{"title":"[Differentiated approach to cognitive rehabilitation of patients after stroke].","authors":"A V Kotelnikova, A A Kukshina, E A Turova","doi":"10.17116/kurort20241010615","DOIUrl":null,"url":null,"abstract":"<p><p>Post-stroke cognitive impairments are widespread and significantly reduce the quality of life and rehabilitation prognosis of patients. Clinical observations show a serious variability of cognitive impairments in patients after acute cerebrovascular accident. Thus, the classification of above mentioned disorders, based on which it would be possible to determine the order of individualization of a cognitive rehabilitation program, is currently not available in literature.</p><p><strong>Objective: </strong>To scientifically establish the differentiated approach to cognitive rehabilitation by verification of patients groups, differing in the structure of post-stroke complications.</p><p><strong>Material and methods: </strong>Cognitive status of 45 patients in the early rehabilitation period after ischemic stroke (26 (57.8%) women, 19 (42.2%) men aged 63.0±8.0 years), who underwent inpatient treatment stage of medical rehabilitation was studied by means of «Short neuropsychological examination of cognitive sphere (SNECS)» methodology. Indicators of neurodynamics according to the domains of the International Classification of Functioning, Disability and Health were considered as well.</p><p><strong>Results: </strong>The conducted neuropsychological study revealed 4 groups of patients, 3 of which had a significant cognitive functions' deficiency, manifested in the 1st group by reduced indicators of psychomotor control level (neurodynamic impairments, asthenia, exhaustion), executive functions, ability to analytical-synthetic activity, attention and working memory; in the 2nd group - by reduced ability to perform graphical test tasks on constructional praxis and reproduction of sequences' set; in the 4th group - by reduced indicators of «unfinished images» test task performance, reflecting state of visual object gnosis. Cognitive functions' state in the persons of the 3rd group was assessed as satisfactory.</p><p><strong>Conclusion: </strong>The present study provides an attempt to classify cognitive disorders in patients who underwent stroke aimed at the formation of differentiated cognitive rehabilitation programs. As a result, 4 groups of patients, differing in the structure of post-stroke complications, were verified, and the directions of rehabilitation work for each of them were indicated in the cognitive functions investigation using «SNECS» methodology.</p>","PeriodicalId":39492,"journal":{"name":"Voprosy kurortologii, fizioterapii, i lechebnoi fizicheskoi kultury","volume":"101 6","pages":"5-11"},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Voprosy kurortologii, fizioterapii, i lechebnoi fizicheskoi kultury","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17116/kurort20241010615","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Post-stroke cognitive impairments are widespread and significantly reduce the quality of life and rehabilitation prognosis of patients. Clinical observations show a serious variability of cognitive impairments in patients after acute cerebrovascular accident. Thus, the classification of above mentioned disorders, based on which it would be possible to determine the order of individualization of a cognitive rehabilitation program, is currently not available in literature.
Objective: To scientifically establish the differentiated approach to cognitive rehabilitation by verification of patients groups, differing in the structure of post-stroke complications.
Material and methods: Cognitive status of 45 patients in the early rehabilitation period after ischemic stroke (26 (57.8%) women, 19 (42.2%) men aged 63.0±8.0 years), who underwent inpatient treatment stage of medical rehabilitation was studied by means of «Short neuropsychological examination of cognitive sphere (SNECS)» methodology. Indicators of neurodynamics according to the domains of the International Classification of Functioning, Disability and Health were considered as well.
Results: The conducted neuropsychological study revealed 4 groups of patients, 3 of which had a significant cognitive functions' deficiency, manifested in the 1st group by reduced indicators of psychomotor control level (neurodynamic impairments, asthenia, exhaustion), executive functions, ability to analytical-synthetic activity, attention and working memory; in the 2nd group - by reduced ability to perform graphical test tasks on constructional praxis and reproduction of sequences' set; in the 4th group - by reduced indicators of «unfinished images» test task performance, reflecting state of visual object gnosis. Cognitive functions' state in the persons of the 3rd group was assessed as satisfactory.
Conclusion: The present study provides an attempt to classify cognitive disorders in patients who underwent stroke aimed at the formation of differentiated cognitive rehabilitation programs. As a result, 4 groups of patients, differing in the structure of post-stroke complications, were verified, and the directions of rehabilitation work for each of them were indicated in the cognitive functions investigation using «SNECS» methodology.
期刊介绍：
The journal deals with the study of the mechanism of a physiological and therapeutic effect of physical and health resort factors, methods and results of their employment, as well as with theoretical and practical problems involved in the use of exercise therapy in combined treatment of different diseases. The results of research and experience of using physical and health resort methods in medical practice and organization of physiotherapeutic and sanatorial and health resort service, book reviews on physiotherapy, health resort science and exercise therapy are published. Scientific life of allied specialities, proceedings of congresses, conferences, symposia (including foreign), the activity of republican and local societies, etc., are covered.
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