THE INFLUENCE OF ACTIVE REHABILITATION ON THE RECOVERY OF COGNITIVE AND PSYCHOEMOTIONAL DISORDERS AFTER ISCHEMIC...

The aim: Was to evaluate the impact of active rehabilitation treatment in the scheme of comprehensive therapy of patients with cerebral hemispheric ischemic stroke on the dynamics of recovery of cognitive and psychoemotional disorders, as well as to study their correlations.

Materials and methods: The study involved 138 patients: 30 apparently healthy individuals (control group, CG, n = 30) without acute cerebrovascular disorders (anamnestic and neuroimaging), of whom 53.33% were men (n = 16) and 46.67% women (n = 14), the average age of patients in the group was 57.9 ± 1.45 years; 108 people diagnosed with cerebral hemispheric ischemic stroke (n = 108), of whom 62.96% were men (n = 68) and 37.04% women (n = 40), the average age of patients in the group was 58.4 ± 0.76 years. The neurocognitive assessment was performed using the international standardized scales: MMSE, MoCa were used to assess the cognitive sphere, and BDI, STAI (STAI SA, STAI TA) were used to assess psychoemotional disorders.

Results: Patients in the comprehensive treatment scheme were additionally prescribed and given two courses of rehabilitation treatment using active rehabilitation methods after the first and third examinations, recovery of cognitive and psychoemotional disorders was significantly faster and better than in group 1, where "classical" measures were applied with the predominance of medicinal therapy. Thus, the average score on the MoCa scale during examination on days 3-7 after cerebral hemispheric ischemic stroke in group 1 was 19.71 ± 0.62 points, in group 2 - 19.17 ± 0.54 points, and during evaluation after 6 months in group 2 - 24.72 ± 0.26 points against 22.19 ± 0.41 points (p <0.0001) in group 1. According to the MMSE scale during examination on days 3-7 after cerebral hemispheric ischemic stroke, the average indicator in group 1 was 22.56 ± 0.43 points, in group 2 - 22.47 ± 0.37 points, and when evaluated after 6 months in group 2 - 25.83 ± 0.23 points against 24.35 ± 0.27 points (p = 0.0001) in group 1.

Conclusions: The use of methods for active rehabilitation in the treatment of patients in acute and recovery periods of cerebral hemispheric ischemic stroke significantly contributes to the acceleration and enhancement of the recuperation of cognitive and psychoemotional functions after the acute cerebral accident. The obtained results can find practical application in improving the effectiveness of therapeutic and rehabilitation programs in patients with cerebral hemispheric ischemic stroke to reduce their post-stroke deficit.