PHYSICAL THERAPY FOR PATIENTS AFTER STROKE
Authors: Homola А. V. , Prokopovych Ye. V. , Antonova-Rafi Y. V. 
Published: April 2021

Abstract. Objectives: to summarize the data on the spread and complications of patients after stroke in Ukraine and in the world, the noted motor and cognitive impairments are the basis of disability; to prove the effectiveness of physical therapy methods for recovery of motor function of patients after a stroke. The strategy of solving the problem consists in reducing the limitations of daily living activities, increased mastering new skills and abilities. Patients are examined using modern tests and scales, which allow summarizing the examination results, and having a high level of reliability.

Purpose of the study: the dynamics of the functional motor state of patients after undergoing complex physical therapy. The effectiveness of the methods at the stage of restoration of motor abilities has been substantiated.

Methods. Every day at the MDK meeting, communication takes place in accordance with medical ethics and moral principles, the legal norms of the patient and his family. On the basis of the Kiev City Clinical Hospital № 6, the Department of Physical and Rehabilitation Medicine 34 patients were separated in the early recovery period with plegia of the upper limb and divided into two groups: the main and the control one. In the late period after a stroke with spasticity of the upper limb, 26 patients were also divided into two groups. Women age ranges from 35 to 83 years old; men - from 37 to 84 years old. The dynamics of the functional motor state of patients after undergoing complex physical therapy was investigated.

Research results. In Ukraine, there are many versions of physical therapy for patients after stroke in the acute and early period. The Ukrainian Stroke Association has created protocols for rehabilitation assistance. Some success has been achieved in the rehabilitation of patients in the acute period. Difficulties arise in the late period of physical therapy, namely, functional motor disorders. This negatively affects the social and everyday activity and the usual activities of patients. The consequences of a stroke are muscular disorders such as a complete absence of voluntary movements (plegia), accompanied by a painful syndrome, loss of balance, coordination during movement. Also, the growing spasticity that forms contractures, there are pain sensations and restrictions in everyday activities. Patients face the problem of muscle spasticity, which interferes with a full-fledged rehabilitation process, becomes an obstacle in the restoration of motor functions, leads to a loss of working capacity, self-care skills, and sharply reduces the quality of life. A physical therapist must own, know and use the methods and means of physical therapy. The use of the international classification of functioning influences the course of work of a multidisciplinary team, aimed at a direct and specific rehabilitation process for the qualitative and complex restoration of the patient's lost motor functions.

Conclusion. On the basis of the Kiev City Clinical Hospital № 6, Department of Physical and Rehabilitation Medicine, developed a complex program of physical therapy, for a group of patients after stroke. The multidisciplinary team does not divide life before and after a stroke, it tries, on the basis of evidence-based medicine, an integrated and individual approach to activate an independent life, help and restore the patient's lost functions, compensate and find a way out where others refuse.