Effectiveness of the physical therapy program for post-stroke patients in the early recovery period

Abstract

The goal is to increase the effectiveness of physical therapy programs for patients who have suffered a hemorrhagic stroke by differentially applying rehabilitation measures according to the severity of neurological deficits and comorbidities. Materials and methods. 100 patients were observed in the neurorehabilitation center of the Ivano-Frankivsk Regional Clinical Hospital. Patients in the early recovery period after a stroke (50 men, 50 women, average age 63,57 ± 0,43 years). All patients underwent a clinical and neurological examination according to a specially developed protocol according to modern scales (NIHSS, mRS) on the 10th, 30th, 90th and 180th day of the disease, and subsequent patients with symptoms received differentiated treatment according to treatment standards and protocols. Patients were divided into four groups of 25 patients each. The first group included patients with a hemorrhagic stroke with a mild degree of severity of post-stroke disability (on the NIHSS scale ≤ 7 points) and without concomitant diseases. The second group consisted of patients with mild post-stroke disability (NIHSS score ≤7 points) and concomitant diseases (heart pathology, diabetes, chronic obstructive pulmonary disease of the II stage). The third group included stroke patients (IIN) with moderate and obvious severity of post-stroke disability (NIHSS score >7 points) and the absence of concomitant diseases. The fourth group consisted of patients with moderate post-stroke disability (NIHSS status >7 points) and concomitant pathology. A statistical analysis was carried out using the methods of descriptive statistics. Relationships between qualitative characteristics were assessed using Pearson's χ test. Results. According to the results of treatment among patients of the 1st group, good progress was observed in 20 patients (80,0%) (mRS index 0-2). In group I, only 5 patients (20,0%) had relatively good results (mRS index ≥3 points). In the II group, 17 patients (72,0%) had a positive result and 8 (28,0%) had a relatively good result. III group – good result in 15 patients (60,0%), relatively good – in 10 patients (40,0), IV group – good result only in 14 patients (56,0%), relatively good – in 11 patients ( 44,0%). Conclusion. The differentiated application of rehabilitation programs and physical therapy to different groups of post-stroke patients, taking into account the prognosis of the individual recovery period and the choice of treatment methods, leads to a significant increase in the effectiveness of rehabilitation measures.