EFFECTIVENESS OF EARLY REHABILITATION IN PATIENTS WITH ACUTE ISCHEMIC STROKE IN NEUROLOGY UNIT
Article PDF

Keywords

stroke, ischemic stroke, rehabilitation, depression, transcutaneous electrical nerve stimulation, TENS

How to Cite

O. I. Kolenko, I. O. Chemerys, & I. V. Chernetskyi. (2020). EFFECTIVENESS OF EARLY REHABILITATION IN PATIENTS WITH ACUTE ISCHEMIC STROKE IN NEUROLOGY UNIT. Eastern Ukrainian Medical Journal, 8(2), 123-128. https://doi.org/10.21272/eumj.2020;8(2):123-128

Abstract

Introduction.   The   theoretical  grounding  and   solution   of   the scientific problem, which consist in the study of factors that contribute to the improvement of patients with ischemic brain stroke rehabilitation, are presented in this paper; it is a study of modern methods of rehabilitation and their effectiveness. The objective of the study was to find out reasons why the conducted research shows the significant importance of the use of kinesitherapy, transcutaneous electrical nerve stimulation, and psychotherapy in the system of early rehabilitation of patients.

Based on the study, we established that lateralization of brain lesions is an important factor that affects the rehabilitation potential of patients.

The signs of motor impairment and cognitive deterioration in patients with  ischemic  stroke  requires  the  development  of  individual  and intensive rehabilitation measures in order to restore brain function, and adequate treatment of all possible manifestations that impair the effectiveness of rehabilitation and the quality of patients’ life after ischemic stroke. In addition, our task was to study the incidence of post- stroke depressive disorders and their relationship with psychosocial factors.

Material and methods. The empirical part was performed by collecting information about 60 patients who were treated and had initial rehabilitation in the early recovery period in the stroke unit. Patients were divided into 2 groups according to the timing of recovery to assess the likelihood of post-stroke depression and recovery against time. The analysis of data obtained after processing of materials was carried out using Microsoft Excel’16 program. Statistical processing of the results was carried out by the method of variational statistics using the Student’s test. The data  were collected from patients with  cerebral circulation disorders of Communal Institution in neurology unit of Sumy City Council “City Clinical Hospital No.4”.

Study results: It was established that gender is not a determining factor in the recovery of patients after ischemic stroke and does not significantly impact  the  rehabilitation  prognosis.  The  most  effective factors in recovering lost functions and skills after an ischemic stroke were complexity, phasing, and early start of rehabilitation measures.

Post-stroke depression is a common consequence of ischemic stroke and 54 (90 %) patients (p < 0.05) have it. The characteristic feature of depression in post-stroke patients was the persistence of symptoms, mild and moderate degree of severity, criticism of their condition, etc. Depressive disorders were complex, polymorphic, and included signs of both organic depression and personal response to the development of brain damage. The relationship of depression with the severity of neurological deficits, localization of the focus, as well as with psychosocial factors such as lonely living, loss of work, high social and professional status were shown. Further study of cognitive impairment and the role of specialists in solving the problem of their correction are required. Thus, a complete clinical-neurological and rehabilitation characteristic of patients with different baseline data and conditions is given, based on the results of our own research

https://doi.org/10.21272/eumj.2020;8(2):123-128
Article PDF

References

1. Bruni MF, Melegari C, De Cola MC, Bramanti A, Bramanti P, Calabrò RS. What does best evidence tell us about robotic gait rehabilitation in stroke patients: A systematic review and meta-analysis. J Clin Neurosci. 2018; Feb;48:11-17. doi: 10.1016/j.jocn.2017.10.048
2. Bindawas SM, Vennu V, Mawajdeh H, Alhaidary H. Functional outcomes by age after inpatient stroke rehabilitation in Saudi Arabia. Clin Interv Aging. 2017; Oct 24;12:1791-1797. doi: 10.2147/CIA.S145402
3. Maier M, Ballester BR, Verschure PFMJ. Principles of Neurorehabilitation After Stroke Based on Motor Learning and Brain Plasticity Mechanisms. Front Syst Neurosci. 2019; Dec 17;13:74. doi: 10.3389/fnsys.2019.00074
4. Mamin FA, Islam MS, Rumana FS, Faruqui F. Profile of stroke patients treated at a rehabilitation centre in Bangladesh. BMC Res Notes. 2017; Oct 27;10(1):520. doi: 10.1186/s13104-017-2844-x
5. Tararoschenko NV, Babkina NV, Aliynyk DA, Kovalenko VM, Yangol VI. [Early rehabilitation of patients with stroke in neurological department]. Ukrainian Neurological Journal. 2015; 2: 77-81.
6. Vinychuk SM, Fartushna OYe. [Early rehabilitation after acute ischemic cerebrovascular events]. International Neurological Journal. 2016; 8(86): 34-39. doi: 10.22141/2224-0713.8.86.2016.90909
7. Wang XC, Liu T, Wang JH, Zhang JJ. Post-stroke hand spasm treated with penetrating acupuncture combined with kinesiotherapy: a randomized controlled trial. Zhongguo Zhen Jiu. 2020; Jan 12;40(1):21-5. doi: 10.13703/j.0255-2930.20190106-k0003
8. Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, et al.; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2016; Jun;47(6):e98-e169. doi: 10.1161/STR.0000000000000098
9. Zhang ZQ, Li KP, He J, Jiang LM, Wang W, Hu XS, Feng W. Acupuncture of fascia points to relieve hand spasm after stroke: a study protocol for a multicenter randomized controlled trial. Trials. 2020; Jan 10;21(1):69. doi: 10.1186/s13063-019-3999-7
10. Zirk M, Storm V. Subjective Stroke Impact and Depressive Symptoms: Indications for a Moderating Role of Health-Related Locus of Control. Front Psychiatry. 2019; Dec 19;10:918. doi: 10.3389/fpsyt.2019.00918
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.