PHYSICAL REHABILITATION OF DISABLED PEOPLE WHO HAVE SUFFERED A STROKE (EARLY PERIOD)

Abstract

The aim - is to increase the effectiveness of the physical therapy program for patients with the consequences of a hemorrhagic stroke with the help of differentiated application of rehabilitation measures depending on the severity of the neurological disorder and concomitant diseases. Materials and methods. 100 patients were observed in the neurorehabilitation center of the Ivano-Frankivsk Regional Clinical Hospital. (50 men and 50 women, average age 63.57 ± 0.43 years) in the early post-stroke recovery period. All patients were clinically and neurologically examined according to a specially developed protocol according to modern scales - NIHSS, mRS on the 10th, 30th, 90th and 180th day of the disease and differentiated treatment in accordance with the standards and protocols of care for patients who have suffered a stroke. The patients were divided into four groups of 25 patients each. The first group included patients with hemorrhagic stroke, among whom the severity of post-stroke disorders was mild (NIHSS score ≤ 7 points), without concomitant diseases. The second group consisted of patients with a mild degree of post-stroke disorders (NIHSS score ≤7 points) and concomitant pathology (heart pathology, diabetes, chronic obstructive pulmonary disease of the II stage). The third group included patients with intracerebral stroke, among whom the severity of post-stroke disorders was moderate and obvious (NIHSS score > 7 points), without concomitant pathology. The fourth group consisted of patients with moderate severity of post-stroke disorders (NIHSS status > 7 points) and accompanying pathology. A statistical analysis of the use of descriptive statistics methods was carried out. The relationship between qualitative features was assessed using the χ2Pearson test. The results. According to the results of treatment, among the patients of group I, 20 patients (80.0%) (mRS index 0–2) had a favorable course. In group I, a relatively favorable result (mRS index ≥3 points) was achieved only in 5 patients (20.0%); in the II group, a positive result was achieved in 17 patients (72.0%), a relatively favorable result was achieved in 8 (28.0%); in group III - a favorable result was achieved in 15 patients (60.0%), relatively favorable - in 10 (40.0%), and in group IV - a favorable result was found only in 14 patients (56.0%), relatively favorable – in 11 (44.0%).
 Conclusions. The assessment of the functional state of disabled people in the early period of a stroke made it possible to establish that the basis of their low motor activity lies in: walking disorders (41% of disabled people), balance functions (35.9%), a decrease in the strength and endurance indicators of muscle groups that have preserved their functionality, low level of adaptive potential of the circulatory system (56.4%), dysregulation of neuropsychological processes
 Differentiated application of the program of rehabilitation and physical therapy in post-stroke patients in different groups, taking into account the severity of neurological disorders of the recovery period and the selection of methods and methods of treatment, leads to a significant increase in the effectiveness of rehabilitation measures.