the assistance to patients who suffer from stroke. Patients with CIS were divided into four groups. The first group included 111 patients (36.4 %) with CIS, among whom the severity of post-stroke disorders was mild (state on NIHSS ≤ 7 points), without comorbid conditions. The second group consisted of 120 patients (39.3 %) also with a mild degree of post-stroke disorders (state on NIHSS ≤7 points) and the comorbidity (heart pathology, diabetes mellitus, chronic obstructive pulmonary disease of the IInd stage). The third group included 36 patients (11.8 %) with CIS, among whom the severity of post-stroke disorders was moderate and obvious (state on NIHSS > 7 points), without comorbidity. The fourth group consisted of 38 patients (12,5 %) with moderate and severe post-stroke disorders (state on NIHSS > 7 points) and comorbid pathology. Statistical analysis was carried out using descriptive statistics methods. The interrelation between qualitative features was evaluated according to the criterion of the Pearson’s chi-square test.Results. As a result of the treatment among the patients in group I, 97 patients (87.4 %) (index mRS 0–2) had a favorable outcome, relatively favourable one (index mRS ≥3 points) – only 14 (12.6 %); In group II, 104 patients (86.7 %) achieved favorable treatment, relatively favorable one – 16 (13.3 %); in group III – a favorable outcome was recorded in 13 patients (36.1 %), relatively favorable – in 23 (63.9 %), and in group IV – a favorable outcome was revealed in 13 patients (34.2 %), relatively favorable one – in 25 (65.8 %).Conclusions. The differentiated application of medical and physical rehabilitation in patients with CIS in different groups, taking into account the individual prognosis of the recovery period and selection of methods and ways of treatment, has improved significantly the effectiveness of rehabilitation measures.

Highlights

  • Cerebrovascular diseases and their acute forms – cerebral strokes – are one of the important problems of clinical neurology [1,5]

  • In the course of complex treatment, we were guided by the basic principles of medical and physical rehabilitation:

  • – early start of rehabilitation measures; – the complexity of using all available and necessary rehabilitation measures; – individuality of the rehabilitation program; – the stage of rehabilitation; – regularity and continuity throughout all stages of rehabilitation; – social orientation of rehabilitation measures; – use of methods to control the adequacy of loads and the effectiveness of rehabilitation

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Summary

Introduction

Cerebrovascular diseases and their acute forms – cerebral strokes – are one of the important problems of clinical neurology [1,5]. In Ukraine, about 100,000 brain strokes are registered annually and, mortality rates from them are much higher than in developed European countries [2]. Most patients who have suffered from a stroke have become persons with disability, and only 10–15 percent restore their working ability. This problem has got medical, but a great socio-economic significance as well [3,4,5]. The development of differentiated rehabilitation complexes with the wide use of methods and ways of medical and physical rehabilitation is timely and relevant

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