Physical rehabilitation of elderly patients with acute cerebrovascular accident. Literature review

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A sharp increase in life expectancy over the past century has led to a significant increase in demand for long-term medical and social care.

With aging, the reactivity of the body to the effects of the external environment changes, in particular, a decrease in resistance to pathogenic factors. Older people have chronic diseases (cardiovascular system, respiratory and digestive organs, central nervous system, joints, organs of vision and hearing, as well as diabetes, oncological diseases, etc.) that reduce physical and social activity.

Vascular diseases of the brain remain one of the most acute medical and social problems that cause enormous damage to society. A special place among them is occupied by cerebral stroke due to the high mortality rate, significant disability and social maladaptation of elderly patients. According to modern data, at least 1/3 of stroke patients develop motor function disorders on average. These disorders significantly worsen the daily functioning of the quality of life.

The aim of rehabilitation of elderly patients who have suffered a stroke is to return the patient to active social and household activities, create optimal conditions for his active participation in society and, ultimately, improve the quality of life of both the patient and his relatives. The task of psychological and physical recovery, social and labor adaptation of post-stroke patients is most successfully solved in the system of complex multidisciplinary rehabilitation. The lack of timely restorative treatment leads to irreversible anatomical and functional changes and a violation of the psychoemotional status of a person.

Evidence has been provided that physical rehabilitation measures for elderly patients can significantly improve the indicators of physical, mental and social functioning without increasing the risk of undesirable effects. Successful and safe interventions have made it possible to achieve the goal of rehabilitation, increasing the functional status of elderly patients and independence in everyday life, as well as reducing the burden of the disease for both the individual and his family and society as a whole.

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About the authors

Alexey A. Martsiyash

Kemerovo State Medical University

ORCID iD: 0000-0003-2948-9666
SPIN-code: 4344-0290

MD, Dr. Sci. (Med.), Professor

Russian Federation, Kemerovo

Vadim G. Moses

Kemerovo State Medical University

ORCID iD: 0000-0002-3269-9018
SPIN-code: 5854-6890

MD, Dr. Sci. (Med.), Professor

Russian Federation, Kemerovo

Kira B. Moses

Kemerovo State Medical University

ORCID iD: 0000-0003-2906-6217
SPIN-code: 7479-6695

MD, Assistant

Russian Federation, Kemerovo

Lilia A. Lastochkina

Kemerovo State Medical University

Author for correspondence.
ORCID iD: 0000-0002-1767-7320
SPIN-code: 6984-2066

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Kemerovo


  1. World Population Prospects: The 2010 Revision, Press Release [3 May 2011]. World Population to reach 10 billion by 2100 if Fertility in all Countries Converges to Replacement Level. United Nations, Department of Economic and Social Affairs, Population Division; 2011.
  2. Dontsov VI, Krutko VN, Trukhanov AI. Anti-aging medicine: fundamental foundations. Moscow; 2010. 680 р. (In Russ).
  3. Belskaya GN, Chuprina SE, Vorobyev AA, et al. Cognitive disorders in stroke: possibilities of drug correction. J Neurol Psychiatry. 2016;116(5):33–37. (In Russ). doi: 10.17116/jnevro20161165133-37
  4. Danti L, Agosti M, Outcome pre-dictors of rehabilitation for first stroke in the elderly. Eur J Phys Rehabil Med. 2008;44(1):3–11.
  5. Koh GC, Chen C, Cheong A, et al. Trade-offs between effective-ness and efficiency in stroke rehabilitation. Int J Stroke. 2012;7(8):606–614. doi: 10.1111/j.1747-4949.2011.00612.x
  6. Veerbeek JM, Kwakkel G, van Wegen EE, et al. Early prediction of outcome of activities of daily living after stroke: a sys-tematic review. Stroke. 2011;42(5):1482–1488. doi: 10.1161/STROKEAHA.110.604090
  7. Kovalchuk VV. Patient after stroke. Principles of rehabilitation and features of management. Moscow; 2016. 328 р. (In Russ).
  8. Pisova NV. Issues of rehabilitation of patients after stroke in outpatient settings. Medical Advice. 2018;(12):18–22. (In Russ). doi: 10.21518/2079-701X-2018-12-18-22
  9. Kadykov AS, Shakhparonova NV. Rehabilitation after stroke. Moscow: Medical Information Agency; 2017. 240 р. (In Russ).
  10. Grokhovsky SS, Kubryak OV. On the question of the "dose" of motor rehabilitation after stroke: a review. Physiotherapy Balneology Rehabilitation. 2018;17(2):66–71. (In Russ). doi: 10.18821/1681-3456-2018-17-2-66-71
  11. National Institute for Health and Care Excellence. Stroke rehabilitation in adults. Available from: Accessed: 27.11.2020.
  12. Belda-Lois J, Mena-del Horno S, Bermejo-Bosch I, et al. Rehabilitation of gait after stroke: a review towards a top-down approach. J Neuroeng Rehabil. 2011;8:66. doi: 10.1186/1743-0003-8-66
  13. Pennycott A, Wyss D, Vallery H, et al. Towards more effective robotic gait training for stroke rehabilitation: a review. J Neuroeng Rehabil. 2012;9:65. doi: 10.1186/1743-0003-9-65
  14. Mehrholz J, Pohl M, Elsner B. Treadmill training and body weight support for walking after stroke. Cochrane Database Syst Rev. 2014;23(1):CD002840. doi: 10.1002/14651858.CD002840.pub3
  15. French B, Thomas L, Leathley M, et al. Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis. J Rehabilitation Med. 2010;42(1):9–14. doi: 10.2340/16501977-0473
  16. Galvin R, Cusack T, Stokes E. A randomised con-trolled trial evaluating family mediated exer-cise (FAME) therapy following stroke. BMC Neurology. 2008;20(8):22. doi: 10.1186/1471-2377-8-22
  17. Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet. 2011;377(9778):1693–1702. doi: 10.1016/S0140-6736(11)60325-5
  18. Lohse KR, Lang CE, Boyd LA. Is more better? Using metadata to explore dose-response rela-tionships in stroke rehabilitation. Stroke. 2014;45(7):2053–2058.
  19. Veerbeek JM, van Wegen E, van Peppen R, et al. What is the evidence for physical therapy post-stroke? A systematic review and meta-analysis. PLoS One. 2014;9(2):e87987. doi: 10.1371/journal.pone.0087987
  20. Nikiforova ON. Study of the effectiveness of kinesiotherapy in upper limb paresis after ischemic stroke. We Will Lie. Health-Saving Technologies. 2018;(4):98–103. (In Russ).
  21. Kwakkel G, Kolten BJ, Krebs HI. Effects of robot-assisted therapy on upper limb recovery after stroke: a systematic review. Neurorehabil. Neural Repair. 2008;22(2):111–121. doi: 10.1177/1545968307305457
  22. Eremushkin MA. Motor activity and health. From therapeutic gymnastics to parkour. Moscow: Sport; 2016. 184 p. (In Russ).
  23. Bowman C, Whistler J, Ellerby M. A national census of care home residents. Age and Ageing. 2004;33(6):561–566. doi: 10.1093/ageing/afh177
  24. Continuing Care Conference. Care at the Crossroads: CCC Care Census Points the Way Forward. London, Monday, 3 July 2006. Available from: Accessed: 27.11.2020.
  25. Balboa-Castillo T, Léon-Muñoz LM, Graciani A, et al. Longitudinal association of physical activity and sedentary behavior during leisure time with health-related quality of life in community-dwelling older adults. Health Quality Life Outcomes. 2011;9(1):47. doi: 10.1186/1477-7525-9-47
  26. Machoney F, Barthel D. Functional evalution: the Barthel Index. Md State Med J. 1965;14:61–65.
  27. Wade DT. Measurment in neurological rehabilitation. New York: Oxford University Press; 1992. 388 p.
  28. Kwantabisa N. Occupational therapy ADL checklist sell maintenance. Merton and Sutton Community NHS Trust, Stroke Rehabilitation Team Protocol-L; 1999. P. 7–9.
  29. Katz S, Ford AB, Chinn AB, et al. Studies of illness in the aged. The index of ADL and psychosocial function. JAMA. 1963;185:914–919. doi: 10.1001/jama.1963.03060120024016
  30. Berg K, Wood-Dauphinée S, Williams J, Gayton D. Measuring balance in the elderly preliminary development of an instrument. Physiotherapy (Canada). 1999;41:304–311. doi: 10.3138/ptc.41.6.304
  31. Hamilton M. A rating scale for depression. J Neurology Neurosurg Psychiat. 1960;23:56–62. doi: 10.1136/jnnp.23.1.56
  32. Bergner M, Bobbitt RA, Carter WB, et al. The Sickness Impact Profile: development and final revision of a health status measure. Med Care. 1981;19(8):787–805. doi: 10.1097/00005650-198108000-00001
  33. Folstein MF, Folstein, SE, Hugh PR. Mini-Mental State. A practical method for grading the cognitive state of patients for the clinician. J Psych Research. 1975;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6
  34. National Institute for Health and Clinical Excellence. Occupational therapy interventions and physical activity interventions to promote the mental wellbeing of older people in primary care and residential care. NICE public health guidance. 2008. Available from: Accessed: 27.11.2020.
  35. Bourret EM, Bernick LG, Cott CA, Kontos PC. The meaning of mobility for residents and staff in long-term care facilities. J Advanced Nur. 2002;37(4):338–345. doi: 10.1046/j.1365-2648.2002.02104.x
  36. Marciyash AA, Kalmykova EV. Assessment of the symptoms of the disease and the quality of life of patients in the early recovery period of stroke in the conditions of the medical rehabilitation center. Nervous Diseases. 2017;(1):52–57. (In Russ).
  37. Gerritsen DL, Smalbrugge M, Teerenstra S, et al. Act In case of Depression: the evaluation of a care program to improve the detection and treatment of depression in nursing homes. Study Protocol. BMC Psychiatry. 2011;11(91):1–7. doi: 10.1186/1471-244X-11-91
  38. Lin KC, Chen YA, Chen CL, et al. The effects of bilateral arm training on motor control and functional performance in chronic stroke: a randomized controlled study. Neurorehabil Neural Repair. 2010;24(1):42–51. doi: 10.1177/1545968309345268
  39. Braam AW, Prince MJ, Beekman AT, et al. Physical health and depressive symptoms in older Europeans. Results from EURODEP. British J Psychiatry. 2005;187:35–42. doi: 10.1192/bjp.187.1.35
  40. Sung K. The effects of 16-week group exercise program on physical function and mental health of elderly Korean women in long-term assisted living facility. The J Cardiovascular Nur. 2009;24(5):344–351. doi: 10.1097/JCN.0b013e3181a80faf
  41. Blake H, Mo P, Malik S, Thomas S. How effective are physical activity interventions for alleviating depressive symptoms in older people? A systematic review. Clinical Rehabilitation. 2009;23(10):873–887. doi: 10.1177/0269215509337449
  42. Windle G, Hughes D, Linck P, et al. Is exercise effective in promoting mental well-being in older age? A systematic review. Aging Mental Health. 2010;14(6):652–669. doi: 10.1080/13607861003713232
  43. Kalmykova EV, Duda EE, Kalmykova YA, Marciyash AA. Age-related features of anxiety-depressive disorders and quality of life indicators of patients in the early and late recovery periods after a cerebral stroke. Palliative Med Rehabilitation. 2013;(2):41–46. (In Russ).
  44. Department of Health, Physical Activity, Health Improvement and Protection (DH). Start active, stay active: a report on physical activity from the four home countries' Chief Medical Officers. Gateway reference: 16306. 2011. Available from: Accessed: 27.11.2020.
  45. Kalmykova EV, Gulyaeva EN, Marciyash AA. Quality of life of stroke patients, depending on marital status. Neurological J. 2016;21(5):287–291. (In Russ). doi: 10.18821/1560-9545-2016-21-5-287-291
  46. Paw MJ, van Uffelen JG, Riphagen I, van Mechelen W. The functional effects of physical exercise training in frail older people: a systematic review. Sports Med. 2008;38(9):781–793. doi: 10.2165/00007256-200838090-00006
  47. Weening-Dijksterhuis E, de Greef MH, Scherder EJ, et al. Frail institutionalized older persons: a comprehensive review on physical exercise, physical fitness, activities of daily living, and quality-of-life. Am J Physical Med Rehabilitat. 2011;90(2):156–168. doi: 10.1097/PHM.0b013e3181f703ef
  48. Potter R, Ellard D, Rees K, Thorogood M. A systematic review of the effects of physical activity on physical functioning, quality of life and depression in older people with dementia. Int J Geriatric Psychiatry. 2011;26(10):1000–1011. doi: 10.1002/gps.2641
  49. Morris JN, Fiatarone M, Kiely DK, et al. Nursing rehabilitation and exercise strategies in the nursing home. J Gerontology. 1999;54(10):M494–500. doi: 10.1093/gerona/54.10.m494
  50. Faber MJ, Bosscher RJ, Paw MJ, van Wieringen PC. Effects of exercise programs on falls and mobility in frail and pre–frail older adults: a multicenter randomized controlled trial. Arch Physical Med Rehabilitat. 2006;87(7):885–895. doi: 10.1016/j.apmr.2006.04.005
  51. Santana-Sosa E, Barriopedro MI, López-Mojares LM, et al. Exercise training is beneficial for Alzheimer's patients. Int J Sports Med. 2008;29(10):845–850. doi: 10.1055/s-2008-1038432
  52. Sihoven SE, Sipilä S, Era P. Changes in postural balance in frail elderly women during a 4-week visual feedback training: a randomized controlled trial. Gerontology. 2004;50(2):87–95. doi: 10.1159/000075559
  53. Bruyere O, Wuidart MA, Di Palma E, et al. Controlled whole body vibration to decrease fall risk and improve health-related quality of life of nursing home residents. Arch Physical Med Rehabilitat. 2005;86(2):303–307. doi: 10.1016/j.apmr.2004.05.019
  54. Peri K, Kerse N, Robinson E, et al. Does functionally based activity make a difference to health status and mobility? A randomised controlled trial in residential care facilities (The Promoting Independent Living Study; PILS). Age Ageing. 2008;37(1):57–63. doi: 10.1093/ageing/afm135
  55. Brittle N, Patel S, Wright C, et al. An exploratory cluster randomized controlled trial of group exercise on mobility and depression in care home residents. Clin Rehabilitat. 2009;23(2):146–154. doi: 10.1177/0269215508098891
  56. Buettner LL, Ferrario J. Therapeutic recreation-nursing team: a therapeutic intervention for nursing home residents with dementia. Ann Therapeutic Rec. 1998;7:21–28.
  57. Ouslander JG, Griffiths P, McConnell E, et al. Functional incidental training: applicability and feasibility in the Veterans Affairs nursing home patient population. J Am Med Directors Association. 2005;6(2):121–127. doi: 10.1016/j.jamda.2005.01.004

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