Patient-oriented medical rehabilitation after stroke in long-term recovery period

Abstract

To evaluate the effectiveness of patient-oriented medical rehabilitation on microcirculation, motions in affected limbs and quality of life in patients with previous stroke in long-term recovery period. The study included 120 patients with previous stroke, hemiparesis and spastic disorders in late recovery period. All patients received standard drug therapy and medical rehabilitation (exercise therapy and medical massage). All patients were divided into 3 groups depending on additional measures: group 1 (n=40) - massage in a pulsed low-frequency electrostatic field in addition to standard complex of rehabilitation; group 2 (n=40) - course of multimodal physiotherapeutic effects (Alpha LED Oxy Light-Spa) in addition to standard complex; group 3 (n=40) - standard drug therapy and medical rehabilitation only (exercise therapy and medical massage). Patients were examined immediately after treatment, 3 and 6 months later. We analyzed effectiveness of rehabilitation using laser Doppler flowmetry (LAKK-01, Russia) and goniometry. Subjective indicators of quality of life were assessed according to the EQ-5D questionnaire (European Quality of Life Questionnaire). At baseline, all patients showed a decrease in microcirculation, motions in affected limbs and subjective decrease in the quality of life. In the 1st group, rehabilitation program improved microcirculatory processes that was confirmed by increment of capillary blood flow by 24% and total vasomotor activity of capillaries by 26.8%. There was a significant decrease in EQ-5D score by 37% in the 1st and 2nd groups after treatment that indicated increase in the quality of life. In the 3rd group, we observed mild increase of microcirculation parameters, range of motions and quality of life. Ersonalized methods of complex rehabilitation contribute to improvement of microcirculation, range of motions in affected limbs and quality of life in patients with spasticity in long-term recovery period after stroke.