Assessment of the effectiveness of the reconstraction of social-everyday skills on the hardware-training complex of audio-visual reconstruction of the environment of patients after acute cerebrovascular accident

Abstract

BACKGROUND: Motor disorders as a result of аcute cerebrovascular accident are the most common cause of disability and not only significantly reduce the quality of life of patients, but also cause restriction of social and household independence of patients in a familiar environment.

AIM: the evaluation of the effectiveness for restoring the social and domestic activity skill ― shopping in the supermarket in patients undergoing stroke in the right middle cerebral artery after course of the special apparat trainings with audio-visual reconstruction of the environment.

MATERIALS AND METHODS: The study included 65 participants, they were divided into 3 groups, the first and the second group ― the patients who undergoing the stroke (main and control groups): the main group of patients received a base standard rehabilitation program (kinesiotherapy, mechanotherapy on cyclic apparatгs, massage) and additional the social and domestic trainings with audio-visual reconstruction of the environment. The control group ― a base standard rehabilitation program. The duration of the rehabilitation course was 21 days. The third comparison group are the healthy participants, who were necessary for defining "etalon" options for training of socially important skill.

RESULTS: As a result of the study in both groups (main and control) as compared with the initial findings the lowering of the heaviness ischemic stroke outcome (NIHSS): 6.2±0.4 in the first group and 6.8±0.7 in the second group vs. 4.2±0.2 and 5.9±0.8 (р ≤0.05). By comparison the first and the second groups with the health participants were defined the statistically significant changes of the studing time options in the main group during making these skills: take the bag and sling it through the shoulder, open the pockets of the bag (2 pockets), take the jacket from the clothes hanger and put on. Although in patients of the first group after restoring threatment course with using method of functional spatially-oriented rehabilitation it was authentic lesser disturbance of everyday life activity: in estimating Bartel Index 61.3±4.9 vs. 43.75±5.1 (initial) (р ≤0.05), what was signuficantly higher be comparison with control group results. In estimating functional independence by Modified Scale FIM: 71.4±4.9 in the main group vs. 53.7±3.1 (initial) (р ≥0.05), what was although significantly higher in comparison with the second group. By HADS it was lowering of the anxiety symptoms in the first group from 13.02±1.9 till 10.12±1.2 (р ≤0.05) as compared with the control group where the level of anxiety was staying quietly high and was 12.6±0.6 by comparison the initial findings 13.14±1.5 (р ≥0.05).

CONCLUSION: The obtained resalts point at the effectiveness of using functional spatially-oriented rehabilitation in restoring threatment programs for patient undergoing stroke for elevation of the independence level in real life terms. An additional point is that this kind training promote significantly positive influence on the patient’s motivation for actualization of active movement to improvement of the social and domestic adaptation.

Keywords

social-domestic skills / ergotherapy / stroke / reduced quality of life / audio-visual reconstruction of the environment / hemiparesis

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