Possibilities for Correcting Emotional and Behavioral Impairments in Stroke Patients during Rehabilitation Therapy

Abstract

Objectives. To assess the efficacy of a set of rehabilitation measures including use of mechanotherapy and cognitive stimulation using tablet PC technology in relation to emotional and behavioral impairments in patients during the acute phase of ischemic stroke. Materials and methods. The study included 100 patients with ischemic stroke admitted to hospital in the acute period. All patients were randomized to two groups: a study group and a control group. The study group (50 patients) received daily robot mechanotherapy using a MOTOmed bedside trainer and tablet PC technology for independent exercises for patients to develop memory, perception, reactions, and counting. Patients of the control group (50 patients) received standard therapy. Functional status was assessed using the modifi ed Rankin scale. Objective evaluation of emotional and behavioral impairments was obtained using psychometric scales (Beck Depression and Anxiety Scales). Results. Use of complex rehabilitation programs in the acute period of ischemic stroke promoted regression of emotional and behavioral impairments (p = 0.0001). The severity of depressive disorders was decreased in patients of the study group by the end of the in-patient period, and further regression in these patients continued throughout the observation period, to the six-month point (p = 0.001). Measures of anxiety showed statistically significant decreases during the whole of the observation period in patients of the study group (p = 0.0001), in contrast to those of the control group, where no changes were seen. Functional recovery was better in patients of the study group, as evidenced by statistically significant changes in mean measures of changes on the Rankin scale. Conclusions. The rehabilitation program presented here, including mechanotherapy and cognitive stimulation using tablet PC technology, is a simple and accessible method for correcting emotional and behavioral impairments in patients in the acute period of ischemic stroke. The results achieved not only persisted over time, but were followed by further improvements in measures at three and six months.