Modification of lifestyle factors as a measure of secondary prevention of stroke.
Authors:   S. I. Spasokukotsky Moscow Centre for research and practice in medical rehabilitation, restorative and sports medicine of Moscow Healthcare Department, Petrova L. V. , Kostenko E. V. ,   Federal State Autonomous Educational Institution of Higher Education «Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian Federation,   S. I. Spasokukotsky Moscow Centre for research and practice in medical rehabilitation, restorative and sports medicine of Moscow Healthcare Department, Pogonchenkova I. V. ,   S. I. Spasokukotsky Moscow Centre for research and practice in medical rehabilitation, restorative and sports medicine of Moscow Healthcare Department, Ivanova T. I. ,   S. I. Spasokukotsky Moscow Centre for research and practice in medical rehabilitation, restorative and sports medicine of Moscow Healthcare Department, Kopetsky I. S. ,   Federal State Autonomous Educational Institution of Higher Education «Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian Federation, Polunin V. S. ,   Federal State Autonomous Educational Institution of Higher Education «Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian Federation, Buslaeva G. N. ,   Federal State Autonomous Educational Institution of Higher Education «Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian Federation, Opryshenko S. A. ,   Federal State Autonomous Educational Institution of Higher Education «Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian Federation, Polunina N. V. ,   Federal State Autonomous Educational Institution of Higher Education «Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian Federation
Published: February 2025

The risk of recurrent stroke in the first year after is 15.8%, the probability of which reaches more than 30.0% after 5 years and more than 45.0% after 10 years. Pronounced limitations of vital activity are formed in every second patient, the probability of death within the first month ranges from 23.2% to 40.7%. It has been established that such controlled risk factors as smoking, diet and low activity are responsible for the risk of recurrent stroke and are present in 90% of stroke patients. A positive change in modifiable factors can improve the health and quality of life of patients and reduce the likelihood of mortality from cardiovascular diseases by 9%-10%. An urgent task of modern rehabilitation is to find strategies for the prevention of cerebrovascular events and aspects that allow optimizing the medical and social rehabilitation of patients with IS.
The purpose of the study: development of recommendations aimed at optimizing the medical and social rehabilitation of IS-stroke patients and improving their health in outpatient clinics.
Materials and methods. The study of the state of health was carried out based on medical documentation, lifestyle characteristics of patients after stroke – based on the results of a survey of 1,438 patients with IS.
Results. A high prevalence of negative factors such as overweight, smoking, lack of stress relief skills, insufficient night sleep and sedentary lifestyle has been established in patients with IS, which are more pronounced in patients with recurrent IS and in the older age group. The average number of adverse factors per patient with primary IS is 3.8±0.17, with repeated – 3.95± 0.19. It was revealed that low physical activity (r = + 0.714, m =± 0.18), insufficient night sleep (r = + 0.672, m =± 0.16), irrational eating habits (r = +0.624, m =± 0.14), smoking have a significant (p <0.001) effect on health (r = + 0.648, m =± 0.16), lack of stress relief skills (r = + 0.622, m =± 0.14), overweight (r = +0.456, m =±0.14). Comprehensive medical and social rehabilitation, adapted to the social and hygienic characteristics and preferences of patients, contributed to an increase in motivation for a healthy lifestyle, more effective restoration of impaired functions and the prevention of new cardiovascular events.
Conclusion. In order to restore functioning after IS, it is necessary to carry out medical and social rehabilitation, including drug therapy, classes with a medical psychologist and training in a healthy lifestyle. To enhance the success of rehabilitation, a personalized plan is devised that considers the patient’s health condition and socio-hygienic background. The effectiveness of rehabilitation depends on the degree of the patient involved in the activities.
Scope of the results. Use of medical and social rehabilitation, including drug therapy, sessions with a medical psychologist and training in a healthy lifestyle to formulate preventive measures.