FUNCTIONAL RECOVERY OF PATIENTS WITH ISCHEMIC STROKE AFTER PHYSICAL THERAPY AND REHABILITATION

Abstract

Introduction: The main goal in rehabilitating persons affected by stroke is the establishment of maximum functional capacities in activities of every day living, their personal and social identity.

Objective: To determine the degree of functional recovery of patients after first ischemic stroke of anterior circulation syndrome, posterior circulation syndrome and lacunar syndrome in acute and post-acute phase of physical therapy and rehabilitation.

Materials and Methods: The study was prospective; the study consecutively included a total of 90 patients with  first  ischemic stroke. The first group consisted of 30 patients with the syndrome of anterior circulation; the second group of 30 patients with the posterior circulation syndrome, and the third group of 30 patients with lacunar syndromes. After they have been discharged from the Department of Neurology, they conducted stationary rehabilitation treatment at the Clinic of Physical Medicine and Rehabilitation which lasted 8 weeks. Control re-testing of the patients was conducted six months after the stroke. In order to monitor motor and functional recovery, the Scale of motor assessment was used- "Motor Assessment Scale" (MAS). Initial testing was carried out in the Clinic of Neurology, after completing the rehabilitation treatment at the Clinic of Physical Medicine and Rehabilitation, six months after the stroke. Within the MAS, six months after the stroke, motor recovery of the hand in particular, was analyzed in all the groups, as well as overall functioning.

Results: The functional recovery of patients is statistically significant for all three groups of patients (patients with lacunar syndromes, anterior and posterior circulation) after the physical treatment and six months after the initial testing (p<0.0001). Functional recovery after conducting physical treatment and six months after the stroke is significantly better in the group of patients with lacunar syndromes (p=0.001) and group with the stroke in the posterior circulation (p=0.01) than in the group of patients with the anterior circulation. Functional recovery was statistically significant in the group of patients with lacunar syndromes than in patients with anterior circulation syndrome (p<0.0001 for initial testing; p=0.0046 after the physical treatment; p=0.0042 six months after the stroke; p=0.0001 for motor recovery of the hand). Functional recovery was statistically significant in the group of patients with lacunar syndromes than in patients with posterior circulation: after physical therapy p=0.01; six months after the stroke p=0.01; p=0.02 for the motor recovery of the hand and p=0.05 for overall functioning.

Conclusion: The functional recovery of patients after first ischemic stroke is significant in acute and post-acute phase of physical therapy and rehabilitation. Total activating and motor recovery of the hand was significantly better in the group of patients with lacunar syndromes than in the group of patients with the anterior and posterior circulation syndrome.

Keywords: ischemic stroke, rehabilitation, functional recovery