The correlation of the organization of activities and walk disorders stroke patients

Мождани удар је клинички синдром васкуларне етиологије који се карактерише наглим настанком фокалног или глобалног можданог дефицита, који траје дуже од 24 сата или завршава смртним исходом. Подаци Светске здравствене организације говоре да је и поред дијагностичких и терапијских могућности, мождани удар болест на трећем месту узрока смртности у свету (иза кардиоваскуларних и малигних), а на другом месту узрока функционалне онеспособљености. Око 50% свих преживелих, активностима дневног живота се врати 30%, док 20-30% није способно да самостално функционише. Степен функционалне онеспособљености се креће од лаког (35,8%); средње тешког (23,3%); тешког (30,9%). Имајући у виду постојећу статистику, сасвим је разумљива улога и значај медицинске рехабилитације. Рехабилитација болесника после можданог удара је комплексан и мултидимензионални проблем. Предпоставља се да постоји условљеност квалитета моторног опоравка и функционалног оспособљавања са степеном очуваности когнитивних функција. Способност планирања и организација активности као когнитивна особина којом ће бити спроведене намере и остварен циљ, представља највиши ниво функционисања фронталних режњева. Предмет нашег истраживања је био испитивање корелације способности организације активности и пажње и поремећаја хода после можданог удара и у каквој је вези тај однос са постизањем функционалне независности болесника. У оквиру циља истраживања анализиран је однос између нивоа способности организације активности и пажње и поремећаја хода код болесника после можданог удара; између способности организације активности и пажње и функционалног оспособњавања болесника после можданог удара; између поремећаја хода и функционалног оспособљавања болесника после можданог удара. Испитани узорак чинило је 50 болесника после можданог удара, укључених у процес рехабилитације и 50 испитаника одабраних методом случајног узорка, усклађених према старосној доби, који у својој анамнези немају дијагностикована неуролошка обољења...A stroke is a clinical syndrome of vascular ethiology characterized by a fast occurence of the focal or global brain deficit which lasts more than 24 hours or ends up with a death outcome. World Health Organization information says that, although there are both diagnostic and therapeutic options, a stroke is the third frequent cause of death in the world (after cardiovascular and malignant diseases), and the second frequent cause of functional disabilities. About 50% of those who survive, 30% return to daily life routines, while 20-30% are not capable of functioning on their own. The level of functional disability ranges from light (35.8%), medium hard (23.3%) to hard (30.9%). Bearing in mind the existing statistics, the role and importance of medical rehabilitation is quite understandable. Patient rehabilitation after a stroke is a complex and multidimensional problem. It is assumed that the relation between the quality of motor recovery and functional capability of cognitive functions is preconditioned. The ability of planning and organization of activities as a cognitive characteristic with which an intention will be carried out and the aim accomplished represents the highest level of frontal lobes functioning. The subject of our study was the examination of correlation ability of the organization of activity and attention and walk disorders after a stroke and how that relation can influence the recovery process and achieving the functional independence of a patient. Within the aim of the research, the relation between the levels of organization activities and attention and walk disorders at patients after a stroke has been analysed; between the ability of organization of activities and attention and functional recovery of patients after a stroke; between the walk disorders and functional recovery of patients after a stroke. The examined sample consisted of 50 patients after a stroke, included in the rehabilitation process and 50 patients chosen by accident, according to their age, who do not have diagnosed neurological diseases. The tests for the evaluation of executive functions, attention, cognitive state, the tests for the evaluation of motor functions including the evaluation of all gait parameters and the test for the evaluation of functional abilities have been used in the paper. The results were analysed in relation to the qualitative test parametres, as well as from the aspect of the existing knowledge in the scientific field which deals with the patient rehabilitation after a stroke..

Correlation between the Quality of Attention and Cognitive Competence with Motor Action in Stroke Patients

It is considered that cognitive function and attention could affect walking, motion control, and proper conduct during the walk. To determine whether there is a difference in the quality of attention and cognitive ability in stroke patients and patients without neurological damage of similar age and education and to determine whether the connection of attention and cognition affects motor skills, the sample consisted of 50 stroke patients tested with hemiparesis, involved in the process of rehabilitation, and 50 persons, randomly chosen, without neurological damage. The survey used the following tests: Trail Making (TMT A B) test for assessing the flexibility of attention; Mini-Mental State Examination (MMSE) for cognitive status; Functional Ambulation Category (FAC) test to assess the functional status and parameters of walk: speed, frequency, and length of stride; STEP test for assessing the precision of movement and balance. With stroke patients, relationship between age and performance on the MMSE test was marginally significant. The ratio of performance to TMT A B test and years does not indicate statistical significance, while statistical significance between the MMSE test performance and education exists. In stroke patients, performance on MMSE test is correlated with the frequency and length of stride walk. The quality of cognitive function and attention is associated with motor skills but differs in stroke patients and people without neurological damage of similar age. The significance of this correlation can supplement research in neurorehabilitation, improve the quality of medical rehabilitation, and contribute to efficient recovery of these patients

Povezanost demografskih odlika, kognitivnog funkcionisanja i funkcionalne nezavisnosti kod bolesnika posle moždanog udara

Introduction It has been assumed that there is causality of the achieved level of functional independence with the degree of preservation of cognitive function in stroke patients. Demographic characteristics may be important for monitoring the achieved level of functional independence. Objective The aim of this study was to examine the relationship of demographic characteristics and functional independence in regard to the level of cognitive impairment in stroke patients. Methods The study included 50 stroke patients after rehabilitation, as well as age- and gender-matched 50 subjects selected randomly, according to the demographic characteristics of the studied sample, who in their medical history had no neurological disorders. For the assessment of functional independence, the Functional Independence Measure (FIM) test was used. The general cognition was estimated by the Mini-Mental State Examination (MMSE) test. The statistical analyses included the Mann-Whitney test, for two independent samples, measures of canonical correlation, and χ2 test. Results There was a statistically significant difference between the groups in relation to risk factors, hypertension and diabetes mellitus type II (p lt 0.001); There was a statistically significant difference within the groups in relation to the cognitive impairment in all the examined demographic characteristics (p lt 0.001); the differences within the groups in relation to the cognitive impairment are present on all subscales of the FIM test (p lt 0.05); the differences within the groups in relation to handedness, hemiparesis, show that mild cognitive impairment is more common among left hemiparesis, while a more severe one is more common among right-sided hemiparesis (p lt 0.05); More severe cognitive impairment is common among women, the elderly and in persons with lower education (p lt 0.05). Conclusion By prevention of risk factors, and prevention of possible cognitive impairment, consequences of stroke can be reduced, the recovery can be made more successful, and quality of life can be improved.Uvod Pretpostavlja se da postoji uslovljenost postignutog nivoa funkcionalne nezavisnosti sa stepenom očuvanosti kognitivnih funkcija kod bolesnika posle moždanog udara. Demografske odlike mogu biti značajne u praćenju postignutog nivoa funkcionalne nezavisnosti. Cilj rada Cilj istraživanja je bio da se ispita odnos demografskih odlika i funkcionalne nezavisnosti u odnosu na nivo kognitivnog oštećenja kod bolesnika posle moždanog udara. Metode rada Istraživanjem je obuhvaćeno 50 bolesnika posle moždanog udara u procesu rehabilitacije i 50 ispitanika odabranih metodom slučajnog uzorka, usklađenih prema demografskim odlikama, koji u svojoj anamnezi nisu imali neurološka oboljenja. Za procenu funkcionalne nezavisnosti korišćen je FIM test (engl. Functional Independence Measure), za procenu kognitivnog stanja korišćena je MMSE skala (engl. Mini Mental State Examination), dok su za statističku obradu podataka korišćeni Man-Vitnijev (Mann-Whitney) test, neparametrijski test za dva nezavisna uzorka, mere kanoničke korelacije i χ2-test. Rezultati Postoji statistički značajna razlika između grupa u pogledu faktora rizika, hipertenzije i dijabetes melitusa tip II (p lt 0,001). Statistički značajna unutargrupna razlika zabeležena je i u odnosu na kognitivno oštećenje kod svih ispitanih demografskih odlika (p lt 0,001). Unutar- grupna razlika u odnosu na kognitivno oštećenje postojala je na svim supskalama FIM testa (p lt 0,05). Unutargrupna razlika u odnosu na lateralizovanost hemipareza pokazala je da je blago kognitivno oštećenje češće kod levostranih, dok je teže oštećenje češće kod desnostranih hemipare- za (p lt 0,05). Teže kognitivno oštećenje je bilo češće kod žena, kod osoba starije životne dobi i ispitanika nižeg obrazovanja (p lt 0,05). Zaključak Prevencijom faktora rizika i mogućih kognitivnih oštećenja posledice moždanog udara mogu se umanjiti; oporavak će biti uspešniji, a kvalitet života bolesnika bolji

Modern approach to neuropsychological assessment as a predictor of computerized cognitive rehabilitation

Neuropsychological tests are specially designed tasks used to assess cognitive function, known to be related to a particular brain structure or pathway. The modern approach in neuropsychological assessment involves the application of the test in a computer application. This approach has many advantages, simple application of other technology and sensors, to get as informative the data. The purpose of this research was to analyze the possibilities for realization of certain neuropsychological tests in the form of computer applications, with the use of an additional sensor and application of the data obtained in rehabilitation. The Wisconsin Card Sorting Test - WCST, a card sorting test, was used as an example of the test. The survey included 20 respondents from the regular population, ages 17-29, selected by the random sample method, who voluntarily accepted to participate in the research. Respondents solved the test in a computer application with an additional sensor attached to an Emotiv Epoc Electroencephalograph. The results show that it takes less time to solve the test in a computer application and that errors that the examiner may make are excluded. Moreover, the additional sensor provides accurate data on registered features that can be used in diagnostics as well as in rehabilitation. All this information cannot otherwise be obtained by the usual test method

Interkulturalna perspektiva škola u Srbiji

Starting from the current role of school in preparing students for life in a socially and culturally diverse world, this paper points out the need to change the paradigm a Članak predstavlja rezultat rada na projektu "Modeli procenjivanja i strategije unapređivanja kvaliteta obrazovanja u Srbiji" (broj 179060), koje finansira Ministarstvo prosvete, nauke i tehnološkog razvoja Republike Srbije. towards an open constructivist curriculum and new learning strategies in the implementation of the concept of interculturality in the school context. Special attention has been devoted to developing intercultural competences of both students and teachers starting from the changes in the school culture, constructivist, contextual and integrated approach in viewing multicultural contents and activities. The paper presents two examples of the implementation of this concept which were created within the second component of the project entitled "the Support to Human Capital Development and Research -General Education and Human Capital Development -Razvionica" in schools in Serbia. The summary provides an outline of the pedagogical measures for supporting intercultural education, including the role of developing the school culture in that process.Polazeći od savremene uloge škole u pripremanju učenika za život u soci-jalno i kulturno različitom svetu, u radu se ukazuje na potrebu menjanja para-digme ka otvorenom konstruktivističkom kurikulumu i novim strategijama učenja u uključivanju koncepta interkulturalnosti u školski kontekst. Po-sebna pažnja posvećena je izgradnji interkulturalnih kompetencija učenika, ali i nastavnika polazeći od promena u kulturi škole, konstruktivističkog, kontekstualnog i integracijskog pristupa u sagledavanju multikulturalnih sadržaja i aktivnosti. U radu smo prikazali dva primera implementacije ovog koncepta koja su nastala u okviru druge komponente projekta "Podrška razvoju ljudskog kapitala i istraživanja-Opšte obrazovanje i razvoj ljudskog kapita-la-Razvionica" u školama u Srbiji. U zaključku je dat osvrt na pedagoške me-re za podršku interkulturalnom obrazovanju i vaspitanju, uključujući i ulogu izgradnje školske kulture u tom procesu

Lexical-semantic abilities in children with developmental dysgraphia

Empirijski podaci pokazuju da deca sa razvojnom disgrafijom mogu ispoljavati različite smetnje u oblasti jezičke strukture. Međutim, još uvek nije utvrđeno da li jezičke smetnje doprinose teškoćama u ovladavanju veštinom pisanja ili je reč o njihovom udruženom ispoljavanju. Cilj ovog rada je da utvrđivanjem leksičko-semantičkih sposobnosti kod dece sa disgrafijom doprinesemo sagledavanju odnosa razvoja leksičko-semantičke građe i sposobnosti pisanja. Uzorak je obuhvatio 84 učenika, 42 učenika sa razvojnom disgrafijom i 42 učenika bez smetnji u pisanju. Leksičko-semantičke sposobnosti su procenjivane Semantičkim testom i Testom za ispitivanje govorne razvijenosti. Istraživanje je sprovedeno u tri osnovne škole u Istočnoj Hercegovini, školske 2016/2017. godine. Rezultati istraživanja su pokazali da deca sa disgrafijom postižu značajno lošije rezultate na Semantičkom testu u poređenju sa decom bez smetnji u pisanju. Niža postignuća kod dece sa razvojnom disgrafijom uočena su na svim ispitivanim leksičkim kategorijama, kao i na ukupnom skoru Semantičkog testa. Rezultati Testa za ispitivanje govorne razvijenosti pokazuju da deca sa disgrafijom znatno lošije definišu zadate pojmove u poređenju sa svojim vršnjacima tipičnog razvoja. Zaključeno je da deca sa disgrafijom imaju značajno slabije razvijene leksičko-semantičke sposobnosti od dece tipičnog razvoja. Ovi nalazi ukazuju na potrebu pružanja dodatne podrške u razvoju leksikona i bogaćenju rečnika kod dece sa smetnjama u pisanju.Empirical data indicate that children with developmental dysgraphia may exhibit various disorders in the field of linguistic structure. However, it has not yet been determined whether linguistic impairment contributes to difficulties in mastering writing skills or whether they are a joint expression. The aim of this paper is to contribute to the understanding of the relation between the development of lexical-semantic structure and the ability to write by identifying lexical-semantic abilities in children with dysgraphia. The sample included 84 students, 42 students with developmental dysgraphia, and 42 students without disabilities. The lexical-semantic abilities were assessed by means of the Semantic Test and the Test for Speech Development. The survey was conducted in three primary schools in 2016-17 in Eastern Herzegovina. The results of the study showed that children with dysgraphia achieved significantly worse results on the Semantic Test compared to children without disabilities. Lower achievement in children with developmental dysgraphia was observed in all lexical categories examined, as well as in the overall score of the Semantic Test. The results of the Speech Development Test show that children with dysgraphia have significantly lower definitions of given terms compared to their peers of typical development. It was concluded that children with dysgraphia have significantly less developed lexical-semantic abilities than children of typical development. These findings highlight the need for additional support for vocabulary development and vocabulary enhancement in children with disabilities

Correlation between Functional Independence and Quality of Executive Functions in Stroke Patients

Objective: The rehabilitation of stroke patients is complex. It is believed that there is a correlation between the quality of functional independence and degree of preserved executive and cognitive functions. The aim of this work was to investigate potential correlations between the quality of executive and cognitive functions and the achieved level of functional independence during the rehabilitation of stroke patients. Material and Methods: The study included 50 stroke patients evaluated during rehabilitation and 50 beneficiaries of the Gerontology Center as control subjects randomly chosen, with no diagnosed neurological damage. The following tests were used: Wisconsin Card Sorting Test (WCST) for executive function assessment, Mini-Mental State Examination (MMSE) for cognitive screening, and Functional Independence Measure (FIM) test for functional independence assessment. The statistical analyses included the Mann-Whitney U test for comparisons between two independent samples, canonical correlation analysis, and.2-test. Results: Our results show a statistically significant difference in all assessed functions between the two groups (p lt .001). Furthermore, we show a positive correlation between executive functions and achieved functional independence in stroke patients (p lt .001). Moreover, a positive correlation exists between cognitive functions and level of functional independence in stroke patients. Conclusion: Our results show that stroke patients with lower executive function scores achieve less functional independence. Stroke patients with existing cognitive impairment achieve less functional independence in all domains compared with stroke patients without cognitive impairment

The impact of sports activities on quality of life of persons with a spinal cord injury

Objectives. Studying the quality of life of people with a spinal cord injury is of great importance as it allows the monitoring of both functioning and adaptation to disability. The aim of this study was to determine the difference between persons with a spinal cord injury involved in sports activities and those not involved in sports activities in relation to their quality of life and the presence of secondary health conditions (pressure ulcers, urinary infections, muscle spasms, osteoporosis, pain, kidney problems-infections, calculosis and poor circulation). Methods. The study included a total of 44 participants with spinal cord injury-paraplegia of both genders; 26 of them were athletes and 18 were not athletes. The athletes were training actively for the last two years, minimally 2-3 times per week. A specially designed questionnaire, medical documentation and the Spinal Cord Injury Quality of Life Questionnaire (SCI QL-23) were used for research purposes. Chi-square test was used to analyze the differences between the groups, while multiple analysis of variance (MANOVA) was used to determine the differences between the sets of variables. Results. Among the participants, the athletes perceived higher quality of life than the non-athletes (male gender p lt 0.001 and female gender p lt 0.05). Regarding secondary health conditions, the athletes reported the presence of less pain (p=0.034) and a subjective feeling of better circulation (p=0.023). Conclusion. The implementation of sports activities significantly improves quality of life in the population of people with spinal cord injury-paraplegia. However, sports activities only partially affect secondary health conditions

Kognitivni aspekti šizofrenije - narativni pregled

Cognitive dysfunction has been recognized as a key aspect of schizophrenia evident even during remission of symptoms. During the previous decade, interest in cognitive deficits has increased due to the recognition of their key importance for the functional outcome and degree of social adaptation. Prominent cognitive deficits are disorders of memory, attention and executive functions that manifest themselves as a disorder of verbal fluency, problems with serial learning, difficulty in problem solving, and disturbance of executive functions. The observed cognitive deficit is attributed to the dysfunction of cortical-cerebellar-thalamic circuits. Social cognition is the ability to construct an image of relationships between oneself and others and the ability to use flexible mental constructs as a guide to social interactions. The data from previous studies strongly support the association of neurocognitive and sociocognitive deficits with the performance of independent functioning and quality of life, emphasizing the need for prevention and treatment of cognitive deficits.Kognitivna disfunkcija je prepoznata kao ključni aspekt šizofrenije, očigledan čak i tokom remisije simptoma. Tokom prethodne decenije povećano je interesovanje za kognitivne deficite zbog prepoznavanja njihovog ključnog značaja za funkcionalni ishod i stepen socijalne adaptacije. Izraženi kognitivni deficiti su poremećaji pamćenja, pažnje i izvršnih funkcija koji se manifestuju kao poremećaj verbalne fluentnosti, problemi sa serijskim učenjem, teškoće u rešavanju problema i poremećaj izvršnih funkcija. Uočeni kognitivni deficit se pripisuje disfunkciji kortikalno – cerebelarno - talamičkih kortikalnih kola. Socijalna kognicija je sposobnost da se konstruiše slika odnosa između sebe i drugih i sposobnost korišćenja fleksibilnih mentalnih konstrukata kao vodiča za društvene interakcije. Podaci iz prethodnih studija snažno podržavaju povezanost neurokognitivnih i sociokognitivnih deficita sa performansama samostalnog funkcionisanja i kvalitetom života, naglašavajući potrebu za prevencijom i lečenjem kognitivnih deficita

Kognitivni aspekti šizofrenije - narativni pregled

Cognitive dysfunction has been recognized as a key aspect of schizophrenia evident even during remission of symptoms. During the previous decade, interest in cognitive deficits has increased due to the recognition of their key importance for the functional outcome and degree of social adaptation. Prominent cognitive deficits are disorders of memory, attention and executive functions that manifest themselves as a disorder of verbal fluency, problems with serial learning, difficulty in problem solving, and disturbance of executive functions. The observed cognitive deficit is attributed to the dysfunction of cortical-cerebellar-thalamic circuits. Social cognition is the ability to construct an image of relationships between oneself and others and the ability to use flexible mental constructs as a guide to social interactions. The data from previous studies strongly support the association of neurocognitive and sociocognitive deficits with the performance of independent functioning and quality of life, emphasizing the need for prevention and treatment of cognitive deficits.Kognitivna disfunkcija je prepoznata kao ključni aspekt šizofrenije, očigledan čak i tokom remisije simptoma. Tokom prethodne decenije povećano je interesovanje za kognitivne deficite zbog prepoznavanja njihovog ključnog značaja za funkcionalni ishod i stepen socijalne adaptacije. Izraženi kognitivni deficiti su poremećaji pamćenja, pažnje i izvršnih funkcija koji se manifestuju kao poremećaj verbalne fluentnosti, problemi sa serijskim učenjem, teškoće u rešavanju problema i poremećaj izvršnih funkcija. Uočeni kognitivni deficit se pripisuje disfunkciji kortikalno – cerebelarno - talamičkih kortikalnih kola. Socijalna kognicija je sposobnost da se konstruiše slika odnosa između sebe i drugih i sposobnost korišćenja fleksibilnih mentalnih konstrukata kao vodiča za društvene interakcije. Podaci iz prethodnih studija snažno podržavaju povezanost neurokognitivnih i sociokognitivnih deficita sa performansama samostalnog funkcionisanja i kvalitetom života, naglašavajući potrebu za prevencijom i lečenjem kognitivnih deficita