Psychocorrective effect of application of combined medical rehabilitation methods in patients with ischemic stroke

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Abstract

Background. The annual death rate from stroke in Russia remains the highest in the world.

Aims: To study the influence of combined methods of medical rehabilitation on the psychological status and functional independence of patients with post-stroke spasticity.

Materials and methods. The article presents data on the effectiveness of the influence on the psychological status and functional independence of the combined methods of medical rehabilitation in 60 patients with ischemic stroke with movement disorders in the form of hemiparesis with increased muscle tone by the type of spasticity in the long-term period. The patients were divided into 2 groups comparable in terms of clinical and functional characteristics: the main group (n=30), who received combined methods of physiotherapy (thermotherapy, oxygen therapy, oxyhyperthermia, vibrotherapy, aromatherapy) from the Alpha LED Oxu Light Spa™ apparatus in addition to the standard rehabilitation complex , which includes exercise therapy, medical massage, kinesitherapy, and a control group (n=30), who received only a standard rehabilitation complex. To assess the initial psychological status and functional independence of the observed patients undergoing medical rehabilitation in the period from 3 to 6 months after the disease, the SAN method (well-being, activity, mood) and the FIM scale were used.

Results. Before the start of rehabilitation in all patients included in the study. Тhere was a moderate degree of deterioration in well-being, a decrease in activity and mood, as well as a decrease in indicators of independence in everyday life. After the course of treatment (on day 14) and in the long-term period (after 8 months) the patients of the main group had a pronounced positive dynamics of the psycho-emotional status, which was manifested in an improvement in the indicators of well-being — by 1.93 times (by 28%), activity — by 1.95 times (by 29.6%) and mood — by 2.01 times (by 29.8%) points. In the control group, after the standard course of treatment, there was less pronounced dynamics of psychometric indicators. When evaluating the results of functional independence on the FIM scale, there was a significant improvement in the indicators of independence in everyday life by 32%.

Conclusion. The use of combined methods of medical rehabilitation in patients with post-stroke spasticity contributes to a significant increase in their quality of life and psychological status, which is confirmed by the FIM and SAN tests.

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About the authors

Anna A. Mikhailova

Petrovsky National Research Centre of Surgery

Author for correspondence.
Email: mikhaylova003@gmail.com
ORCID iD: 0000-0002-4260-1619
SPIN-code: 7673-3241

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

Russian Federation, Moscow

Natalya B. Korchazhkina

Petrovsky National Research Centre of Surgery

Email: mikhaylova003@gmail.com
ORCID iD: 0000-0001-6913-8778
SPIN-code: 9733-7646

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

Russian Federation, Moscow

Elizaveta S. Koneva

The First Sechenov Moscow State Medical University (Sechenov University)

Email: mikhaylova003@gmail.com
ORCID iD: 0000-0002-9859-194X
SPIN-code: 8200-2155

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

Russian Federation, Moscow

Konstantin V. Kotenko

Petrovsky National Research Centre of Surgery

Email: mikhaylova003@gmail.com
ORCID iD: 0000-0002-6147-5574
SPIN-code: 5993-3323

MD, Dr. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences

Russian Federation, Moscow

References

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  3. Vlasenko AV, Mikhnovich VI, Mashanskaya AV, et al. The experience of using selective electrostimulating effects in children with motor disorders. Questions of Balneology, Physiotherapy and Therapeutic Physical Culture. 2017;94(6):22–25.
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  7. Kotenko KV, Epifanov VA, Epifanov AV, Korchazhkina NB. Rehabilitation for diseases and injuries of the nervous system. The series "Library of a specialist doctor". Moscow: GEOTAR-Media; 2016. 656 p.
  8. Koneva ES. Comparative evaluation of the effectiveness of rehabilitation programs in patients with spasticity syndrome [dissertation abstract]. Moscow; 2011. 28 p.
  9. Epifanov AV, Achkasov EE, Epifanov VA, et al. Medical rehabilitation. A textbook for medical schools and colleges. Moscow: GEOTAR-Media; 2019. 560 p.
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