Occupational Therapy For Patients Research Articles

Methods of examination in physical therapy, and occupational therapy of people after stroke (clinical case)

the prognosis of recovery of patients after acute cerebrovascular accident depends on the type, severity, and area of brain damage. This article highlights standardized tests and scales for physical therapy and occupational therapy for patients after stroke. An example is given of a clinical case of a patient with stroke consequences, with right-sided spastic hemiplegia. Medical rehabilitation was provided in April 2023 at the Municipal Non-Profit Enterprise "Consultative and Diagnostic Center", branch №6, Sviatoshynskyi district, Kyiv, Department of Physical and Rehabilitation Medicine. After the patient visited the outpatient department of physical and rehabilitation medicine, the examination was conducted by the attending physician. A multidisciplinary team of a physical therapist and an occupational therapist was involved. An important step is the use of standardized tests and scales in physical therapy and occupational therapy. Based on the results of the examinations, the patient's goals are determined, and an individual rehabilitation program is built using evidence-based physical therapy and occupational therapy methods to provide a high-quality and effective rehabilitation cycle. Description of the objective. The standardized tests and scales in physical therapy, and occupational therapy are analyzed on the example of a clinical case of a patient after a stroke with right-sided spastic hemiplegia. Materials and methods. The clinician's handbook for 2020 on stroke rehabilitation was analyzed, with the justification of standardized tests and scales for physical therapy, and occupational therapy. A systematic review of the PubMed database was conducted, which included 44 scientific randomized trials and meta-analyses with accurate diagnoses of tests and scales for physical therapy and occupational therapy. The National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (mRS) were used to assess stroke. Modified Ashworth Scale for the assessment of spastic muscles in patients with neurological disorders. To determine cognitive outcomes and complications after stroke: Montreal Outcome Cognitive Assessment (MOCA); Modified Barthel Index (BI); Line Drawing Test. For motor function: Fugl-Meyer Assessment (FMA); Chedoke Arm and Hand Activity Instrument (CAHAI). Berg Balance Assessment; Morse Fall Risk Test; Stand and Walk Test. Results. The results of the initial examination in physical therapy and occupational therapy determined the patient's functional and cognitive state, consequences, and limitations arising after a stroke. The intermediate examination summarizes the effectiveness of the selected rehabilitation measures. If the patient's results remain unchanged, the physical and occupational therapist changes the approach and methods to achieve the goals. The final examination analyzes the dynamics of restoration of impaired functions, and achievement of goals by the end of the rehabilitation cycle. Therefore, we used the patient's clinical case to compare the initial, intermediate, and final examinations. This allowed us to analyze the results and determine the effectiveness of the selected individual rehabilitation program. Conclusions. The main principle of providing quality rehabilitation measures is the examination in the clinical practice of a physical therapist, and occupational therapist, which is used to measure the goals and compare the results achieved.

Breathing Control Exercises Delivered in a Group Setting for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

Breathing control exercises are an important component of occupational therapy in patients with chronic obstructive pulmonary disease (COPD). Delivering these exercises in group settings may enhance their benefits. Therefore, this study assessed the effectiveness of breathing control exercises delivered in a group format to patients with severe COPD remitting from an acute pulmonary exacerbation. This randomized controlled trial of 6 weeks' duration compared the addition of breathing exercise sessions delivered in a group setting to a standard exercise inpatient rehabilitation program (usual care) versus usual care alone. The standard exercise program consisted of endurance and strength training and therapeutic patient education. The intervention group received, in addition to usual care, 20 sessions of 30 min duration of breathing control exercises in a group setting. The primary outcome was quality of life (Saint George's Respiratory Questionnaire). Secondary outcomes were the COPD assessment test, modified Borg scale, handgrip strength test, and five-time sit-to-stand test. Thirty-seven patients aged 69 ± 7 years were recruited. After the 6-week period, all outcomes significantly improved and exceeded the minimal clinically important difference in the intervention group only. Between-group changes were significant for each outcome. Conclusions: breathing control exercises in a group setting provide clinically relevant benefits in patients with severe COPD who are remitting from an acute pulmonary exacerbation.

Upper Limb Function Recovery by Combined Repetitive Transcranial Magnetic Stimulation and Occupational Therapy in Patients with Chronic Stroke According to Paralysis Severity.

Repetitive transcranial magnetic stimulation (rTMS) with intensive occupational therapy improves upper limb motor paralysis and activities of daily living after stroke; however, the degree of improvement according to paralysis severity remains unverified. Target activities of daily living using upper limb functions can be established by predicting the amount of change after treatment for each paralysis severity level to further aid practice planning. We estimated post-treatment score changes for each severity level of motor paralysis (no, poor, limited, notable, and full), stratified according to Action Research Arm Test (ARAT) scores before combined rTMS and intensive occupational therapy. Motor paralysis severity was the fixed factor for the analysis of covariance; the delta (post-pre) of the scores was the dependent variable. Ordinal logistic regression analysis was used to compare changes in ARAT subscores according to paralysis severity before treatment. We implemented a longitudinal, prospective, interventional, uncontrolled, and multicenter cohort design and analyzed a dataset of 907 patients with stroke hemiplegia. The largest treatment-related changes were observed in the Limited recovery group for upper limb motor paralysis and the Full recovery group for quality-of-life activities using the paralyzed upper limb. These results will help predict treatment effects and determine exercises and goal movements for occupational therapy after rTMS.

Effectiveness of active occupational therapy in patients with acute stroke: A propensity score-weighted retrospective study.

The effects of therapy and patient characteristics on rehabilitation outcomes in patients with acute stroke are unclear. We investigated the effects of intensive occupational therapy (OT) on patients with acute stroke. We performed a retrospective cohort study using the 2005-2016 Japan Rehabilitation Database, from which we identified patients with stroke (n = 10,270) who were admitted to acute care hospitals (n = 37). We defined active OT (AOT) and non-AOT as OT intervention times (total intervention time/length of hospital stay) longer or shorter than the daily physical therapy intervention time, respectively. The outcomes assessed were the Functional Independence Measure (FIM) and National Institutes of Health Stroke Scale (NIHSS) scores, duration of hospitalization, and rate of discharge. Propensity scores and inverse probability of treatment weighting analyses adjusted for patient characteristics were performed to investigate the effects of AOT on patient outcomes. We enrolled 3,501 patients (1,938 and 1,563 patients in the AOT and non-AOT groups, respectively) in the study. After inverse probability of treatment weighting, the AOT group had a shorter length of hospitalization (95% confidence interval: -3.7, -1.3, p < 0.001), and the FIM (95% confidence interval: 2.0, 5.7, p < 0.001) and NIHSS (95% confidence interval; 0.3, 1.1, p < 0.001) scores improved significantly. Subgroup analysis showed that lower NHISS scores for aphasia, gaze, and neglect and lower overall NIHSS and FIM scores on admission led to a greater increase in FIM scores in the AOT group. AOT improved the limitations in performing activities of daily living (ADL) and physical function in patients with acute stroke and reduced the length of hospitalization. Additionally, subgroup analysis suggested that the increase in FIM score was greater in patients with severe limitations in performing ADLs and worse cognitive impairment, such as neglect, on admission.

Discriminating Brain Activation State in a Patient with Duchenne Muscular Dystrophy Using Near-Infrared Spectroscopy for Communication: An Exploratory Case Study

Introduction: Maintaining means of communication is an extremely important issue in occupational therapy for patients with intractable neurological disease. A brain-computer interface (BCI) is a device control technology for utilizing physiological signals, and is eagerly awaited for application in occupational therapy as a communication aid for patients with severe motor dysfunction. As an exploratory study for the development of BCI, we examined the accuracy of discriminating brain activation state using near-infrared spectroscopy (NIRS) signals and the effects of cognitive tasks on subjective burden through case study.

308 A Geriatric Emergency Medicine Assessment Team Reduces Hospital Length of Stay through Faster Discharge to Subacute Rehabilitation

308 A Geriatric Emergency Medicine Assessment Team Reduces Hospital Length of Stay through Faster Discharge to Subacute Rehabilitation

Efficacy of Leap Motion tracking device in Rehabilitation

One of the most common fractures seen in emergency rooms is distal radial fractures (DRF), which commonly occur when an upper extremity is broken. A FOOSH injury is one that occurs when the mechanism of injury involves a dorsal bending force being applied across the distal radial (fall onto an outstretched hand). The DRF has a bimodal distribution and is the most common upper limb fracture across all age groups, peaking in young men and postmenopausal women with an incidence ratio of 1:4. A randomised controlled experiment was conducted to evaluate and analyse the improvement in functional status and pain in patients who followed a home exercise programme without supervision and a physiotherapy plan under observation. A comprehensive analysis of Following some upper limb fractures, exercise helps patients function better and minimises disability. A randomised controlled trial comparing the effectiveness of physical therapy alone to physical therapy and occupational therapy in patients with distal radial fractures receiving conservative treatment A new experimental investigation that focuses on the efficacy of leap motion tracking equipment must be carried out with larger samples, more standardisation in the type of intervention, and treatment methodology.

A Preliminary Study of Alterations in Iron Disposal and Neural Activity in Ischemic Stroke.

Purpose The study aimed to evaluate the postrehabilitation changes in deep gray matter (DGM) nuclei, corticospinal tract (CST), and motor cortex area, involved in motor tasks in patients with ischemic stroke. Methods Three patients participated in this study, who had experienced an ischemic stroke on the left side of the brain. They underwent a standard rehabilitation program for four consecutive weeks, including transcranial direct current stimulation (tDCS), neuromuscular electrical stimulation (NMES), and occupational therapy. The patients' motor ability was evaluated by Fugl-Meyer assessment-upper extremity (FMA-UE) and Wolf motor function test (WMFT). Multimodal magnetic resonance imaging (MRI) was acquired from the patients by a 3 Tesla machine before and after the rehabilitation. The magnetic susceptibility changes were examined in DGM nuclei including the bilateral caudate (CA), putamen (PT), globus pallidus (GP), and thalamus (TH) using quantitative susceptibility mapping (QSM). Functional MRI (fMRI) in the motor cortex areas was acquired to evaluate the postrehab functional motor activity. The three-dimensional corticospinal tract (CST) was reconstructed using diffusion-weighted imaging (DWI) and diffusion tensor tractography (DTT), and the fractional anisotropy (FA) was measured along the tract. Ultimately, the relationship between the structural and functional changes was evaluated in CST and motor cortex. Results Postrehabilitation FMA-UE and WMFT scores increased for all patients compared to the prerehabilitation. QSM analysis revealed increasing in susceptibility values in GP and CA in all patients at the ipsilesional hemisphere. By fMRI analysis, the ipsilesional hemisphere demonstrated an increase in functional activity in motor areas for all 3 patients. In the ipsilesional hemisphere, the fractional anisotropy (FA) was increased in CST in two patients, while the mean diffusivity (MD) was decreased in CA in a patient, in PT and TH in another patient, and in PT in two patients. Conclusion This preliminary study demonstrates that the magnetic susceptibility may decrease at some ipsilesional DGM nuclei after tDCS, NMES, and occupational therapy for patients with ischemic stroke, suggesting a drop in the level of iron deposition, which may be associated with an increase in the level of activity in motor cortex after rehabilitation.

REHABILITATION OF HAND BURN PATIENTS IMPLEMENTING OCCUPATIONAL THERAPY

Patients with burns to their hands require rehabilitation for their early return to work and good quality of life. The aim of this study was to evaluate the effect of early intervention with occupational therapy in patients with burns to their hands. This study included 60 patients with second or third degree hand burns. Patients were included to the study 2 weeks after their burn wounds and grafted areas had healed. They had 3 occupational therapy sessions per week for 8 weeks. These sessions included active and passive range of motion exercises, stretching exercises, active resistive exercises and practicing activities of daily living. Before and after the 8 weeks of occupational therapy using the DASH questionnaire, functionality of the hand was assessed. Before intervention with occupational therapy, the average DASH score was 62.5, and after 8 weeks of occupational therapy it was 30.4 (average difference between the pre-intervention and post- intervention DASH scores is 32.1 points, p &lt; 0.001). After 8 weeks of occupational therapy, patients performed daily living activities with relatively very less difculty, and functionality of the hands was also increased. This study suggests that early intervention with rehabilitative therapies is benecial and may result in improved hand function.

Effects of Cognitive Exercise Therapy on Upper Extremity Sensorimotor Function and Activities of Daily Living in Patients with Chronic Stroke: A Randomized Controlled Trial.

This study investigated the effects of cognitive exercise therapy on upper extremity sensorimotor function and daily activity in patients with chronic stroke and compared these effects to those of conventional occupational therapy. The 30 patients with chronic stroke (mean age: 63.6 ± 12.7 years; height: 162.8 ± 8.1 cm; weight: 60.6 ± 7.6 kg; body mass index: 22.8 ± 1.9 kg/m2) were divided into two treatment groups with 15 patients in each. The respective interventions were provided for 30 min per day, five times weekly for 4 weeks. Manual and sensory function tests were conducted to evaluate the sensorimotor function, while the Korean-Modified Barthel Index was used to assess daily activities. All outcome variables were assessed before and after the interventions. A significant interaction was observed in sensory function (p = 0.001) but not motor function or daily activities (p > 0.05). No significant main group effects were found for any outcome variables (p > 0.05). The experimental group showed significant improvements in motor function (p < 0.001), sensory function (p < 0.001), and daily life activities (p = 0.001) after cognitive exercise therapy, whereas the control group showed significant improvement only in daily life activities post-intervention (p = 0.012). These results demonstrated the positive effects of cognitive exercise therapy on upper extremity sensorimotor function and daily life activities and the lack of improvement in motor and sensory function following conventional occupational therapy in patients with chronic stroke. Thus, the combination of cognitive exercise and conventional occupational therapies may be an effective way to improve sensory function and upper extremity motor function in patients with chronic stroke.

Evaluation of Outcomes in Patients Receiving Modafinil to Improve Alertness after Traumatic Brain Injury

Background: Modafinil is used for improving wakefulness associated with narcolepsy, obstructive sleep apnea, and shift work sleep disorder. The goal of this study is to evaluate alertness and participation in physical therapy and occupational therapy in patients with a first-time diagnosis of traumatic brain injury using modafinil. Methods: This was a single-center, retrospective, chart review, cohort study of Ochsner Medical Center patients from January 2016 to December 2018. Patients included in the study were 18 years of age or older who were hospitalized due to a traumatic brain injury and received modafinil either by mouth, nasogastric, or enteral feeding tube to help improve alertness. The primary outcome is the change in Glasgow Coma Scale (GCS) score from baseline to 72 hours after initiating modafinil. Results: One-hundred and Forty patients were included with a mean age of 67.8 years and 59.3% were male. The majority of the patients (52.9 %) were predominantly patients who suffered ischemic stroke. The mean change in GCS score in 72 hours was +0.35 (95% CI [-0.16, 0.88], p=0.177). One of the secondary endpoints was the mean change in course of therapy GCS score which showed significant improvement in neurological function after initiation of modafinil: +1.22 (95% CI [0.64, 1.80], p=0.0001). The percent physical therapy/occupational therapy (PT/OT) session participation at 72-hour post-modafinil initiation was 96.7% compared to 95.7% during the course of therapy. The correlation between increase in GCS score and percent PT/OT therapy session participation was analyzed at 72 hours and throughout the course of therapy, which revealed no significant association (r=0.14 [p=0.0911] and -0.06 [p=0.4881], respectively). Conclusion: Our study did not find a significant increase in the mean change of GCS score at 72 hours of modafinil use. Although, there were high percentage of patients participated in PT/OT in 72 hours and course of therapy (96.7% and 95.7%), there was no significant statistical correlation between increase in GCS score and PT/OT participation. Randomized studies are needed to further assess the impact of modafinil for treating traumatic brain injury associated sleep-wake disturbances while considering factors such as medication initiation time, appropriate dosage, GCS score, and long-term outcomes.

Independence in Daily Activities after Stroke among Occupational Therapy Patients and Its Relationship with Unilateral Neglect.

More research is needed to better understand the impact of occupational therapy (OT) in stroke patients and syndromes of unilateral neglect (UN) and anosognosia. A prospective, observational, longitudinal design was conducted on a sample of 27 OT patients. The objectives were to examine: (1) the presence of UN and anosognosia; (2) the functional outcomes; and (3) the association of UN at baseline with functional status at discharge from OT. The outcomes were Barthel (functional independence) and the Rivermead Mobility Index (RMI). The baseline proportion of participants with UN was 33% according to the Star Cancellation Test (STC), and 48.1% according to the Catherine Bergego Scale (CBS) therapist-version. There was a significant difference between the therapist and participant-rated CBS scores (p = 0.004). Functional independence improved significantly between the initial and final assessments (p < 0.001); the effect size (r) was large (r = 0.61). There was a significant improvement in RMI scores (p < 0.001), which was large in size (r = 0.59). Both the STC and CBS-therapist scores were significantly correlated with the Barthel (p < 0.001, p = 0.005, respectively) and with the RMI (p = 0.004, p = 0.028, respectively). The participants substantially enhanced their functional status skills. UN and anosognosia were common problems, and neglect was associated with worse OT program outcomes.

Interventions in the Scope of Occupational Therapy to Improve Psychosocial Well-Being in Older Adults with Low Vision and Mental Health Concerns: A Systematic Review

Research has found that occupational therapy practitioners focus on functional and participation outcomes in the low vision population, but overlook corresponding psychosocial outcomes in rehabilitation. The purpose of this systematic review is to answer the PICO question: “What is the evidence to support interventions within the scope of occupational therapy for improving psychosocial well-being or quality of life in adults experiencing depression or anxiety as a result of low vision?” The team conducted a search of literature published between 2008 and 2020. Inclusion criteria consisted of interventions within the scope of occupational therapy for patients with low vision, and which measured mental health or quality of life factors. Eleven articles met inclusion criteria. The majority of the evidence consisted of 1B (45%) and 2B (36%) level randomized control trials. Two studies were 3B level evidence. Mental health outcomes were measured primarily using depression rating scales, although a number of studies also utilized vision-specific quality of life questionnaires. Established intervention themes included behavioral activation plus occupational therapy low vision rehabilitation, cognitive problem-solving approaches, usual care ‘plus’ skill-based training, and group service delivery approaches. Moderate evidence supports behavioral activation plus occupational therapy low vision rehabilitation, problem-solving approaches, and group service delivery approaches for improving mental health outcomes. There is moderate evidence that does not support usual treatment ‘plus’ skill-based training to improve mental health.

Effect of Occupational Therapy in Patients Receiving Hemodialysis: A Randomized Controlled Study

Effect of Occupational Therapy in Patients Receiving Hemodialysis: A Randomized Controlled Study

Occupational therapy for patients with schizophrenia who resist treatment in a forensic psychiatric ward in Japan

Occupational therapy for patients with schizophrenia who resist treatment in a forensic psychiatric ward in Japan

Factors related to the effects of repeated transcranial magnetic stimulation and occupational therapy in patients with chronic stroke upper limb paralysis:

Factors related to the effects of repeated transcranial magnetic stimulation and occupational therapy in patients with chronic stroke upper limb paralysis:

History of medical rehabilitation

The World Health Organization defines rehabilitation as a set of measures to restore functions impaired as a result of illnesses, injuries, accidents, birth defects, aimed at adapting this category of people to the most fulfilling life in modern society. Complex of rehabilitation measures should be aimed at restoring health, ability to work and social adaptation, restoring the personal value of each individual. Medical rehabilitation is a process aimed at providing comprehensive care to people with one or another category of disorders and, if possible, ensuring the most comprehensive recovery of the lost functions. People began to resort to rehabilitation as an important way to restore the functions of the damaged organism from ancient times. Even the doctors of Ancient Egypt suggested using some methods of ergotherapy to accelerate the restoration of the health in their patients. Doctors of Ancient Greece and Rome also used physical activity and occupational therapy for patients in therapeutic measures. Various types of massage were widely used in the same countries as a hygienic and therapeutic agent, as well as in order to increase work activity. Since the Roman Empire constantly waged wars to maintain its power, expand and strengthen its borders, the number of people who were mutilated and lost their ability to work was constantly growing. Against this background it was proposed in Rome to provide assistance to the disabled citizens who were injured when defending the fatherland to restore their health (“invalid” – as these people are called in some counties – translated from Latin means “weak”, “feeble”). In particular, in the Roman Empire it was ordered to provide land allotments with slaves and one-time material compensation to former soldiers, who received military injuries during military campaigns. Today rehabilitation has become a separate medical discipline, this issue is supervised by the governments of many countries, and WHO provides interaction with dozens of international non-governmental organizations working in this direction.

Cost-utility analysis of multimodal occupational therapy in patients with thumb base osteoarthritis

Purpose: Patient education, hand exercises, and use of assistive devices and orthoses are regarded as first-line treatment for patients with hand osteoarthritis (OA), however there is limited evidence for the cost-effectiveness of such treatment. The purpose of this study is to assess the cost-utility of a multimodal occupational therapy treatment delivered in the waiting period before surgical consultation in patients with thumb base OA compared to usual care. Methods: This study presents an economic evaluation assessing the difference in health care use and quality-of-life during a 24-month period in a Norwegian multicenter randomized controlled trial designed to assess if multimodal occupational therapy in the waiting period before surgical consultation is more cost-effective compared to usual care. The outcomes in this study was to measure the quality adjusted life years (QALYs) in both the intervention and control group. All patients referred to surgical consultation due to thumb base OA at three departments of rheumatology between 2013 and 2015 were eligible for inclusion. In total, 180 patients were included and randomized to a control group or a multimodal occupational therapy group (90 patients in each group). During the waiting period between referral and actual surgical consultation, the control group continued with usual care which was staying on the waiting list and receiving information on hand OA. The intervention group got information on hand OA, ergonomic principles and use of assistive devices, and they were instructed in home-based hand exercises and received a prefabricated day orthosis and a customized night orthosis. The intervention group was instructed to use the orthoses and assistive devices as much as possible and perform home exercises three times per week for 12 weeks. They returned for adjustment of the exercise program and orthoses after 14 days. The patients were assessed at baseline, before surgical consultation (after approximately 4 months) and after 18 and 24 months. The within-trial economic analysis reports the incremental cost-effectiveness ratio (ICER) reflecting the between-group difference in incremental cost per QALY over 24 months. ICER is defined as the ratio of the difference in costs to the difference in effectiveness between two strategies. A generic health-related quality of life questionnaire, the EuroQol 5 Dimension (EQ-5D-5L) was used to calculate the QALYs at baseline, 4, 18 and 24 months. Costs were collected from different sources, taking a health care perspective; The occupation therapist reported the number of consultations related to the intervention; surgical procedure and post-operative follow-up were collected from patients’ journals; and additional consumption of primary and specialist health care was self-reported by the patient. Sensitivity analyses were performed to assess the robustness of the reported Results. The results are presented in a cost-effectiveness plane using bootstrapping. Willingness-to-pay threshold is set to be € 27 500 linked to the severity of this condition. Results: The mean age of the included patients was 63 years (SD 7.6) and 142 (79%) were women. There was a total between-group difference in QALYs of 0.07 utilities after 24 months, in favour of the intervention group. Operations constituted the main costs with 22 operations in the intervention group compared to 33 in the control group. The between-group difference in costs due to health care consumption was estimated to € 500 in favour of the intervention group (Figure 1). Conclusions: The Results in this within-trial analysis indicate that multimodal occupational therapy in the waiting period before surgical consultation compared to usual care is a cost-effective alternative taking a health care perspective.

ASMENŲ, PATYRUSIŲ GALVOS SMEGENŲ INSULTĄ, KVAPŲ SUVOKIMO SUTRIKIMAI IR JŲ KOREKCIJA, TAIKANT ERGOTERAPIJĄ

Galvos smegenų insultas (GSI) yra viena pagrindinių priežasčių, sukeliančių sergamumą ir neįgalumą Lietuvoje bei pasaulyje. Tyrimo tikslas buvo įvertinti asmenų, patyrusių išeminį GSI, kvapų suvokimo sutrikimus ir jų korekcijos efektyvumą, taikant ergoterapiją. Tyrimas buvo atliekamas 2018 m. kovo – gegužės mėnesiais Kauno klinikinės ligoninės Fizinės medicinos ir reabilitacijos II skyriuje. Tyrime dalyvavo asmenys, patyrę išeminį GSI. Tyrimo imtis n = 20. Tyrimui atlikti buvo naudojamas Trumpas protinės būklės testas (TPBT), skirtas įvertinti asmenų pažinimo funkcijas. Kvapų suvokimo sutrikimams įvertinti buvo naudojamas kvapų suvokimo sutrikimų testas (ang. SOIT – Scandinavian odor identification test), kurį sudaro 16 skirtingų kvapų. Tyrimo rezultatai. Taikant įprastinę ergoterapiją ir kvapų suvokimą lavinančias užduotis, gerėja pažinimo funkcijos. Tyrimo rezultatai parodė, kad moterys kvapus skiria geriau, nei vyrai, ir prieš tyrimą, ir po jo. Išvados. Visiems asmenims, patyrusiems išeminį GSI, po tyrimo pažinimo funkcijos pagerėjo. Asmenų, kuriems buvo taikoma ergoterapija ir kvapų suvokimą lavinančios užduotys, kvapų suvokimas ir pažinimo funkcijos pagerėjo. Moterys skiria kvapus geriau, nei vyrai.

Stroke Patients Motivation Influence on the Effectiveness of Occupational Therapy.

Introduction Individuals who have experienced stroke are often described as apathetic, having lost of interest, and unmotivated. This might be a problem in achieving treatment results. It is still unclear what impact age and gender have on the motivation. The Aim of Research To evaluate motivation influence on the effectiveness of occupational therapy in patients with stroke. Methods Study included 30 patients who experienced acute stroke. Multidimensional Health Locus of Control (MHLC) scale has been used for motivation assessment. Internal persons' motivation was evaluated to determine how much a person believes that his recovery depends on his own behaviour and external persons' motivation—how a person relates his state of health to the impact of the surrounding people. Performance of daily activities was assessed using Functional Independency Measure (FIM). Results At the beginning of rehabilitation of the patients with stroke, external motivation was greater than the internal one. At the end of rehabilitation internal motivation has increased by 1.8±0.4 points, while the external motivation decreased by 2.4±0.6 points (p<0.05). At the beginning of rehabilitation patients independence in activities of daily living assessed with FIM was 70.0±2.9 points. At the end of rehabilitation their ability to perform daily activities improved by 26.9±1.9 points and reached 96.9±2.7 points (p<0.05). We found statistically significant (p<0.05) moderate correlation (r=0.72) between patients internal motivation at the beginning of the rehabilitation and increase of independence after rehabilitation. Conclusion Older patients had lower internal motivation than younger ones, and independence in daily activities improvement was influenced by younger age and by brain damage depth.