THE EFFECT OF THE REHABILITATION AND PHYSICAL THERAPY PROGRAM ON THE FUNCTIONAL STATUS OF POST-STROKE PATIENTS
Authors: Havrylenko A.V. , Yashchyshyn Z. M. 
Published: October 2024

The article examines the impact of a physical rehabilitation program on the functional state of the musculoskeletal system in elderly patients who have suffered an intracerebral stroke and are in the conditions of a neurorehabilitation center in the early post-stroke period. Before the implementation of the program, post-stroke patients have pronounced walking disorders and a pronounced dependence on external assistance.
The aim of the articale is to reveal the effectiveness of the physical rehabilitation program for post-stroke patients in the early recovery period.
 Results. Features of hemodynamic adaptation in post-stroke patients in the conditions of the rehabilitation center were revealed.
Conclusion. As a result of the research, it was found that post-stroke patients had concomitant diseases: chronic heart failure and arterial hypertension in all studied patients, diabetes – in 20% of patients. All these conditions were taken into account during the selection of optimal means of the program physical rehabilitation. After completing the program, patients became more independent and needed less daily assistance, and also mastered such a vital and necessary skill as walking. This is confirmed by tests of functional status (Bartel index, Rivermead) and assessment of independent walking (Hauser walking index). The level of disability according to the Rankin scale decreased by 20%, the Rivermead mobility index increased by 50.6%, the Barthel index of daily activity increased by 13.5%, the Hauser walking index increased by 31.8%, the range of motion in the joints of the limbs also increased, the level of spasticity according to the modified Ashworth scale decreased by 22.5% in the in the upper and lower extremities, the strength according to the MRCS scale increased, in the extremities by 20%. Thus, after completing the rehabilitation program, all patients observed a increase in paretic muscle strength, decreased muscle spasticity tone, and improved range of motion in the joints. Implementation of the physical rehabilitation program resulted in a significant increase in MRCS muscle strength in the limbs by 20% (p < 0.01). After completing the program, patients became more independent and needed less daily assistance, as well as mastered such a vital and necessary skill as walking. This is confirmed by tests of functional status (Bartel index, Rivermead) and assessment of independent walking (Hauser walking index). The level of disability according to the Rankin scale decreased by 20%, the Rivermead mobility index increased by 50.6%, the Barthel daily activity index increased by 13.5%, the Hauser walking index increased by 31.8%, the range of motion in the joints of the upper and of the lower limbs also increased, the level of spasticity according to the modified Ashworth scale decreased by 22.5% in the upper limb and by 20% in the upper and of the lower limbs, the strength according to the MRCS scale increased, in the limbs by 20%. Patients were able to move with little resistance. The effect of the rehabilitation program and physical therapy is evident in the increase in paretic muscle strength, reduction in spasticity, and increase in joint range of motion. Most patients regained the ability to walk, which contributed to increasing their level of independence. In general, the research results obtained after the implementation of the selected means of physical rehabilitation indicate the effectiveness of such a program.