Physical therapy of persons after acute cerebrovascular accident in a long-term rehabilitation period
Authors: Kerestei Vadym , viriaka Oleksandr Z , Kalmykova Yuliya , Polkovnyk-Markova Viktoriia , Lianna Olha 
Published: July 2024

Purpose: to study the dynamics of recovery of walking, balance and quality of life of persons after acute cerebrovascular accident in a long-term rehabilitation period.

Material and methods: patients were randomly divided into a main group (MG), which included 35 patients (n=35), and a comparison group (CG), which included 38 patients (n=38). The groups received rehabilitation intervention in accordance with the concept of the International Classification of Functioning, Disability, and Health (ICF). A categorical profile was created for each person and SMART goals were set. A physical therapy (PT) program was developed for MG after acute cerebrovascular accident (ACVA) in the long-term rehabilitation period. Short- and long-term goals were set in the SMART format, which included the use of therapeutic exercises. Functional capabilities and quality of life were assessed before and after the rehabilitation intervention using the ten-meter walk test, the Tinetty balance and fall risk scale, the modified Renkin functional independence scale and quality of life.

Results: the dynamics of the ten-meter walking test during the PT program among patients in the MG is reflected in a decrease in the test completion time, which amounted to 23,6 s, and in the CG – 7 s. By the time of the final examination, the range of the obtained values was limited to 8 and 15 s in the MG, and among the CG, the extreme values were found at the levels of 12 and 160 s. By the time of the final examination, the "balance" item on the Tinetty balance and risk of falls scale in the MG was 13,8 ± 1,69 points out of a possible 16 points; the Me (25%; 75%) indicators were 14 (13; 15) points. In the CG, the indicator was slightly lower and was 12,3 ± 2,61 points; the Me (25%; 75%) indicators were 13 (10; 15) points. The difference between the groups by the end of the study for this indicator was significant (p<0.05). As for the increase, it was 4.7 points in the MG and 3.1 points in the CG. The average statistical results of the assessment of the “Risk of Falls” section in the MG were 9.2±1.59 points out of a possible 12; the Me (25%; 75%) indicators were 9 (8; 11) points. In the CG patients, the indicator was slightly lower and was 5,2±1,99 points; the Me (25%; 75%) indicators were 6 (4; 6.3) points. The difference between the groups by the end of the study for this indicator was significant. (р<0,01). As for the increase, it was 5 points in MG and 1,4 points in CG. The intermediate results on the Renkin scale were 1,83±0,62 and 2,13±0,74 points in MG and CG with Me (25%; 75%) – 2 (2; 2) and 2 (2; 3), respectively. At this stage, there was no statistical difference between the groups (p>0,05), but both groups showed a reliable improvement compared to the initial result (p<0,01). During the final examination, the results in MG patients improved and were 1,11±0,62 points, where the Me (25%; 75%) indicators were found at the level of 1 (1; 2) point. Among the CG patients, the final result was worse (p<0.01) and was found at the level of 1,55±0,72 points with Me (25%; 75%) 1 (1; 2) point.

Conclusions: Analysis of the dynamics of walking, balance and quality of life indicators after acute cerebrovascular accident in a long-term rehabilitation period confirmed the advantages of the developed physical therapy program for individuals from the MG.